19 research outputs found
Health human capital and economic growth in sub-Saharan Africa : a dynamic panel data analysis
No full textThesisThis study set out to determine the relationship between health human capital and economic growth for 30 sub Saharan African countries during the period 1995 and 2014. The study did this in two parts. First, we first estimated a model of health production to ascertain the impact of economic growth and other factors on population health. Second, an economic growth model was estimated focusing on the impact of the stock of, investments into and quality of health on economic growth rates. The analysis was extended to examine the long term and short term influence of health stock on economic growth.
Due to expected endogeneity in the health and growth models, the Arellano Bond two step Generalised Method of Moments (GMM) estimator was employed. Using life expectancy and infant mortality as measures of health, the study found that population health had a significant long term impact on economic growth in the region with a 1 percent rise in average life expectancy leading to a 0.3 percent rise in GDP per capita in 10 and 12 years. Similarly, infant mortality has a negative significant impact on growth when lagged by 12 years. While life expectancy did not show evidence of a short term impact on growth, infant mortality had a negative and significant impact on economic growth in the short term.
As for the determinants of population health, education, health expenditure, health care quality and alcohol consumption significantly determined both the levels of infant mortality and life expectancy in the region. The study concluded that the accumulation of population health capital would raise economic growth levels in the long term for the region. To exploit this growth effect, there is need for policy makers to invest in improving population health by focusing on the main determinants of health (education, health quality, health expenditure and life style factors).
Key Words: Health human capital, economic growth, long term, Sub Saharan Africa, Dynamic Panel Data, GMM difference estimato
Trends and predictors of unmet need for family planning among women living with HIV in Zambia: implications for elimination of vertical transmission of HIV
No full textAbstract Background Prevention of vertical (mother to child) transmission of HIV is one of the key strategies towards HIV epidemic control. Despite considerable progress over the past decade in Zambia, the country is yet to reach global and national target for elimination of vertical transmission of HIV. Avoidance of unintended pregnancy among women living with HIV is one of the cost-effective interventions in a comprehensive approach to prevent vertical transmission of HIV. Therefore, this study aimed at ascertaining trends in and predictors of unmet need for family planning among women living with HIV in Zambia. Methods The study employed a repeated cross sectional (RCS) study design, using data from the three (3) most recent consecutive rounds of the Zambia Demographic and Health Survey (ZDHS) conducted in 2007, 2013/2014 and 2018. The study used data from a total of 27,153 women aged 15–49 years over the three survey periods among whom 4,113 had an HIV positive result following a rigorous HIV testing algorithm of the demographic and health surveys, and these constituted our sample size of women living with HIV. We used descriptive statistics and logistic regression analyses to respectively ascertain trends in and predictors of unmet need for family planning among women living with HIV. Results Over the three survey points, unmet need for family planning among women living with HIV has largely remained unchanged from 20.8% in 2007 to 20.5% in 2013/14 and 21.1% in 2018 DHS. Residence, age of women, household wealth, woman’s parity, employment, and age of spouse emerged as significant predictors of unmet need for family planning among women living with HIV in Zambia. Conclusion Preventing HIV infection in a child preserves life, contributes to improving quality of life from its early stages and averts lifetime costs of HIV treatment and associated healthcare costs. There is need to consider optimization of interventions to prevent vertical transmission of HIV including shaping programming regarding preventing unintended pregnancies among women living with HIV. Among other aspects, policy and practice need to strengthen SRH/HIV integration and better target rural residents, younger women, those with high parity and consider positive male engagement to reduce unmet need for family planning among women living with HIV
Factors that influence married/partnered women’s decisions to use contraception in Zambia
No full textAccording to the Demographic and Health Surveys (DHSs), Zambia has shown an increasing trend in the percentage of married women using contraceptives in the last three decades. As of 2018, this percentage increased from 34.2% in 2001 to 40.8% in 2007 and from 45% in 2013 to 48% in 2018. Despite the increasing trend in contraceptive use, the unmet needs remain relatively high. The low percentage of contraception use translates into 20% of women of reproductive age who are either married/partnered and want to stop or delay childbearing but are not using contraception. This study analyzed factors other than availability that influence women’s ability to make or influence the decision to use contraception using logistic regression using data from the Zambia 2013/2014 and 2018 DHSs. Furthermore, adjusted odds ratios and predicted probabilities were estimated using the fitted logistic regression. Data on 8,335 women were analyzed, and 13.7% (n = 1,145) had their husband as the sole decision maker for contraception use, while 86.3% (n = 7,189) made the decisions or participated in making the decision. Contrary to most literature, those with primary or secondary school education were less likely to decide than those without education. The data also associate women who contribute to daily household decisions to having a say in deciding to use contraception. Lastly, women using reversible contraception methods, other methods, hormonal methods, and fertility awareness were associated with less likelihood to decide on using contraceptives than those using barrier methods. Women with lower household decision-making powers are less likely to make or influence decisions to use contraception. Consequently, there is a need to prioritize such women in interventions aimed at increasing contraception use decision-making. Furthermore, more studies are required to investigate why uneducated women in Zambia are more likely to choose contraception. Also, the vast odds ratio difference between all other methods compared to barrier methods (condoms) indicates underlying factors that play a role, which warrants further studies
The potential health and revenue effects of a tax on sugar sweetened beverages in Zambia
No full textThe global burden of non-communicable diseases (NCDs) has been rising. A key risk factor for NCDs is obesity, which has been partly linked to consumption of sugar sweetened beverages (SSBs). A tax on SSBs is an attractive control measure to curb the rising trend in NCDs, as it has the potential to reduce consumption of SSBs. However, studies on the potential effects of SSB taxes have been concentrated in high-income countries with limited studies in low-income and middle-income countries. Using data from the 2015 Zambia Living Conditions Monitoring Survey (LCMS) data, the 2017 Zambia NCD STEPS Survey, and key parameters from the literature, we simulated the effect of a 25% SSB tax in Zambia on energy intake and the corresponding change in body mass index (BMI), obesity prevalence, deaths averted, life years gained and revenues generated using a mathematical model developed using Microsoft Excel. We conducted Monte Carlo simulations to construct 95% confidence bands and sensitivity analyses to account for uncertainties in key parameters. We found that a 25% SSB would avert 2526 deaths, though these results were not statistically significant overall. However, when broken down by gender, the tax was found to significantly avert 1133 deaths in women (95% CI 353 to 1970). The tax was found to potentially generate an additional US$5.46 million (95% CI 4.66 to 6.14) in revenue annually. We conclude that an SSB tax in Zambia has the potential to significantly decrease the amount of disability-adjusted life years lost to lifestyle-related diseases in women, highlighting important health equity outcomes. Women have higher baseline BMI and therefore are at higher risk for NCDs. In addition, an SSB tax will provide government with additional revenue which if earmarked for health could contribute to healthcare financing in Zambia
Exploring key challenges for healthcare providers and stakeholders in delivering adolescent sexual and reproductive health services and information during the COVID-19 pandemic in Malawi, Zambia and Zimbabwe: a qualitative study
No full textAbstract Introduction This study aimed to explore the direct and indirect influences of COVID-19-related restrictions on adolescents and young people’s (AYP’s) sexual and reproductive health and rights (SRHR) in Malawi, Zambia, and Zimbabwe, with a focus on teenage pregnancy and access to and utilization of HIV testing and counselling services. Methods Thirty-four purposively sampled interviews that comprised of selected representatives of organizations involved in activities aimed at addressing adolescent sexual and reproductive health and rights (ASRHR), teenage pregnancies, and HIV testing were conducted in Malawi, Zambia and Zimbabwe. In Zambia, the study conducted an additional four group discussions with adolescents and young people. Adolescents and young people were asked to describe their experience and perceptions of the impact of COVID-19 on their SRHR. Thematic analysis was used to analyze the data. Results Priority shifts resulted in the focus of service provision to the COVID-19 response. This led to shortages of already insufficient human resources due to infection and/or isolation, supply chain disruptions leading to shortages of important sexual and reproductive health (SRH)-related commodities and supplies, compromised quality of services such as counselling for HIV and overall limited AYP’s access to SRH information. Suggestions for interventions to improve SRH services include the need for a disaster preparedness strategy, increased funding for ASRHR, the use of community health workers and community-based ASRHR strategies, and the use of technology and social media platforms such as mHealth. Conclusion Disruption of SRH services for adolescents and young people due to pandemic related-restrictions, and diversion of resources/funding has had a ripple effect that may have long-term consequences for adolescents and young people throughout the East and Southern African region. This calls for further investment in adolescents and young people’s access to SRHR services as progress made may have been deterred
The role of community-based volunteers in integrating interactive playful parenting interventions for early childhood development in rural community systems for health in Zambia: a qualitative study
No full textAbstract Background Early childhood development (ECD) programmes play a crucial role in child development through the promotion of health, nutrition, early education, and playful parenting interventions. Community-based volunteers (CBVs) also play an essential role in facilitating the integration of ECD into rural community systems for health to promote interactive playful parenting for early childhood development. However, little is known about the role of CBVs integrating interactive playful parenting interventions for early childhood development and health in Zambia’s community systems for health. This study explores the role of community-based volunteers in integrating interactive playful parenting interventions for early childhood development in rural community systems for health in Zambia. Methods This was a qualitative study conducted in Katete and Petauke districts in Eastern Province, Zambia. We conducted 38 qualitative interviews including 12 focus group discussions (FGDs) with parents/caregivers and CBVs, 18 key informant interviews (KIIs) with district government and NGO stakeholders involved in the implementation, and 8 in-depth interviews (IDIs) with representatives from the Neighbourhood Health Committee (NHC). Data was analysed using thematic analysis guided by five domains of Atun’s conceptual framework on the integration of innovations into health systems: nature of the problem, attributes of the intervention, adoption system, broad system characteristics, and broad context. Findings For the nature of the problem, the stakeholders recognized ECD as a cross-cutting issue and highlighted the need for the delivery of ECD interventions that foster playful parenting while emphasizing the need for trained manpower to deliver these interventions. The attributes of the ECD interventions included the design of an ECD training package, provision of capacity-building training and the distribution of training materials and resources to support implementation. The degree of adoption of ECD interventions into community systems for health depended on actors’ perspectives, including community leadership, parents, and teachers on ECD activities. The broader system characteristics shaping ECD integration included district-based multisectoral collaboration in delivery of ECD, community-based collaboration, education and linkages on ECDs. Additionally, the availability of community structures played a significant role in shaping the delivery of ECD activities, while school administration was instrumental in coordinating ECD programmes. Healthcare workers played a key role in providing supportive supervision for delivery of ECD interventions. The broader context influencing the integration of ECD interventions was shaped by the policy and legal environment, political commitment to deliver ECD interventions, challenges related to inadequate allocation of human, financial, and material resources. Furthermore, the lack of infrastructure development posed a barrier to collaborative efforts in delivering ECD services effectively. Conclusion The integration of playful and interactive parenting highlights both barriers and facilitators, particularly regarding resources, personnel, and infrastructure. Addressing these challenges requires collaborative and coordinated efforts among the health, education, and social sectors to enhance the integration of ECD interventions. Strengthening ECD service delivery further necessitates increased resource allocation, expanded capacity building initiatives, and infrastructure development to support holistic child development and health
Individual, community and health systems factors influencing time to notification of tuberculosis: situating software and hardware bottlenecks in local health systems
No full textAbstract Background Despite several global interventions, tuberculosis (TB) remains a leading cause of death affecting millions of people globally. Many TB patients either have no access to quality care or go undetected by national health systems. Several multilevel factors account for under-detection of persons with TB. This study sought to explore patient-related software, community and health systems software and hardware factors influencing time to notification of TB in Lusaka District, Zambia. Methods This was an exploratory qualitative case study that adopted a software and hardware lens of conceptualizing health systems. Data were collected from across three sites – urban and peri-urban areas: Chongwe, Kafue, and Lusaka – within Lusaka Province, Zambia. Sixteen key informants - TB corner nurses, community TB treatment supporters, and TB program managers - were interviewed. Six focus groups were held with TB patients. Data were analyzed using thematic analysis. Results The study identified factors influencing timely TB notification, categorized into software and hardware elements. Patient-related software elements, including TB knowledge and awareness, and health-seeking behavior, are crucial for prompt notification among TB patients. In the community health system, software elements like social stigma and undesirable community attitudes towards contact tracing, and hardware elements such as unbalanced schedules, excessive workload and limited capacity of community TB treatment supporters contribute to delayed TB notification. In the formal health system, software elements like negative attitudes of health providers towards TB patients and demotivation of TB staff, and hardware elements such as high diagnostics and transportation costs, outdated diagnostics in primary care facilities, and slow referral mechanisms, can also delay TB notification. Conclusion Delays in time to TB notification are influenced by a combination of software (attitudinal and behavioral) and hardware (resource-related) elements across TB patients, community health systems, community TB treatment supporters, health providers, and TB staff. Addressing these factors, particularly social stigma, negative attitudes, and resource constraints, is crucial to improving timely TB detection and treatment
Disease status and morbidity management practices among hydrocele patients in Luangwa District.
No full textDisease status and morbidity management practices among hydrocele patients in Luangwa District.</p
Potential implementation strategies to address identified CHS barriers.
No full textPotential implementation strategies to address identified CHS barriers.</p
