Chimezie Igwegbe Nzoputam

Background. The cost of health financing is an age-long social challenge in resource-constrained settings. Out-of-pocket (OOP) health spending adversely affects maternal healthcare provisions and use, making health insurance one of the most effective social interventions. Objective. The purpose of this research was to study the effect of OOP health expenditure on socioeconomic factors and health insurance coverage among Ghanaian women. Materials and Methods. Secondary statistical data pulled out from Ghana Demographic and Health Survey (GDHS)2014 was investigated. A sample of 9,396 women whose ages ranged from 15 to 49 years was studied. We used marginal predictive model to examine the interaction effect between socioeconomic factors and health insurance coverage on OOP health expenditure. The significance level was determined at 5. Results. Overall, about 41.9 (95 CI: 39.444.4) of Ghanaian women reported OOP health expenditure for drugs and services. Amongst those covered by health insurance, this was 37.9 (95 CI: 35.344.4). The marginal interaction effects of OOP health expenditure were higher for women in the lowest neighborhood socioeconomic disadvantage group (42.6) than those in the highest neighborhood socioeconomic disadvantage group (26.0) who were covered by health insurance. In addition, the marginal interaction effects of OOP health expenditure were found to be greater among women who had higher education (43.8) compared with those who had no formal education (34.0) who were covered by health insurance. Furthermore, the marginal interaction effects of OOP health expenditure were higher for rural (39.0), than their urban counterpart (36.6.0) who were under the covering of health insurance. Conclusion. There is a gap in health insurance coverage, which leads to increased OOP health expenditure. The OOP health expenditure effect was more concentrated among high socioeconomic women with health insurance. The healthcare systems stakeholders should implement policies aimed at eliminating OOP health expenditure for maternal health services.

Sexual orientation is a multifaceted and multidimensional concept that researchers and practitioners define differently based on its theoretical and practical deliberations. This study examined the determinants of sexual identity and preferences of female students in a Tertiary Institution in Southern Nigeria. This is an analytical cross-sectional study which was conducted among 423 female students in University of Benin, Benin City, Nigeria. Extracted data was analyzed using IBM SPSS version 26.0. Descriptive statistics were used to show the characteristics of the women and multivariate logistic regression was used to examine determinants of sexual preference and sexual identity. Statistical significance was set at 5%. The age of the respondents was 21.4 ± 2.6 years. Approximately 53.0% (n = 224) of the participants have had sexual intercourse, with the mean SD age of sexual debut being 18.3 ± 2.3 years. Majority 309 (73.1%) of the respondents’ sexual preference was vaginal, while only 18.2% and 8.7% preferred oral and anal sex respectively. Approximately 92.0% (n = 389) of the respondents were into heterosexual sex; 4.2% were bisexual (n = 18), and 3.8% (n = 16) were homosexuals. Significant predictors of sexual identity and preference were age, parents’ marital status and guardian of the respondents. Though, most respondents preferred vaginal sexual intercourse and majority were heterosexual, there are still considerable number of bisexuals and homosexuals, and those who preferred both oral and anal sex. There is need for young people to be aware of their sexuality, especially among female students in the university where the study was conducted.

Background: HIV remains a global public health concern, and women continue to be disproportionately affected. Understanding the factors associated with pre-exposure prophylaxis awareness among women is crucial as an effective HIV prevention strategy. Objectives: We investigated the prevalence and associated factors of pre-exposure prophylaxis awareness among women in Burkina Faso. Design: This was a cross-section study that used population-based data. Methods: A total of 17,659 women of reproductive age (15–49 years) from the 2021 Burkina Faso Demographic and Health Survey were analyzed. Percentage and multivariable logistic regression model were used to examine the prevalence and factors associated with pre-exposure prophylaxis awareness. Results: The prevalence of pre-exposure prophylaxis awareness was 8.2% (95% confidence interval = 7.8%–8.6%). Women’s age was positively associated pre-exposure prophylaxis awareness. Women with primary and secondary education had 39% and 48% higher odds of pre-exposure prophylaxis awareness, when compared with women with no formal education. The odds of pre-exposure prophylaxis awareness were 1.40 (95% confidence interval = 1.19–1.66) times higher among Christians when compared with the Muslims. Women who were exposed to mass media including newspaper or magazine, radio, TV, and Internet had higher odds of pre-exposure prophylaxis awareness, when compared with those without exposure to mass media channels. Women who have previously tested for HIV had 37% higher odds of pre-exposure prophylaxis awareness, when compared with those who have not been tested (adjusted odds ratio = 1.37; 95% confidence interval = 1.09–1.72). Conclusion: This study found women’s age, geographical region, education, religion, exposure to mass media channels, employment, and HIV testing to be associated with pre-exposure prophylaxis awareness. These findings can inform the development of targeted interventions and public health campaigns to increase awareness and practice to pre-exposure prophylaxis, particularly among key population.

Background: Human immunodeficiency virus (HIV) self-testing (ST) is a convenient and discreet practice to know HIV status. It is required to reach the underserved population subgroups. We examined the uptake and factors associated with HIVST among reproductive-aged South African women. Methods: A sample of 8182 women from 2016 South African Demographic and Health Survey data were analysed. Percentage and multivariable logistic regression model were conducted. The significance level was set at p < 0.05. Results: Approximately 3.1% of women had HIVST uptake. Respondents with primary education had a 75% reduction in the odds of HIVST, compared with women who had no formal education. Women who are employed were 1.44 times as likely to have HIVST uptake compared to those not employed. Women aged 20–24 years, 25–29 years, 30–34 years, and 40–44 years had about two times higher odds of HIVST, when compared with women aged 15–19 years. Women who read newspaper or magazine less than once a week or at least once a week were 1.90 and 2.25 times as likely to have HIVST uptake, respectively, when compared with those who do not read at all. Conclusion: The prevalence of HIVST uptake was low. HIVST was associated with women’s sociodemographic characteristics. The findings highlight the importance of addressing women’s needs to know their HIV status. Contribution: This study adds to the body of literature in understanding the utilisation patterns of HIVST across women in South Africa.

Background: Human cytomegalovirus (HCMV) is an important pathogen in immunocompromised individuals where it causes end organ diseases leading to increased morbidity and mortality. The aim of this study was to determine the prevalence of HCMV infection and its associated risk factors among HIV patients in Edo State, Nigeria. Methods: A total of 150 HIV patients consisting of 80 males and 70 females were enrolled for this study. About 4 mL of venous blood was aseptically collected from each participant by venipuncture and was centrifuged to obtain serum. The serum was screened by ELISA for HCMV IgG and IgM antibodies. Results: The results obtained were analyzed using SPSS version 20 for data analysis. An overall prevalence of 32.7% for HCMV IgM antibodies was recorded among the HIV patients. Males had a higher prevalence of 55.1% HCMV IgM antibodies than their female counterparts with 44.9% HCMV IgM antibodies. HCMV was more prevalent among the age group 60 years, and 40–59 years recorded a prevalence of 12.2% and 6.1%, respectively. Conclusions: The co-occurrence of HCMV IgG and IgM antibodies, religion and location significantly influenced the acquisition of HCMV infection among HIV patients. Integrating HIV prevention by spreading awareness and early diagnosis of HCMV is key to reducing complications from these viral infections in HIV disease patients.

Maternal mortality ratios in sub-Saharan Africa remain high and worrisome. Moreover, maternal health indicators have remained poor despite large efforts in the last two decades. This study assesses maternal mortality patterns by age and country. The demographic and health survey data were used for the study. Based on the results, countries with the lowest adult female mortality rate include Senegal, Comoros, Rwanda, Mauritania, Sao Tome and Principe, Gambia, and Ethiopia. In addition, Chad (44.7%), Niger (38.7%), the Congo Democratic Republic (34.8%), Nigeria (34.2%), Mauritania (32.0%), Senegal (29.2%), Liberia (28.8%), Benin (27.8%), and Guinea (27.5%), respectively, reported the highest female deaths that are pregnancy-related. Overall, Lesotho (1024; 95% CI: 731–1318), Liberia (913; 95% CI: 638–1189), Chad (860; 95% CI: 728–993), Congo Democratic Republic (846; 95% CI: 690–1003), Sierra Leone (796; 95% CI: 632–960) and Guinea (724; 95% CI: 531–916) had the leading pregnancy-related mortality ratio per 100,000 live births. The study found that the patterns of death vary across different countries. There is a need for concerted efforts to reduce pregnancy-related deaths in sub-Saharan countries.

The impact of chronic diseases on labour force participation is not frequently examined or considered as part of cost-of-illness studies. The aim of this study was to determine the impact of chronic diseases on labour force participation among South African women. This study included 6126 women from the 2016 South African Demographic and Health Survey. Labour force participation/employment was the outcome variable. Data were analyzed in percentage and multivariable binary logistic regression. Results showed that approximately 28.7% of women participated in the labour force and about 5.0% had diabetes. The prevalence of diabetes among women who are not in the labour force was 5.5%, whereas those in the labour force reported 3.8% prevalence of diabetes. The diabetic women had 35% reduction in labour force participation when compared with non-diabetic women (aOR = 0.65; 95% CI: 0.48 to 0.89). Geographical region was associated with labour force participation. Rural women and those currently in union/living with a man had 35% (aOR = 0.65; 95% CI: 0.56 to 0.76) and 27% (aOR = 0.73; 95% CI: 0.64 to 0.85) reduction in labour force participation, respectively, when compared with their urban and single counterparts. The findings of this study revealed that diabetes was significantly associated with reduction in labour force participation among women.

Objective: We investigated the prevalence and risk factors of ARI in children under 5 years old in 37 SSA countries. Methods: Data from Demographic and Health Survey (DHS) of 37 African countries was examined in this analysis. Data from children under the age of 5 years old were examined. Forest plot was used to identify disparities in the occurrence of ARIs across SSA countries. Results: We observed a higher prevalence of ARI among children under 5 in Uganda, Kenya, Sao Tome and Principe (9% each), Gabon, Chad, Eswatini (8% each), Burundi, Ethiopia, Congo Democratic Republic (7.0% each). The prevalence of ARI among under-five children who sought medical advice/treatment from health facility was higher in South Africa (88%), Sierra Leone (86%), Tanzanian (85%), Guinea (83%) and Uganda (80%). The prevalence rate of ARI among under-five children who received antibiotics was higher in Tanzania (61%), Sao Tome and Principe (60%), Rwanda and Congo (58% each), Angola (56.0%), Mozambique (54.0%), Kenya (53.0%), Namibia (52.0%) and Gabon (50.0%). This study found that the household wealth index, maternal education, and urban residence were significantly associated with ARI (p <0.001). A higher prevalence of ARI was observed among urban residents, low income families, and those with mothers with lower education. Conclusion: ARI prevalence could be reduced by improving household socioeconomic status, child nutrition and community awareness of indoor and outdoor pollution. Interventions and programs focused on early diagnosis, treatment and prevention of ARIs are crucial in reducing ARIs particularly in developing countries.

Sexually transmitted infection refers to a group of clinical syndromes that can be acquired and transmitted through sexual activity and are caused by a variety of pathogens such as bacteria, fungi, viruses, and parasites. Methods: Demographic and Health Survey data involving women aged 15–49 years were analyzed for this study. The surveys were conducted between 2006–2021. Statistical significance was determined at p < 0.05. Results: From the results, Liberia (33.0%), Mali (14.0%), Guinea (13%), Uganda, and Sierra Leone (12.0% each) had the highest STI prevalence. Prominently from Western sub-Saharan Africa sub-region, Liberia (40.0%), Guinea (31.0%), Mali (28.0%), Cote d’Ivoire (24.0%), Ghana (23.0%) and Mauritania (22.0%) have the highest prevalence of reporting a bad smelling or abnormal genital discharge. In addition, Liberia (30.0%), Uganda (13.0%) and Malawi (10.0%) have the highest prevalence of reporting genital sores or ulcers. Liberia (48.0%), Guinea (34.0%), Mali (32.0%), Ghana and Mauritania (25.0% each) and Uganda (24.0%) reported the leading prevalence of STI, genital discharge, or a sore or ulcer. Conclusion: The prevalence of vaginitis varied according to women’s characteristics. In many countries, younger women, urban dwellers, educated women, rich and unmarried women reported a higher prevalence of STI, genital discharge, or a sore or ulcer. Women should be educated on the advantages of proper hygiene, and prevention and control of STIs. Program planners and policymakers should assess and improve the collaboration and coordination of nutritional and family health programs aimed at addressing women’s health issues.

Background: Overweight and obesity in adults are on the rise around the world, contributing significantly to noncommunicable disease deaths and disability. Women bear a disproportionate burden of obesity when compared with men, which has a negative impact on their health and the health of their children. The objective of this study was to examine the country-level prevalence of overweight and obesity among women of reproductive age in sub-Saharan countries. Methods: A total of 504,264 women from 2006 to 2021 were examined using cross-sectional Demographic and Health Surveys data. The outcome variables for this study include: (a) women who are overweight according to body mass index (BMI) (25.0–29.9kg/m²); (b) women who are obese according to BMI (≥30.0 kg/m²). Results: Eswatini (28%), Mauritania (27%), South Africa (26%), Gabon, Lesotho and Ghana (25% each) had the highest prevalences of overweight. In addition, obesity prevalence was highest in South Africa (36%), Mauritania (27%), Eswatini (23%), Lesotho (20%), Gabon (19%) and Ghana (15%), respectively. Overweight and obesity were more prevalent among older women, those living in urban areas, women with secondary/higher education and those in the richest household wealth quintiles. Conclusion: The risk factors for overweight and obesity, as well as the role that lifestyle changes play in preventing obesity and the associated health risks, must be made more widely known. In order to identify those who are at risk of obesity, we also recommend that African countries regularly measure their citizens’ biometric characteristics.