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Abstract Women who experience intimate partner violence (IPV) face increased risks of reproductive health issues and psychological distress. There is also a growing scholarly interest in its effect on cardiovascular health. About 30% of Kenyan women experience emotional violence, and 9.37% are hypertensive. Yet, there is the absence of localized studies on the role of emotional violence on hypertension risk. This study aims to address this gap by investigating the association between emotional violence and hypertension risk among women of reproductive age in Kenya. Using data from the 2022 Kenya demographic and health survey, we analysed the data of 5,109 women. The outcome and exposure were hypertension status and emotional violence, respectively. Descriptive analysis and binary logistic regression models were computed in STATA version 18. Results were presented in tables, showing the frequency, percentage, and adjusted odds ratio (AOR) at a 95% confidence interval (CI). The prevalence of hypertension was 9.78% [95% CI 8.73–10.94]. Women who had experienced emotional violence had 69% higher odds of hypertension [AOR 1.69; 95% CI 1.39–2.06]. After adjusting for covariates (i.e., age, place of residence, wealth status, exposure to media, and educational level), individuals who reported experiencing emotional violence exhibited a 51% higher odds of hypertension compared to those who did not [AOR 1.51; 95% CI 1.23–1.85]. There is a significant association between emotional violence and hypertension. The findings underscore a need for policy makers in Kenya to address emotional violence against women not only as a social issue but as a serious health risk factor. As such, the experience of emotional violence should be considered as part of the criteria to enhance hypertension screening among women.

Abstract Background In resource-constrained settings, availability and access to mammography is a challenge. As such, the World Health Organization (WHO) recommends clinical breast examination (CBE) for women in such settings. Yet, CBE uptake remains low. We, therefore, aimed to contribute to the discourse on factors that influence women’s screening practice by investigating the association between the frequency of internet use and women’s uptake of CBE in Ghana. Methods This study was based on data from 15,013 women who participated in the 2022 Ghana demographic and health survey. We performed descriptive analysis, computed Pearson’s chi-square test, and fitted multivariable logistic regression models. The findings from the regression model were presented in adjusted odds ratio (AOR) at a 95% confidence interval. Results Only 18.39% of women 15–49 years had their breasts examined by a healthcare provider. About 38.22% of the total sample often used the internet. Compared to women who did not use the internet at all, those who often used it had twice the odds of getting screened (COR = 2.86; 95%CI: 2.62–3.13). The odds of CBE uptake remained significantly higher among those who often used the internet (AOR = 1.26; 95%CI: 1.12–1.43) even after adjusting for the covariates. Conclusion We conclude that CBE uptake is significantly high among women who frequently use the internet. This association persists even when considering other influential factors such as age, education level, marital status, and socioeconomic status. As such, it is imperative for the Ministry of Health in collaboration with the Ghana Health Service to recognize the potential of digital health interventions, including online health education campaigns and telehealth services, in reaching and engaging women to get their breast examined by a healthcare provider.

Abstract Background Cervical cancer ranks third in terms of cancer incidence and mortality in Cape Verde. Understanding the factors associated with the age of cervical cancer screening (CCS) is essential because it helps identify populations at risk of delayed screening, enabling targeted interventions to ensure timely detection and treatment, ultimately reducing the burden of cervical cancer. We examined the factors associated with age at first screening for cervical cancer among adult Cape Verdean women. Methods Data from the 2020 WHO STEPs survey were used. We analyzed data from 1,082 women aged 30–69 years who had ever screened for cervical cancer. Bivariable and multivariable logistic regression models were computed in STATA version 18. Results Overall, 30.6% of women in the study had their first CCS before or at age 30. Except for visits to the health facility within the last 12 months, all variables significantly predicted women’s first age for CCS in the crude model. In the adjusted model, women with tertiary education showed greater odds [AORs = 9.85; 95% CI: 4.12–23.54] compared to those with no formal education. Compared to those who were never married, previously married women had significantly lower odds of screening at an early age [AOR = 0.63; 95% CI: 0.39–0.99]. Women without hypertension had higher odds [AOR = 1.66; 95% CI: 1.18–2.34] of early screening compared to those with hypertension. Also, women who were currently working had significantly higher odds of early screening than those unemployed [AOR = 1.49; 95% CI: 1.09–2.04]. Conclusion In conclusion, implementing targeted educational campaigns, addressing socio-economic barriers, and integrating cervical cancer screening into routine healthcare services can increase the early screening uptake among Cape Verdean women. There is a need to integrate CCS in the routine healthcare services of women living with hypertension. Also, the positive association between formal education and age at first screening, it is imperative for the Cape Verdean public health departments to implement comprehensive education programs within schools to promote awareness about CCS.

Abstract Background The proliferation of internet use in the 21st century has brought about a pluralistic effect on health. Users of the internet are more exposed to health information, thus, making them more health literate and more likely to adopt healthy behaviors. However, frequent use of the internet has been found to adversely affect mental health (e.g., depression), social wellbeing, and obesity. Yet, the link between internet use and physical health outcomes such as hypertension remains less explored. We examined the association between frequency of internet use and hypertension risk among women and men in Kenya using data from the 2022 Kenyan demographic and health survey. Results Overall, the prevalence of hypertension was higher among women (1,398 [8.69%]) compared to men (504 [3.49%]). Those who reported using the internet often reported higher prevalence of hypertension (women: n = 638 [10.49%]; men: n = 279 [3.98%]). The mean age was 29.3 years (SD = 9.6) for women and 29.9 years for men (SD = 10.9). After adjusting for potential confounders, women who reported often using the internet also demonstrated a significant association [AOR = 1.21; 95%CI: 1.03–1.43]. However, we found no significant association between frequency of internet use and hypertension among men after adjusting for confounders. Conclusion Our study concludes that frequent use of internet is positively associated with hypertension risk among women but not men. Policymakers may consider implementing guidelines or regulations to promote healthy internet usage habits and encourage breaks or limits on screen time, especially for individuals at risk of hypertension (i.e., older women of reproductive age, women with higher education, married and previously married women, those in affluent households, parous women, those who consume alcohol and those overweight/obese). Healthcare providers should educate patients about the potential health consequences of prolonged internet usage and incorporate discussions about screen time management into routine clinical encounters.

Los cambios en la sociedad costarricense han traído consigo nuevas demandas a la acción institucional, incluyendo también al Tribunal Supremo de Elecciones (TSE). Desde 2010, el TSE asume un papel activo en la formación en democracia y promoción de la cultura cívica con la creación del Instituto de Formación y Estudios en Democracia (IFED) dentro de su estructura. Este artículo describe el funcionamiento del IFED en 13 años con énfasis en la función de formación en democracia, las acciones más importantes que se han desarrollado, los alcances y los principales desafíos que enfrenta esta área.

Abstract Background In 2021, Madagascar had approximately 13,919 people living with diabetes, with 66.1% of cases being undiagnosed. The implication is that this population are at high risk of developing diabetes complications which will affect their quality of life. However, promoting the uptake of screening practices such as the blood glucose test among the asymptomatic population would offer a chance to reduce the prevalence of undiagnosed diabetes in the country. This study examined the association between place of residence and blood sugar testing practices among men in Madagascar. Methods Secondary data from the men recode file of the 2021 Madagascar Demographic and Health Survey (MDHS) was used. A sample of 9,035 were used for the analysis. Descriptive and multivariate analyses were performed in STATA version 14. The results are presented in adjusted odds ratio (AOR) with the corresponding 95% confidence interval. Results Only 5.83% reported to have ever had their blood glucose/sugar tested by a health professional. Residing in rural areas was associated in lower likelihood of undergoing a test to check one’s blood sugar level [AOR = 0.23; 95%CI = 0.19–0.28] compared to those in urban areas. This association remained consistent even after adjusting for the effects of covariates [AOR = 0.67; 95%CI = 0.52–0.86]. Conclusion We conclude that place of residence plays a significant role in influencing men’s decision to test their blood glucose level. It is, therefore, imperative for the Madagascar Public Health Department to liaise with the government to bridge the rural-urban disparities in terms of accessibility to blood glucose testing services. Practically, this can be achieved by instituting community-based health services centers in the rural areas of Madagascar to mitigate the rural-urban disparities. Also, health education campaigns to raise men’s awareness about the need to test their blood glucose level must necessarily target older men, those without formal education, those without health insurance, and men who have been diagnosed with hypertension.

Abstract Objectives Given the well-established link between hormonal contraceptives and hypertension risk, and the paucity of research on hormonal contraceptive use dynamics in this particular demographic, we hypothesize that there is a likelihood of low utilization of high-risk hormonal contraceptives among women living with hypertension in SSA. This study investigates the prevalence and factors associated with hormonal contraceptive use among women living with hypertension in the SSA. Results Only 18.5% of women living with hypertension used hormonal contraceptives. Hormonal contraceptive use was high among women with a higher level of education (aOR = 2.33; 95%CI: 1.73–3.14), those currently working (aOR = 1.38; 95%CI: 1.20–1.59), those who have heard about family planning on the radio (aOR = 1.27, 95%CI: 1.09–1.47), listened to the radio at least once a week (aOR = 1.29, 95%CI: 1.10–1.51), and those residing in rural areas (aOR = 1.32; 95%CI: 1.14–1.54). Conversely, women aged 45–49 exhibited a substantial decrease in the odds of hormonal contraceptive use (aOR = 0.23, 95%CI: 0.14–0.38) compared to younger women (15–19 years). Likewise, the odds of HCU were low among cohabiting (aOR = 0.66; 95%CI: 0.48–0.89) and previously married women (aOR = 0.67; 95%CI: 0.50–0.91) than never married women.

Abstract Background Despite the widespread prevalence of adolescent smoking in Gambia, a West African country, there is limited research exploring the relationships between exposure to pro-tobacco and anti-tobacco media messages and events and smoking behaviour among young people. This study investigates the interplay of these exposures and smoking behaviour among 11-17-year-old adolescents in Gambia. Methods Secondary data analysis was conducted using the 2017 Gambia Global Youth and Tobacco Survey (GYTS), which included a total of 9,127 respondents. Descriptive and inferential analyses, including proportions, Pearson’s chi-squared tests, and multivariable logistic regression models, were employed to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results The final model revealed significant associations between exposure to anti-tobacco media messages and events and smoking behaviour. Adolescents exposed to anti-tobacco media messages had a 29% increased odds of smoking (aOR 1.29,CI = 1.08,1.53) compared to those unexposed, while exposure to anti-tobacco media events showed a 31% increased odds (aOR 1.31,CI = 1.09,1.59) compared to those unexposed. Exposure to pro-tobacco messages, such as witnessing tobacco use on TV (aOR 1.41, CI = 1.17,1.69) and owning objects with tobacco brand logos (aOR 1.49,CI = 1.19,1.86), was associated with higher odds of smoking. Covariates, including sex, age, and exposure to smoking behaviour by significant others, also demonstrated associations with smoking behaviour. Notably, male respondents showed significantly higher odds of smoking (aOR = 4.01,CI = 3.28,4.89) compared to females. Respondents aged 15 years and older had increased odds of smoking (aOR = 1.47,CI = 1.22,1.76) compared to those below 15 years old. Those whose fathers smoke displayed higher odds of smoking (aOR = 1.35, CI = 1.04,1.76) compared to individuals with non-smoking parents. Additionally, those whose closest friends smoke showed remarkably higher odds of smoking (aOR = 2.87,CI = 2.37, 3.48) compared to those without such influence. Conclusion This study underscores the significant impact of exposure to both anti-tobacco and pro-tobacco media messages and events on smoking behaviour among adolescents in Gambia. However, pro-tobacco messages had a greater influence on smoking prevalence than anti-tobacco messages and events. Understanding these associations is crucial for devising effective public health interventions aimed at reducing tobacco use in this population.

Abstract Background The aim of this study is to examine cervical cancer screening (CCS) uptake among women living with hypertension and HIV in Tanzania. Methods We used the recently released 2022 Tanzania Demographic and Health Survey. The outcome variable assessed in the study was CCS, whereas chronic morbidities constituted the main explanatory variable. Data analysis was based on observations from 6,298 women aged 30–49 years. Multivariable logistic regression models were used to determine the association between hypertension and HIV status, and CCS uptake. The analyses were computed in STATA 18. Results Out of the 6,298 respondents, only 805 (12.8%) had undergone CCS with higher screening uptake among those living with either one of the disease (28.5%) than among those living with neither hypertension or HIV. The highest proportion was found among those who had ever been diagnosed with hypertension (24.1%) and among women with positive HIV test results (36.7%). There was a significantly higher likelihood of undergoing screening for cervical cancer among women living with at least one of the diseases [AOR = 2.4; 95% CI: 1.4–2.8], compared to those without these conditions. Women diagnosed with hypertension showed increased likelihood of undergoing CCS [AOR = 1.4; 95%CI: 1.1–1.7]. Similarly, women with a positive HIV test result demonstrated higher odds of screening uptake [AOR = 5.2; 95%CI: 4.0-6.7]. Conclusion The study found a positive association between comorbidities and CCS uptake in Tanzanian women. Our findings emphasize the critical importance of ensuring accessibility and adherence to essential screenings for individuals with chronic morbid conditions. Future efforts should focus on strengthening existing integrated services and identifying potential barriers to accessing CCS within these healthcare settings to optimize cervical cancer prevention efforts for individuals with chronic morbidities.

Abstract Introduction Cervical cancer is the second dominant type of cancer among Ivorian women with an estimated age-standardised incidence and mortality rate of 31.2 cases and 22.8 deaths per 100,000 women in 2020, respectively. The Ivorian government through its Ministry of Health implemented the National Cancer Control Programme (NCCP) in 2003 with the aim of improving the prevention, early detection and treatment of cancers in Côte d’Ivoire. Yet, there is a low uptake of CCS (1.2%). Thus, making CCS uptake an important public health concern in the country. Understanding of the extent to which reproductive factors predict CCS uptake is limited in literature. This study aimed to investigate reproductive factors as a predictor of women’s uptake of CCS in Côte d’Ivoire. Methods Data from the 2021 Côte d’Ivoire Demographic and Health Survey. A sample of 9,078 women aged 25–49 years were analyzed. The outcome variable was CCS uptake while other variables considered included age at menarche, history of STI, sexual debut, parity, age, educational level, wealth index, health insurance, place of residence, and media exposure. A multivariable logistic regression model was fitted to examine the association between the outcome of interest and predictors at 95% confidence interval. Results Approximately, 7.52% of women aged 25–49 years had ever undergone testing for cervical cancer by a healthcare provider. Early menarche was associated with lower odds of CCS uptake [AOR = 0.78; CI = 0.65–0.95]. Compared to those who had no STI, women with a history of STI were more likely to screen for cervical cancer [AOR = 2.63; CI = 2.02–3.42]. Increasing age, higher educational attainment, having health insurance, and being exposed to media were significantly associated with CCS uptake. Conclusion In Cote d’Ivoire, age at menarche and STI history constitute reproductive factors that were significantly associated with women’s uptake of CCS. It is imperative for public policy to focus on increasing CCS in these higher-risk women (i.e., women who experienced early menarche, women with early sexual debut and higher parity) through increased sensitization on cervical cancer risk factors.

Objective To examine the burden of non-communicable diseases (NCDs) among women of reproductive age in Kenya, highlighting the prevalence and risk factors.Design Cross-sectional design based on the 2022 Kenya Demographic and Health Survey.Setting Kenya.Primary outcomes Predict the burden of hypertension, diabetes, heart disease, lung disease, arthritis, depression, anxiety, breast and cervical cancer.Results Overall, 15.9% of Kenyan women aged 15–49 years were living with at least one NCD. The most prevalent NCD among this cohort was hypertension (8.7%) followed by arthritis (2.9%) and depression (2.8%). Our findings revealed that increasing age, increasing wealth, being married or formerly married, being overweight or obese, consuming alcohol and some occupations were risk factors of NCDs among women of reproductive age in Kenya.Conclusion We conclude that hypertension is the most prevalent NCD among women of reproductive age in Kenya. The findings underscore the multifaceted nature of NCD risk factors in Kenya, emphasising the importance of targeted interventions that consider age, economic status, education, marital status, occupation and lifestyle factors.

Abstract Background There is an interest in the extent to which the wealth status of women predicts their risk of being pre-hypertensive. This understanding is lacking in the current body of empirical literature, particularly within the context of Benin. Thus, indicating a knowledge gap that must be filled. To this end, the present study aimed to assess the association between wealth status and the risk of prehypertension among women aged 30–49 years in Benin. Methods This study used a secondary data from the recent (2018) Demographic and Health Survey of Benin. Bivariate and multivariate logistic regression models were computed to examine the association between wealth index and the risks of prehypertension using Stata version 14. Findings were presented in adjusted odds ratio at 95% confidence level. Results Women in the richest wealth index were significantly more likely to have prehypertension than those in the poorest wealth index [AOR = 1.4; 95%CI: 1.26–2.26]. Women aged 45–49 years were more likely to have prehypertension [AOR = 1.5; 95%CI: 1.15–1.98] compared to younger women. Women who used unclean cooking fuel were less likely to have prehypertension compared to those using clean cooking fuel [AOR = 0.6; 95%CI: 0.37,0.87]. Conclusion The study concludes that wealth status is a significant predictor of prehypertension among women in Benin. Therefore, the Ministry of Health in Benin should prioritize health education and prehypertension awareness campaigns specifically targeting women in affluent communities and households. These campaigns should focus on promoting healthy dietary choices and encouraging physical activity to mitigate the elevated risk associated with wealth status. Recognizing the influence of age on prehypertension risk, it is imperative for older-middle aged women to be targeted as primary beneficiaries of health education programs and prehypertension screening programs.

Abstract Background There is a global consensus that child immunization plays an important role in promoting the health and well-being of children. Despite the quintessential role of immunization, not all children receive full immunization coverage. We examined the association between women empowerment and childhood immunization coverage in sub-Saharan Africa (SSA). Methods The most recent Demographic and Health Survey data of 17 SSA countries were used for the analysis, with a sample of 19,223. The outcome and exposure variables were full immunization coverage and women empowerment, respectively. Full immunization was computed from percentage of children between the ages of 12 and 23 months who had received the following vaccines at any point in time: one dose of Bacille Calmette–Guérin, three doses of the vaccine protecting against diphtheria, pertussis, and tetanus or the tetravalent/pentavalent vaccine, three doses of the polio vaccine, and one dose of the measles vaccine (either as a standalone measles vaccine or as part of a combination with other immunogens). Women’s empowerment was an index of labour participation, acceptance towards spousal violence, decision-making capacity and general knowledge level. Descriptive analysis and multilevel logistic regression were performed. Results were reported in adjusted odds ratio with a corresponding 95% confidence interval. Results The study found that 56.6% of children were fully immunized. Children of employed mothers were 1.16 times more likely to be fully immunized. Children of mothers with higher acceptance toward violence were less likely to be fully immunized [aOR = 0.90, CI 0.81, 0.99]. The odds of full immunization were higher among children born to mothers with high [aOR = 1.11, CI 1.01, 1.22] decision-making capacity. Higher odds of full immunization were found among children born to mothers with medium [aOR = 1.24, CI 1.13, 1.36] to high [aOR = 1.44, CI 1.27, 1.63] general knowledge level. Conclusions We conclude that empowering women through livelihood empowerment interventions can increase their decision-making capacity and foster their resolve to ensure the full immunization of their children. This can be achieved by consciously investing in initiatives such as vocational training programs, job placement services, or support for entrepreneurship initiatives to encourage and support women's workforce participation.

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

Abstract Background Anaemia has become a major public health concern among women in Sub-Saharan Africa (SSA). However, little is known about the spatial disparities in anaemia prevalence and their associated factors among pregnant women in the region. This study analysed the spatial disparities in anaemia and their associated factors among pregnant women in rural and urban settings in SSA. Methods This is a secondary analysis of the most recent demographic and health surveys of 26 countries in SSA. Spatial autocorrelation and hotspot assessment were conducted, while a multivariate logistic regression model was used to identify demographic factors associated with anaemia. Results Anaemia was reported among ~50% of pregnant women in urban and rural areas of SSA. The hotspot analysis identified the West African sub-region as having a higher concentration of anaemia cases in rural settings. In urban areas, the odds of anaemia were significantly higher among pregnant women in their second trimester (Adjusted OR = 2.39, CI = 1.99, 2.76). On the other hand, pregnant women in their third trimester (Adjusted OR = 1.98, CI = 1.77, 2.22) and those who had taken intestinal parasite drugs (Adjusted OR = 1.12 CI = 1.02, 1.23) had a higher likelihood of having anaemia in rural areas. Pregnant women aged 35–39 years (Adjusted OR = 0.52, CI = 0.33, 0.81) and those aged 40–44 years (Adjusted OR = 0.69, CI = 0.50, 0.95) had a lesser likelihood of having anaemia compared to women aged 15–19 years in urban and rural areas respectively. Compared to Congo DR, Benin (OR = 2.22, CI = 1.51, 3.28) and Mali (OR = 3.71, CI = 2.73, 5.05) had higher odds of anaemia in urban and rural areas respectively. Conclusions Spatial disparities in anaemia persist among pregnant women in rural and urban settings in SSA. Prevailing spatial variations in anaemia may be addressed by specialised interventions considering the contextual residential settings and socio-economic factors highlighted in this study.

The challenge of creating reliable technology-based resources for science learning is a perennial challenge in Philippine education, with limited learning materials accessible to all learners. This study is about the development of a videocast embedded with physics education technology (PhET) simulation that served as supplementary learning material for grade 9 science in response to the scarcity of dependable visualization materials. The study employed the developmental research design with analysisdesign-development-implementation-evaluation (ADDIE) model as the developmental framework. The vodcast evaluation tool, achievement test questionnaire, and vodcast perception survey questionnaire for students and teachers were used in the data collection, while the Kendall's W statistic, mean, percentage, and gain score were used in the data interpretation. The teacher respondents (N=64) have moderate agreement on the ranking of topic difficulty, with Kendall's W of 0.45. The researcher-made vodcast attained an overall rating of 4.78 from experts, which implies that the vodcast can be very good material for classroom implementation. The developed achievement test has acceptable difficulty and discrimination indices. The implementation stage yielded a low normalized gain, which can be accounted for by unfocused attention during the pandemic. Nevertheless, the voicecasts were found very useful in learning projectile motion, as perceived by both students and teacher-observers.

Abstract Background Within the African region, there are an estimated 8 million people living with HIV (PLHIV) in South Africa. Seeking healthcare services from traditional healers (TH) is one of the alternative and complementary approaches to HIV/AIDS treatment. Identifying the associated factors of TH utilisation among older PLHIV is crucial in developing healthcare interventions that cater to the unique needs of this vulnerable group. This study investigated the factors associated with TH utilisation among older PLHIV. Methods We studied 516 older PLHIV using data from the WHO SAGE Well-Being of Older People Study (2011–2013). Chi-square, bivariate and multivariate logistic regression were computed in STATA Version 14. The results were presented with both crude and adjusted odds ratio (AOR) and at 95% confidence interval (CI). Results Of the 516 participants, 15.89% utilised TH. The major reason for TH utilisation among older PLHIV was the perception of receiving better healthcare services from TH (51.2%) and the flexibility to pay with goods instead of money (14.6%). The factors associated with TH utilisation were age [AOR = 0.05; CI 0.01, 0.37], being hypertensive [AOR = 2.07; CI 1.04, 4.11], and having more than four servings of fruits [AOR = 10.64; CI 2.95, 38.34]. TH utilisation was significantly lower among those who visited the clinic once or twice [AOR = 0.17; CI 0.05, 0.63], three to six times [AOR = 0.16; CI 0.05, 0.56], and more than 6 times [AOR = 0.09; CI 0.03, 0.34] compared to those who had no clinic visits. Conclusion In conclusion, a low proportion of TH utilisation was reported among older PLHIV in South Africa. TH utilisation is associated with age, hypertension status, frequency of clinic visits and fruit servings consumed. Our study suggests that being hypertensive was a motivating factor for older PLHIV to utilise TH. Therefore, it is imperative for the South African health department to integrate the services of TH into the mainstream health system to manage non-communicable diseases, particularly hypertension, among older PLHIV.

Abstract Background The World Health Organisation recommends that all mothers seek postnatal care (PNC) within the first two months after childbirth. This study examined PNC utilisation for babies within the first two months after childbirth. Methods We used data from the most recent Demographic and Health Surveys (DHS) (2018–2020) of eleven countries in SSA. Descriptive and a multivariate analysis were carried out, and presented in adjusted odds ratios. The explanatory variables included: age, place of residence, level of formal education, wealth quintile, antenatal care visits, marital status, frequency of watching TV, listening to radio and reading newspaper, getting permission to go medical help for self, getting money needed for treatment, and distance to facility. Results PNC utilisation was 37.5% and 33% in urban and rural residences, respectively. Higher level of education (Urban: AOR = 1.39, CI = 1.25, 1.56; Rural: AOR = 1.31, CI = 1.10, 1.58), 4 or more ANC visits (Urban: AOR = 1.32, CI = 1.23, 1.40; Rural: AOR = 1.49, CI = 1.43, 1.56 0.86), requiring permission to go to the health facility (Urban: AOR = 0.67, CI = 0.61, 0.74; Rural: AOR = 0.86, CI = 0.81, 0.91), listening to the radio at least once a week (Urban: AOR = 1.32, CI = 1.23, 1.41; Rural: AOR = 0.86, CI = 0.77, 0.95), and watching television at least once a week (Urban: AOR = 1.11, CI = 1.03, 1.21; Rural: AOR = 1.15, CI = 1.07, 1.24) were significantly associated with PNC service utilisation in both rural and urban areas. However, belonging to a richer wealth status (AOR = 1.11, CI = 1.02, 1.20) and having a problem with distance (AOR = 1.13, CI = 1.07, 1.18) were significant in only rural areas, while having a problem with money for treatment was significant only in urban areas (AOR = 1.15, CI = 1.08, 1.23). Conclusion In this study, we conclude that the PNC service utilisation within the first 2 months after delivery was low across rural and urban residences. There is, therefore, a need for SSA countries to develop population tailored interventions such as advocacy and health education targeted at women with no formal education in both rural and urban areas. Our study also suggests that SSA countries must intensify radio programs and advertisements on the health benefits of PNC to improve maternal and child health.

Abstract Background Regular breast screening is one of the most effective ways to detect early signs of breast cancer but travel distance to cancer-diagnostic facilities can affect breast screening attendance. Yet, limited studies have examined the impact of distance to cancer-diagnostic facilities on clinical breast screening behaviour among women in sub-Saharan Africa (SSA). This study examined the influence of travel distance to a health facility on clinical breast screening behaviour in five SSA countries: Namibia, Burkina Faso, Cote D’Ivoire, Kenya, and Lesotho. The study further assessed variations in clinical breast screening behaviour across diverse socio-demographic characteristics of women. Methods A sample of 45,945 women was drawn from the most recent Demographic and Health Surveys (DHS) for the included countries. The DHS uses 2-stage stratified cluster sampling to select nationally representative samples of women (15–49) and men (15–64) via a cross-sectional design. Proportions and binary logistic regression were used to examine associations between the women’s socio-demographic characteristics and breast screening attendance. Results The overall proportion of survey participants who underwent clinical breast cancer screening was 16.3%. Travel distance to a health facility had a significant (p

BackgroundDespite global, regional, and national efforts to address intimate partner violence (IPV), physical IPV persists as a significant challenge in Kenya. This study employs geospatial analysis to examine the spatial distribution and determinants of physical intimate partner violence among women, aiming to inform targeted interventions and policies.MethodsThe study used a secondary analysis of a cross-sectional study design based on the 2022 Kenya demographic and health survey. Analyses were conducted using Stata version 17.0 and ArcMap version 10.8. Spatial autocorrelation and hotspot assessment were conducted in the geospatial analysis, while a multilevel logistic regression model was used to examine determinants of physical violence among reproductive-aged women.ResultsThe study found 28.8% (10,477) of the surveyed women reported experiencing physical intimate partner violence. The spatial analysis identified significant clusters in the southwest and central regions, with women in sub-counties like Chepaluugu, Konion, Sotik, Bumula, and Metayos among others experiencing more violence. Conversely, women in areas in the North East and South East corners such as Kisauni, Tarabaj, Waijir North, Lafey, and Mandera North and South among others showed little or no physical intimate partner violence. Multivariable logistic regression identified age, education, wealth index, partner domineering indicators, and justification of wife beating to be associated with physical intimate partner violence. Higher education and wealth were associated with lower violence odds, while partner domineering indicators and justification of wife beating increased odds.ConclusionSpatial variations in intimate partner violence risk for women in Kenya underscore the need for targeted government interventions. Focusing on hotspot regions, especially among women with the poorest wealth index, no formal education, and older age, is crucial. Implementing behavior change campaigns addressing violence justification and partner dominance is vital. Active involvement of male partners in programs aiming to eliminate intimate partner violence is essential for comprehensive impact.

IntroductionIntimate partner violence (IPV) is a significant public health issue, predominantly among women in sub-Saharan Africa, including Ghana. Existing evidence indicates high rates of IPV perpetration and its associated adverse health outcomes. Despite previous studies, reliance on old data underscores the need for current, nationally representative data to inform policy-making and interventions. Therefore, this study utilizes the 2022 Ghana Demographic and Health Survey (GDHS) to examine IPV experiences and associated factors, aiming to provide updated insights for effective IPV mitigation strategies in Ghana.MethodsThis is a cross-sectional study of a weighted sample of 3,741 women between the ages of 15-49 years old from the 2022 GDHS. Binary logistic regression analysis was used in predicting the outcome.ResultsThe study found that 36.4 percent of women in Ghana had experienced some form of IPV, primarily emotional violence (31.5%), physical violence (17.3%), and sexual violence (7.6%). Women with higher levels of education had a significantly reduced risk of 60% of experiencing some form of IPV than those with no formal education. Partner domineering behaviours, such as women whose partners often get jealous for seeing them talk with other men [adjusted OR:1.76, 95%CI:1.25,2.48], accusing them of unfaithfulness [adjusted OR:2.59, 95%CI:1.03,2.46], not permitting them to meet female friends [adjusted OR:1.1.59, 95%CI:1.03,2.46], and limiting their contact with family [adjusted OR:5.75, 95%CI:2.27,13.42], were more likely to experience at least one form of IPV. Similarly, women who justified or endorsed wife beating had a higher likelihood [aOR = 1.57, 95%CI = 1.22,2.02] of experiencing at least one form of IPV than those who did not endorse such behaviour.ConclusionIdentifying educational attainment, partner dominance, and violence endorsement as IPV predictors underscore targeted interventions. Promoting women's education bolsters empowerment and IPV prevention. Addressing dominance through education, counselling, and legal frameworks is crucial for fostering safer relationships and challenging violence normalization.

BackgroundPremarital sexual intercourse has essential implications for the sexual and reproductive health and rights of young women. These include increased sexual pleasure and satisfaction as well as exposure to the risks of unintended pregnancy and sexually transmitted infections, including HIV/AIDS. This study examined the trends, patterns, and associations of premarital sexual intercourse among young women aged 15-24 in Sierra Leone.MethodsNationally representative cross-sectional data from the 2008, 2013, and 2019 Demographic and Health Surveys in Sierra Leone were used for the study. A weighted sample of 9,675 never-married young women was used to estimate the pooled prevalence of premarital sexual intercourse in Sierra Leone. Percentages were used to present the results of the trends and patterns of premarital sexual intercourse. We employed a multilevel binary logistic regression modelling technique to examine the associations of premarital sexual intercourse. The results were presented using adjusted odds ratio with their respective 95% confidence interval.ResultsThe pooled prevalence of premarital sexual intercourse among the young women in Sierra Leone was 62.9%. Over the survey years, premarital sexual intercourse increased from 59.8% in 2008 to 65.1% in 2013. However, it declined by 3.5% to 61.6% in 2019. Young women aged 20-24 (aOR = 12.47, 95% CI = 10.54-14.76) had higher odds of engaging in premarital sexual intercourse than those aged 15-19. Young women with higher educational levels (aOR = 1.87, 95% CI = 1.17-2.99), those who were working (aOR = 1.60, 95% CI = 1.44-1.78), those who listened to the radio (aOR = 1.33, 95% CI = 1.29-1.60), and those who lived in the Northwestern (aOR = 2.19, 95% CI = 1.68-2.84), Eastern (aOR = 1.47, 95% CI = 1.23-1.760, Northern (aOR = 1.48, 95% CI = 1.25 -, 1.76), and Southern (aOR = 1.63, 95% CI = 1.36-1.94) regions were more likely to engage in premarital sexual intercourse compared to those with no formal education, those not working, those who did not listen to the radio, and those who lived in the Western region, respectively. Young women in the richest wealth category (aOR = 0.62, 95% CI = 0.49-0.78), and residing in rural areas (aOR = 0.84, 95% CI = 0.72-0.98) had lower odds of engaging in premarital sexual intercourse relative to those from the poorest wealth quintile and those living in urban areas.ConclusionOur study found a high prevalence of premarital sexual intercourse among young women in Sierra Leone. Premarital sexual intercourse was associated with age, educational level, wealth, employment, and region. This necessitates providing them with comprehensive information regarding sexual and reproductive health behaviours, specifically emphasising the benefits and adverse consequences of engaging in sexual experimentation. Additionally, it is crucial to promote the adoption of abstinence, injections, implants, and condom usage through consistent advocacy for youth-risk communication.

Abstract Objective: This study aimed to examine the association between fruit and vegetable consumption (FVC) and the risk of hypertension among women in Ghana. Design: Data from the 2014 Ghana Demographic and Health Survey were used. Bivariate and multivariate logistic regression analyses were performed using Stata version 14. The study reports the adjusted OR (AOR) and CI. Setting: Ghana Participants: A total sample of 4168 women was used in the analysis. Results: Among women who met the WHO’s recommended intake of FVC, 13·1 % had hypertension. The intake of the recommended servings of fruit and vegetables was not significantly associated with hypertension. However, the likelihood of being hypertensive was significantly associated with increasing age (AOR = 6·1; 95 % CI = 4·29, 8·73), being married (AOR = 1·7; 95 % CI = 1·14, 2·57) or formerly married (AOR = 2·3; 95 % CI = 1·44, 3·70), and being overweight (AOR = 1·6; 95 % CI = 1·24, 2·07) or obese (AOR = 2·4; 95 % CI = 1·82, 3·20). Conclusion: The study concludes that there is no significant association between FVC and hypertension risk among women in Ghana. While this study did not find a significant association between FVC and hypertension risk among women in Ghana, it underscores the point that other multifaceted factors influence hypertension risk. As such, public health campaigns should emphasise a balanced and holistic approach to promoting cardiovascular health, including factors beyond FVC. The findings also highlight the need to target high-risk populations (i.e. older women, married and formerly married women, and overweight or obese women) with hypertension prevention education and related interventions.

Access to reliable and sustainable electricity is still precluded for a large share of global population living in rural areas of developing countries, especially in sub-Saharan Africa. Hybrid microgrids are considered a suitable solution for providing affordable and reliable access to electricity to isolated communities. Properly planning and sizing such systems is although an aspect that can greatly influence the sustainability of the intervention, and the arrival to the market of the third generation minigrids poses new challenges to the process. Three main challenges are identified as pivotal for the proper sizing of new generation microgrids: arrival of the main grid, inappropriateness of Net Present Cost as only objective function in the strategy selection process, and necessity to operate on already existing minigrids. Such aspects are addressed in this work by proposing a methodological advancement to an existing open-source microgrid sizing model: a grid outage model alongside the definition of new constraints and variables for the optimization problem with grid-connected microgrids, a multi-objective optimization option, and a brown-field optimization option. The new version of the model is tested on real life case studies in rural Rwanda (greenfield) and Mozambique (brownfield), proving the profitability of grid-connected and grid-extension solutions for sufficiently low connection distances. Sensitivity analyses are performed to assess variations in system size, cost and CO2 emissions with respect to microgrid and grid connection parameters.

Abstract Background Cervical cancer significantly affects women in Sub-Saharan Africa (SSA). However, limited studies have concentrated on cervical screening behaviour among women in SSA. This study aimed to assess the interplay of distance to health facilities and socio-demographic factors with cervical screening behaviour among women in five SSA countries. Methods The study was based on pooled data of 40,555 women included in Demographic and Health Surveys (DHS) conducted between 2013 to 2021. Proportions and logistic regression models were used in assessing the interplay of distance to health facilities and socio-demographic factors with cervical screening behaviour. Results Approximately, 7.9% of women that saw the distance to a health facility as a big problem, tested for cervical cancer compared to 13.5% who indicated that distance to a health facility is not a big problem. More women in urban areas, with a higher level of education, of richest wealth index, aged 40–44 years and using contraceptives who also indicated that distance to a health facility was a big problem tested for cervical cancer compared to those in rural areas with no education, of poorest wealth index, aged 15–19 years and not using contraceptives. Education, age, contraceptive use, frequent exposure to mass media and Sexual Transmitted Infections (STI) had a significant relationship with testing for cervical cancer. Conclusion The prevalence of cervical cancer screening was low in the five SSA countries largely due to distance barriers and was also significantly influenced by education, age, contraceptive use, frequent exposure to mass media, and STI status. To improve the screening for cervical cancer and its associated benefits in the five SSA countries, there is a need for policymakers, clinicians and public health workers to channel more commitment and efforts to addressing the barriers identified in this study.

Abstract Background People living with HIV (PLHIV) are experiencing increased life expectancy mostly due to the success of anti-retroviral therapy. Consequently, they face the threat of chronic diseases attributed to ageing including hypertension. The risk of hypertension among PLHIV requires research attention particularly in South Africa where the prevalence of HIV is highest in Africa. We therefore examined the prevalence and factors associated with hypertension among older people living with HIV in South Africa. Methods We analysed cross-sectional data on 514 older PLHIV. Data were extracted from the WHO SAGE Well-Being of Older People Study (WOPS) (2011–2013). The outcome variable was hypertension status. Data was analysed using STATA Version 14. Chi-square and binary logistic regression were performed. The results were presented in odds ratio with its corresponding confidence interval. Results The prevalence of hypertension among PLHIV was 50.1%. Compared to PLHIV aged 50–59, those aged 60–69 [OR = 2.2; CI = 1.30,3.84], 70–79 years [OR = 2.8; CI = 1.37,5.82], and 80 + [OR = 4.9; CI = 1.68,14.05] had higher risk of hypertension. Females were more likely [OR = 5.5; CI = 2.67,11.12] than males to have hypertension. Persons ever diagnosed with stroke were more likely [OR = 3.3; CI = 1.04,10.65] to have hypertension when compared to their counterparts who have never been diagnosed with stroke. Compared to PLHIV who had no clinic visits, those who visited the clinic three to six times [OR = 5.3; CI = 1.35,21.01], or more than six times [OR = 5.5; CI = 1.41,21.41] were more likely to have hypertension. Conclusion More than half of South African older PLHIV are hypertensive. The factors associated with hypertension among older PLHIV are age, sex, ever diagnosed with stroke and number of times visited the clinic. Integration of hypertension management and advocacy in HIV care is urgently needed in South Africa in order to accelerate reductions in the prevalence of hypertension among older PLHIV, as well as enhance South Africa’s capacity to attain the Sustainable Development Goal target 3.3.

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