79 research outputs found
Determinants of health care seeking for childhood illnesses in Nairobi slums
No full textThe practice of appropriate health seeking has a great potential to reduce the occurrence of severe and life-threatening child illnesses. We assessed the influence of socio-demographic, economic and disease-related factors in health care seeking for child illnesses among slum dwellers of Nairobi, Kenya. A survey round of the Nairobi Urban Demographic Surveillance System (NUDSS) generated information on 2-week child morbidity, illness symptoms, perceived illness severity and use of modern health services. During this round of data collection, interviewers visited a total of 15 174 households, where 3015 children younger than 5 years lived. Of the 999 (33.1%) children who were reported to have been sick, medical care of some sort was sought for 604 (60.5%). Lack of finances (49.6%) and a perception that the illness was not serious (28.1%) were the main reasons given for failure to seek health care outside the home. Health care seeking was most common for sick children in the youngest age group (0–11 months). Caretakers sought medical care more frequently for diarrhoea symptoms than for coughing and even more so when the diarrhoea was associated with fever. Perception of illness severity was strongly associated with health care seeking. Household income was significantly associated with health care seeking up to certain threshold levels, above which its effects stabilized. Improving caretaker skills to recognize danger signs in child illnesses may enhance health-seeking behaviour. Integrated Management of Child Illnesses (IMCI) programmes must be accessible free of charge to the urban poor in order to increase health care seeking and bring about improvements in child survival.<br/
Child morbidity and healthcare utilization in the slums of Nairobi, Kenya
No full textRapid urbanization and inequitable distribution of social services in African cities significantly contribute to the current deterioration of child health indicators in the region. Determinants of child morbidity and healthcare utilization among slum residents in Nairobi City, Kenya were assessed. Using a morbidity surveillance system, we visited 1691 households every 90?days for 9?months and registered 696 children below 5?years. 264 (37.9 per cent) children were reported to have been sick or injured at least once during the study period. A total of 447 illness episodes were reported among the 264 children (an average of 1.7 episodes per child). Cough, fever, diarrhea, skin problems and eye diseases made up the top five causes of morbidity. Child age below 1 year (OR = 2.7; 95 per cent CI = 1.33, 5.49) and having a working-mother (OR = 2.0; 95 per cent CI = 1.19, 3.31) were significantly associated with child morbidity report. About half of the mothers sought proper medical care for their sick children mostly from health institutions located outside the slum. Healthcare seeking within the slum heavily relied on informal private clinics. Working mothers sought medical care more often than non-working mothers (OR = 0.29; 95 per cent CI = 0.12, 0.7) and infants got priorities compared to older sick children (OR = 0.2; 95 per cent CI = 0.05, 0.83). We conclude that maternal engagement in non-formal low-paying jobs might in the long-run have a questionable gain in child survival among slum resident
Comparing maternal health indicators between teenagers and older women in sub-Saharan Africa: evidence from DHS
No full textDHS data from 21 countries in sub-Saharan Africa are used to examine maternal health indicators among teenagers. A comparison is made between teenagers and older women, based on logistic regression analyses for individual countries and multilevel logistic analyses applied to merged data, controlling for the effect of socio-economic and demographic factors. Teenagers are found more likely to report unintended fertility (especially mistimed), receive inadequate antenatal care (start late and attend fewer visits), have non-facility delivery, and have a small baby at birth. However, teenagers are less likely to have had Caesarean section deliveries compared to older women. There are significant differences in maternal health indicators between countries but the observed pattern by maternal age does not vary significantly between countries, suggesting that these patterns are generalizable for the region. For teenagers with characteristics associated with higher Caesarean section or unwanted fertility rates, being in countries with overall higher risks of these outcomes particularly amplifies their chances of experiencing them
BMC Public Health
No full textBackgroundThe linkage between the socio-economic inequality and HIV outcomes was analysed using data from a population-based household survey that employed multistage-stratified sampling. The goal is to help refocus attention on how HIV is linked to inequalities.MethodsA socio-economic index (SEI) score, derived using Multiple Correspondence Analysis of measures of ownership of durable assets, was used to generate three SEI groups: Low (poorest), Middle, and Upper (no so poor). Distribution of HIV outcomes (i.e. HIV prevalence, access to HIV/AIDS information, level of stigma towards HIV/AIDS, perceived HIV risk and sexual behaviour) across the SEI groups, and other background characteristics was assessed using weighted data. Univariate and multivariate logistic regression was used to assess the covariates of the HIV outcomes across the socio-economic groups. The study sample include 14,384 adults 15 years and older.ResultsMore women (57.5%) than men (42.3%) were found in the poor SEI [P<0.001]. HIV prevalence was highest among the poor (20.8%) followed by those in the middle (15.9%) and those in the upper SEI (4.6%) [P<0.001]. It was also highest among women compared to men (19.7% versus 11.4% respectively) and among black Africans (20.2%) compared to other races [P<0.001]. Individuals in the upper SEI reported higher frequency of HIV testing (59.3%) compared to the low SEI (47.7%) [P< 0.001]. Only 20.5% of those in poor SEI had \u201cgood access to HIV/AIDS information\u201d compared to 79.5% in the upper SEI (P<0.001). A higher percentage of the poor had a stigmatizing attitude towards HIV/AIDS (45.6%) compared to those in the upper SEI (34.8%) [P< 0.001]. There was a high personal HIV risk perception among the poor (40.0%) and it declined significantly to 10.9% in the upper SEI.ConclusionsOur findings underline the disproportionate burden of HIV disease and HIV fear among the poor and vulnerable in South Africa. The poor are further disadvantaged by lack of access to HIV information and HIV/AIDS services such as testing for HIV infection. There is a compelling urgency for the national HIV/AIDS response to maximizing program focus for the poor particularly women.20131 U2G PS 000570/PS/NCHHSTP CDC HHS/United StatesPEPFAR/United States24180366PMC42284121056
Unwanted Pregnancy and Induced Abortion Among Female Youths: A Case Study of Temeke District
No full textUnwanted pregnancy is the major cause of induced abortion, one of the leading causes of maternal mortality and morbidity in the world. Hundreds of thousands of women become pregnant without intending to, and many of them decide to end the pregnancies into abortion. Youth are more susceptible to unwanted pregnancies; this may be explained by the fact that premarital sexual activity is very common and reported to be on the rise in all parts of the world. This could be explained by the fact that youths are facing various problems with regards to their reproductive health needs including contraceptive use e.g. lack of information, misinformation, fear of side effects as well as social, cultural and economic barriers in accessing the family planning services, economic problems, violence as well as cultural and social beliefs. The study assessed the magnitude of unwanted pregnancies and induced abortion among female youths aged 15-24 years in Temeke district. Specifically the study was trying to examine the association between the magnitude of unwanted pregnancies and induced abortion among youths with other factors like contraceptive knowledge and use, socio demographic characteristics, socio cultural factors and sexual factors. Methodology : A cross sectional study, was conducted among 454 youths aged 15-24 years in Temeke district in Dar es Salaam using a Semi structured questionnaire , the respondents were being interviewed after they or their parents/guardian give a consent to the Prime investigator or research assistants. The mean age for fist sexual intercourse was 18 years. 57 % of the study respondents agreed to have used contraceptives, 33 % of all the pregnancies had unwanted pregnancy and 26 % of them ended up into abortions, out of all the abortions 87 % were induced. Out of all the abortions 74 % were the result of an unwanted pregnancy with P value of 0.001.Single youths were found to have more likely hood of having unwanted pregnancy and induced abortion with the proportion of 78 % (P=0.001) and 59 % (P=0.001) respectively. Students were more likely to have unwanted pregnancy, 83% (P =0.001) and induced abortion with the proportion of 83% (P =0.004). The prevalence of unwanted pregnancy and induced abortion were high, and most of the induced abortion was the result of unwanted pregnancy. There was low utilization of contraceptives among female youths but its association with the rate of unwanted pregnancy was found not to be statistically significant. Female youths who were single, unmarried and students were found to have high likelihood of having unwanted pregnancy and induced abortion. I would recommend that the Ministry of health and Social welfare in partnership with other implementing partners , local and international to focus their strategies to the ins school programming , addressing the need of the in school female youth on reproductive health issues. Different partners in partnership with the Government to address the issue of unemployment among female youths, to improve their economic status, hence for them to be able to take care of themselves as well as their children and to conduct a qualitative study in the community especially rural settings in order for them to have an in depth discussion with regard to unwanted pregnancies and induced abortion in order to compliment the findings from his study. This is because this study was conducted in semi urban area of which the results could be different from the rural settings
Sexual activity of out-of-school youth, and their knowledge and attitude about STDs and HIV/AIDS in Southern Ethiopia
No full textAbstract: A cross-sectional survey on sexual activity of out-of-school youth (15-24 years), and their knowledge and attitude towards STDs and HIV/AIDS was done in Awassa in June 1995. Most (94.4%) study subjects knew about HIV/AIDS, whereas, a lesser proportion of them knew the common STDs other than HIV/AIDS. Few of them were aware that the two are inter-related, one facilitating the transmission of the other. Forty-nine percent of the respondents (mean age 17+2 years) claimed to have started sex before the study date. Of these, 27.6% reported condom use during their most recent coitus. Thirty-six percent of the sexually active subjects admitted to have had more than one sex partner during the past 6 months (mean = 2.9+2). Lack of adequate knowledge, being careless often times, fear that condom will reduce sexual excitement, and pressure from sex partners appeared to be the common reasons for less use of condom during sex. The majority (91.0%) agreed that sex education and family life education for young people should be started early in life; in fact a quarter of them suggested as early as 10-12 years. It was concluded that out-of-school youth are sexually active; a considerable number of the sexually active are not practicing safe sex; and even if they have information about HIV/AIDS and STDs, it was not strong enough to bring about any significant behavioral change. This warrants the need for a continued expansion of Information, Education and Communication (IEC) linked with services to the youth, particularly the out-of-school youth which are at a higher risk. [Ethiop. J. Health Dev. 1998;12(1):17-22
Sexual activity of out-of-school youth, and their knowledge and attitude about STDs and HIV/AIDS in Southern Ethiopia
No full textAbstract: A cross-sectional survey on sexual activity of out-of-school youth (15-24 years), and their knowledge and attitude towards STDs and HIV/AIDS was done in Awassa in June 1995. Most (94.4%) study subjects knew about HIV/AIDS, whereas, a lesser proportion of them knew the common STDs other than HIV/AIDS. Few of them were aware that the two are inter-related, one facilitating the transmission of the other. Forty-nine percent of the respondents (mean age 17+2 years) claimed to have started sex before the study date. Of these, 27.6% reported condom use during their most recent coitus. Thirty-six percent of the sexually active subjects admitted to have had more than one sex partner during the past 6 months (mean = 2.9+2). Lack of adequate knowledge, being careless often times, fear that condom will reduce sexual excitement, and pressure from sex partners appeared to be the common reasons for less use of condom during sex. The majority (91.0%) agreed that sex education and family life education for young people should be started early in life; in fact a quarter of them suggested as early as 10-12 years. It was concluded that out-of-school youth are sexually active; a considerable number of the sexually active are not practicing safe sex; and even if they have information about HIV/AIDS and STDs, it was not strong enough to bring about any significant behavioral change. This warrants the need for a continued expansion of Information, Education and Communication (IEC) linked with services to the youth, particularly the out-of-school youth which are at a higher risk. [Ethiop. J. Health Dev. 1998;12(1):17-22
A comparison of pregnancy and child health outcomes between teenage and adult mothers in the slums of Nairobi, Kenya
No full textPregnancy and child heath outcomes among adolescents in Ethiopia
No full textBackground: Adolescent mothers and their children in developing countries fare less in most social and economic outcomes of early childbearing. Clinic-based non-representative data is the mainstream source of our current knowledge on these outcomes.
Objectives: The study compared teenage (below 20 years of age) and adult (20-34 years of age) mothers on sociodemographic characteristics, pregnancy outcomes, and child survival from a population-based national data.
Methods: Demographic and health survey (DHS) data was used to conduct the comparison. A total of 663 teenage and 721 adult mothers who gave birth to their first child within five years preceding the survey were identified from the dataset.
Results: Significantly larger proportion of the teenage mothers, were from rural areas, were poorer, less educated, and gave a history of no marriage. Controlling for potential socio-demographic confounders cancelled the difference between teenage and adult mothers in the rate of pre-natal care attendance, and operative and low birth weight deliveries. A larger percentage of home delivery was reported among teenage mothers. Children of teenage and adult mothers were likely to have comparable vaccination and morbidity status and received equivalent level of care during illness episodes. Maternal age was strongly associated with child survival. The result was contrasted with recent DHS data from Kenya and Uganda, which also showed similar pattern of pregnancy and child health outcomes.
Conclusions: Most factors affecting child survival might be associated with the poor socio-economic achievements of teenage mothers than with their age at childbirth. [Ethiop.J.Health Dev. 2004;18(2):90-95
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