Exploring health insurance and knowledge of the ovulatory cycle: evidence from Demographic and Health Surveys of 29 countries in Sub-Saharan Africa
- Authors: Zegeye, Betregiorgis , Idriss-Wheeler, Dina , Yaya, Sanni
- Date: 2023/09
- Subjects: health insurance , ovulactory cycle , Sub-Saharan Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13311 , vital:78423 , DOI: https://doi.org/10.1186/s12978-023-01675-z
- Description: Background Unplanned pregnancy continues to be a major public health concern in Sub-Saharan Africa (SSA). Understanding the ovulatory cycle can help women avoid unplanned pregnancy. Though a wide range of factors for ovulatory cycle knowledge in SSA countries has not been well assessed, the infuence of health insurance on ovu‑ latory cycle knowledge is largely unknown. As a result, we set out to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age. This study aims to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age in sub-Saharan Africa (SSA). Methods Demographic and Health Surveys (DHSs) data from 29 SSA countries were analyzed. The association between health insurance and ovulatory cycle knowledge was investigated using bivariate and multivariate multi‑ level logistic regression models among 372,692 women of reproductive age (15–49). The fndings were presented as adjusted odds ratios (AOR) with 95% confdence intervals (CI). A p-value of 0.05 was considered statistically signifcant. Results The pooled result shows that the prevalence of knowledge of ovulatory cycle in the studied 29 SSA countries was 25.5% (95% CI; 24.4%-26.6%). Findings suggest higher odds of ovulatory cycle knowledge among women cov‑ ered by health insurance (AOR=1.27, 95% CI; 1.02–1.57), with higher education (higher-AOR=2.83, 95% CI; 1.95– 4.09), from the richest wealth quintile (richest-AOR=1.39, 95% CI; 1.04–1.87), and from female headed households (AOR=1.16, 95% CI; 1.01–1.33) compared to women who had no formal education, were from the poorest wealth quintile and belonged to male headed households, respectively. We found lower odds of ovulatory cycle knowledge among women who had 2–4 parity history (AOR=0.80, 95% CI; 0.65–0.99) compared to those with history of one parity. Conclusions The fndings indicate that the knowledge of the ovulatory cycle is lacking in SSA. Improving health insurance enrollment should be considered to increase ovulatory cycle knowledge as an approach to reduce the region’s unplanned pregnancy rate. Strategies for improving opportunities that contribute to women’s empower‑ ment and autonomy as well as sexual and reproductive health approaches targeting women who are in poorest quin‑ tiles, not formally educated, belonging to male headed households, and having high parity should be considered.
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- Date Issued: 2023/09
Socioeconomic and geographic variations in antenatal care coverage in Angola: further analysis of the 2015 demographic and health survey
- Authors: Shibre, Gebretsadik , Zegeye, Betregiorgis , Idriss-Wheeler, Dina , Ahinkorah, Bright Opoku , Oladimeji, Olanrewaju , Yaya, Sanni
- Date: 2023
- Subjects: Prenatal care , Mothers -- Mortality , Health surveys
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/4489 , vital:44125 , https://doi.org/10.1186/s12889-020-09320-1
- Description: In African countries, including Angola, antenatal care (ANC) coverage is suboptimal and maternal mortality is still high due to pregnancy and childbirth-related complications. There is evidence of disparities in the uptake of ANC services, however, little is known about both the socio-economic and geographic-based disparity in the use of ANC services in Angola. The aim of this study was to assess the extent of socio-economic, urban-rural and subnational inequality in ANC coverage in Angola. We analyzed data from the 2015 Angola Demographic and Health Survey (ADHS) using the World Health Organization (WHO) Health Equity Assessment Toolkit (HEAT) software. The analysis consisted of disaggregated ANC coverage rates using four equity stratifiers (economic status, education, residence, and region) and four summary measures (Difference, Population Attributable Risk, Ratio and Population Attributable Fraction). To measure statistical significance, an uncertainty interval (UI) of 95% was constructed around point estimates. The study showed both absolute and relative inequalities in coverage of ANC services in Angola. More specifically, inequality favored women who were rich (D = 54.2, 95% UI; 49.59, 58.70, PAF = 43.5, 95% UI; 40.12, 46.92), educated (PAR = 19.9, 95% UI; 18.14, 21.64, R = 2.14, 95% UI; 1.96, 2.32), living in regions such as Luanda (D = 51.7, 95% UI; 43.56, 59.85, R = 2.64, 95% UI; 2.01, 3.26) and residing in urban dwellings (PAF = 20, 95% UI; 17.70, 22.38, PAR = 12.3, 95% UI; 10.88, 13.75). The uptake of ANC services were lower among poor, uneducated, and rural residents as well as women from the Cuanza Sul region. Government policy makers must consider vulnerable subpopulations when designing needed interventions to improve ANC coverage in Angola to achieve the 2030 Sustainable Development Goal of reducing global maternal mortality ratio to 70 deaths per 100,000 live births.
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- Date Issued: 2023