Residential status and household wealth disparities in modern contraceptives use among women in Ghana: a cross-sectional analysis

BACKGROUND

Modern contraceptive refers to "a product or medical procedure that interferes with reproduction from acts of sexual intercourse". The aim of this study was to assess the relationship between residential status and wealth quintile, and modern contraceptive use among women in Ghana.

METHODS

We examined residential status and wealth quintile on contraceptive use analysing the 2006, 2011 and 2018 Multiple Indicator Cluster Surveys datasets. A sample of 30,665 women in their reproductive ages (15-49 years) were enrolled in the surveys across Ghana. STATA version 13 was used to process and analyse the data. It examined socioeconomic and demographic characteristics, assessed modern contraceptive use prevalence among women, and used logistic regression models to determine predictors. The results were presented in odds ratio and adjusted odds ratio with 95% confidence intervals. All statistical tests were measured with p < 0.05.

RESULTS

In the three survey years, the highest prevalence of modern contraceptive usage was observed in 2011 (27.16%). The odds of using modern contraceptive increased by 19% in rural places (AOR = 1.19; 95% CI = 1.097-1.284) compared to urban places. The likelihood of women in second (AOR = 1.17; 95% CI = 1.065-1.289), middle (AOR = 1.24; 95% CI = 1.118-1.385), and fourth (AOR = 1.25; 95% CI = 1.113-1.403) wealth quintile using contraceptives increased compared to those of low wealth quintile. With the interactive terms, rural-second (AOR = 1.38; 95% CI = 1.042-1.830), rural-middle (AOR = 1.45; 95% CI = 1.084-1.933), rural-fourth (AOR = 1.52; 95% CI = 1.128-2.059), and rural-high (AOR = 1.42; 95% CI = 1.019-1.973) were more likely to use contraceptives compared to urban-low women. Despite lower odds, women of the age groups 20-24 (AOR = 2.33; 95% CI = 2.054-2.637), cohabitaing (AOR = 1.07; 95% CI = 0.981-1.173), secondary or higher education (AOR = 1.55; 95% CI = 1.385-1.736), Central (AOR = 1.48; 95% CI = 1.296-1.682) and Eastern (AOR = 1.48; 95% CI = 1.289-1.695) regions significantly predicted modern contraceptive use.

CONCLUSION

Modern contraceptive use in Ghana is low. Women in rural-rich categories are more likely to use modern contraceptives. Background factors such as age, marital status, educational attainment, and previous child experiences predict modern contraceptive use. It is recommended for the intensification of contraceptive awareness and utilization for all reproductive age women, regardless of education, marriage, or wealth.

Health-seeking behaviour and practices among immigrant retail traders in an urban setting in North-Western Ghana

Purpose

This study aims to investigate the health-care-seeking behaviour and practices of West African migrants who reside and operate in Wa, Ghana, as itinerant retailers.

Design/methodology/approach

The study was cross-sectional and used the quantitative research approach. The analysis was done on a target population comprising 122 itinerant immigrant retail traders in Wa, Ghana. Fisher’s exact test and logistic regression were used to analyse the data.

Findings

Malaria was the commonest disease among them. Five in ten of the migrants preferred to report malaria episodes to a private health facility than to a government facility. Significant associations were identified between four dimensions (health facility, self-medication, home remedy and consult others) of health-seeking behaviour, and some background characteristics. The main reason why migrants prefer government health facilities was because of their better health personnel. They self-medicated because of easy accessibility of over-the-counter medicine shops. Also, when ill, the migrants usually consulted family members who would be in a position to take them home when their ailment worsens.

Research limitations/implications

Snowball sampling was used to select the respondents which could potentially lead to a sample that is not fully representative of the population in general.

Originality/value

Studies concerning migration and health in Ghana have been focused on internal migrants. Yet, minority immigrant traders equally encounter adverse health conditions but limited studies have been conducted to espouse their health-seeking behaviour. This study imperatively contributes to the subject matter that has limited literature in the country.

Geospatial analysis of childhood morbidity in Ghana

INTRODUCTION

Childhood morbidities are common in Ghana. The present study sought to geospatially analyze morbidities among children (0-23 months of age) using five different survey datasets (1993-2014) from the Ghana Demographic and Health Survey.

METHODS

Logistic regression was used to examine childhood morbidity within a place of residence. Then three spatial statistical tools were applied to analyze morbidities among children (0-23 months of age). These tools were: spatial autocorrelation (Global Moran's I)-used to examine clustering or dispersion patterns; cluster and outlier analysis (Anselin's local Moran's I)-to ascertain geographic composition of childhood morbidity clusters and outliers; and hot spot analysis (Getis-Ord G)-to identify clusters of high values (hot spots) and low values (cold spots).

RESULTS

Children in rural areas were much burdened with the occurrence of childhood morbidity. The study revealed positive spatial autocorrelation for childhood morbidity in Ghana. Childhood morbidity (diarrhoea, ARI, anaemia, and fever) clusters were identified within districts in the country. Children in rural areas were more likely to be morbid with diarrhoea, anaemia, and fever compared to those in urban areas. Hot spot districts for diarrhoea, anaemia and fever were mainly situated in semi-arid areas and those with ARI were located both at the semi-arid areas and coastal portions of Ghana.

CONCLUSION

Rural children are much exposed to have higher burden of a childhood morbidity compared to their urban counterparts. Most semi-arid districts in Ghana are burdened with diarrhoea, ARI, anaemia, and fever. To minimize the occurrence of childhood morbidity in Ghana, designing of more context-based interventions to target hot spots districts of these morbidities are required in order to use scarce resources judiciously.

Maternal challenges of exclusive breastfeeding and complementary feeding in Ghana

Mothers are recommended to exclusively breastfeed their infants for the first six months of their lives. Also, after the sixth month, breastfeeding should continue with added complementary foods to the diets of children. Studies designed to sought the views of mothers on breastfeeding practices are limited. The aim of this study was to explore challenges to breastfeeding practices by considering spatial, societal and maternal characteristics in Ghana. Twenty mothers aged 15–49 years were interviewed purposively in selected communities within two regions of the country. Thematic content analytical procedures were applied to interpret and present findings. Challenges (to both exclusive breastfeeding and complementary feeding) spanned across spatial (home and work places), societal, and maternal characteristics. Key themes identified were in relation to household chores, work schedules, family influence, low breast milk production, swollen breasts or sore nipples, access to food items and preparation or giving foods. Addressing these challenges would require co-creation of supportive environments between couples and significant others as well as tackling institutional barriers that obstruct adequate breastfeeding among mothers. On complementary feeding, there is the need to form community health volunteers help educate mothers more on how to appropriately use local foods to feed their children.

Consumption and drinking frequency of alcoholic beverage among women in Ghana: a cross-sectional study

Background

The consumption and drinking frequency of alcoholic beverage are identified with various individual factors. The aim of this study was to identify background characteristics of women associated with the consumption and drinking frequency of alcoholic beverage.

Methods

Data was extracted from the 2008 Ghana Demographic and Health Survey. The data consisted of women’s (aged 15–49 years) background characteristics and their reported history of consumption and drinking frequency of alcoholic beverage. A weighted sample size of 4916 women was used in the present study. Binary logistic regression and multinomial logistic regression were applied to examine the independent association between the covariates and the consumption and drinking frequency of alcoholic beverage respectively.

Results

Out of the 4916 women that were included in the study, 17.5% consumed alcoholic beverage in the past week. Factors that were found to be associated with women who consumed alcoholic beverage in a binary logistic regression model were age (15–19 years up to 45–49 years), region (Central, Greater Accra, Volta, Ashanti, Northern, Upper East, and Upper West), ethnicity (Ga or Dangme, Mole-Dagbani, Grussi, Gruma or Mande), wealth quintile (middle), and employment status [past 12 months] (those employed). In the multinomial logistic regression model, drinking frequency of alcoholic beverage was associated with women in the Central (none), Greater Accra Region (none and 4 or more times), Eastern (none and 2–3 times), Brong Ahafo (none), Upper East (none), those who attained primary education (4 or more times), Ga/Dangme ethnic group (none), those of middle wealth quintile (none), and those employed (4 or more times).

Conclusions

In the country, about 2 in 10 women consume alcoholic beverage and the drinking frequency of alcoholic beverage varied among women in the country. Hence, the maintenance of moderate alcoholic beverage consumption among women, where applicable, should be encouraged.

Determinants of exclusive breastfeeding among mothers in Ghana: a cross-sectional study

BACKGROUND

Mothers are encouraged to practice exclusive breastfeeding for the first six months of a child's life. The general objective of the study was to assess the predictors of exclusive breastfeeding among mothers in Ghana.

METHODS

This was a cross-sectional study using data from the 2008 Ghana Demographic and Health Survey (GDHS). The study sample (n = 316) was based on infants (0-5 months old) during the survey period; extracted from the individual (women) data set. Binary logistic regression was used to examine the association between selected independent variables.

RESULTS

In general, the rate of exclusive breastfeeding was 64 percent. Marital status, region and place of delivery were found to be associated with the practice of exclusive breastfeeding. The logistic regression model illustrated mothers from the Volta Region, those who delivered in a government health facility, and mothers who perceived their infants to be average in size were more likely to practice exclusive breastfeeding.

CONCLUSION

Appropriate health education programmes by the Ministry of Health targeting mothers who are less likely to practice exclusive breastfeeding are recommended.