1
|
Sambou ML, Bafei SEC, Bass P. Factors associated with knowledge of hypertension risk factors and symptoms among Gambian women: A cross-sectional study based on the Gambia Demographic and Health Survey. Prev Med Rep 2024; 42:102754. [PMID: 38764757 PMCID: PMC11101705 DOI: 10.1016/j.pmedr.2024.102754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/04/2024] [Accepted: 05/06/2024] [Indexed: 05/21/2024] Open
Abstract
Background We examined the factors associated with knowledge of hypertension risk factors and symptoms among Gambian women. Methods This cross-section study was based on 11, 865 female participants (aged 15-49 years) of The Gambia Demographic and Health Survey 2019-2020. We performed descriptive statistics, and multivariate-adjusted logistic regression models. Results Only 34.89 % and 36.82 % of the participants knew at least one risk factor and symptom of hypertension, respectively. Women who had never measured their blood pressure had a reduced odds of knowing a hypertension risk factor (OR = 0.68; 95 %CI: 0.60---0.77; P < 0.01) and symptom (OR = 0.56; 95 %CI: 0.49---0.64; P < 0.01). Compared to women with higher education, those with no education had a lower odds of knowing a hypertension risk factor (OR = 0.18; 95 %CI: 0.12---0.27; P < 0.01) and symptom (OR = 0.32; 95 %CI: 0.23---0.45; P < 0.01). Similarly, women who never used the internet had reduced odds of mentioning a hypertension risk factor (OR = 0.55; 95 %CI: 0.48---0.61; P < 0.01) and symptom (OR = 0.61; 95 %CI: 0.54---0.69; P < 0.01). Those who never watched television had decreased odds of knowing a hypertension risk factor (OR = 0.74; 95 %CI: 0.63--0.86; P < 0.01) and symptoms (OR = 0.68; 95 %CI: 0.58---0.80; P < 0.01). Conclusion: Fewer women could mention at least one hypertension risk factor and symptom. We also found that knowledge of hypertension risk factors and symptoms was associated with education level and socio-economic status.
Collapse
Affiliation(s)
- Muhammed Lamin Sambou
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, The University of the Gambia, Brikama Campus, Gambia
| | | | - Paul Bass
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, The University of the Gambia, Brikama Campus, Gambia
| |
Collapse
|
2
|
Biks GA, Shiferie F, Tsegaye DA, Asefa W, Alemayehu L, Wondie T, Seboka G, Hayes A, RalphOpara U, Zelalem M, Belete K, Donofrio J, Gebremedhin S. In-depth reasons for the high proportion of zero-dose children in underserved populations of Ethiopia: Results from a qualitative study. Vaccine X 2024; 16:100454. [PMID: 38327767 PMCID: PMC10847948 DOI: 10.1016/j.jvacx.2024.100454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/18/2024] [Accepted: 01/30/2024] [Indexed: 02/09/2024] Open
Abstract
Increasing attention is being given to reach children who fail to receive routine vaccinations, commonly designated as zero-dose children. A comprehensive understanding of the supply- and demand-side barriers is essential to inform zero-dose strategies in high-burden countries and achieve global immunization goals. This qualitative study aimed to identify the barriers for reaching zero-dose and under-immunized children and what and explore gender affects access to vaccination services for children in Ethiopia. Data was collected between March-June 2022 using key informant interviews and focus group discussions with participants in underserved settings. The high proportion of zero-dose children was correlated with inadequate information being provided by health workers, irregularities in service provision, suboptimal staff motivation, high staff turnover, closure and inaccessibility of health facilities, lack of functional health posts, service provision limited to selected days or hours, and gender norms viewing females as responsible for childcare. Demand-side barriers included religious beliefs, cultural norms, fear of vaccine side effects, and lack of awareness and sustained interventions. Recommendations to increase vaccination coverage include strengthening health systems such as services integration, human resources capacity building, increasing incentives for health staff, integrating vaccination services, bolstering the EPI budget especially from the government side, and supporting reliable outreach and static immunization services. Additionally, immunization policy should be revised to include gender considerations including male engagement strategies to improve uptake of immunization services.
Collapse
Affiliation(s)
| | | | | | | | | | - Tamiru Wondie
- Project HOPE, Ethiopia Country Office, Addis Ababa, Ethiopia
| | - Gobena Seboka
- Project HOPE, Ethiopia Country Office, Addis Ababa, Ethiopia
| | | | | | - Meseret Zelalem
- Maternal and Child Health, Minister of Health, Addis Ababa, Ethiopia
| | - Kidist Belete
- USAID Ethiopia Country Office, Addis Ababa, Ethiopia
| | - Jen Donofrio
- Bill and Melinda Gates Foundation, United States
| | | |
Collapse
|
3
|
Milosavljevic B, Cook CJ, Fadera T, Ghillia G, Howard SJ, Makaula H, Mbye E, McCann S, Merkley R, Mshudulu M, Saidykhan M, Touray E, Tshetu N, Elwell C, Moore SE, Scerif G, Draper CE, Lloyd-Fox S. Executive functioning skills and their environmental predictors among pre-school aged children in South Africa and The Gambia. Dev Sci 2023:e13407. [PMID: 37128134 DOI: 10.1111/desc.13407] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/11/2023] [Accepted: 04/18/2023] [Indexed: 05/03/2023]
Abstract
Executive functions (EFs) in early childhood are predictors of later developmental outcomes and school readiness. Much of the research on EFs and their psychosocial correlates has been conducted in high-income, minority world countries, which represent a small and biased portion of children globally. The aim of this study is to examine EFs among children aged 3-5 years in two African countries, South Africa (SA) and The Gambia (GM), and to explore shared and distinct predictors of EFs in these settings. The SA sample (N = 243, 51.9% female) was recruited from low-income communities within the Cape Town Metropolitan area. In GM, participants (N = 171, 49.7% female) were recruited from the rural West Kiang region. EFs, working memory (WM), inhibitory control (IC) and cognitive flexibility (CF), were measured using tablet-based tasks. Associations between EF task performance and indicators of socioeconomic status (household assets, caregiver education) and family enrichment factors (enrichment activities, diversity of caregivers) were assessed. Participants in SA scored higher on all EF tasks, but children in both sites predominantly scored within the expected range for their age. There were no associations between EFs and household or familial variables in SA, except for a trend-level association between caregiver education and CF. Patterns were similar in GM, where there was a trend-level association between WM and enrichment activities but no other relationships. We challenge the postulation that children in low-income settings have poorer EFs, simply due to lower socioeconomic status, but highlight the need to identify predictors of EFs in diverse, global settings. RESEARCH HIGHLIGHTS: Assessed Executive Functioning (EF) skills and their psychosocial predictors among pre-school aged children (aged 3-5 years) in two African settings (The Gambia and South Africa). On average, children within each setting performed within the expected range for their age, although children in South Africa had higher scores across tasks. There was little evidence of any association between socioeconomic variables and EFs in either site. Enrichment activities were marginally associated with better working memory in The Gambia, and caregiver education with cognitive flexibility in South Africa, both associations were trend-level significance.
Collapse
Affiliation(s)
- Bosiljka Milosavljevic
- Department of Psychology, University of Cambridge, Cambridge, UK
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK
| | - Caylee J Cook
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tijan Fadera
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Keneba, The Gambia
| | - Giulia Ghillia
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK
- Department of Women and Children's Health, King's College London, London, UK
| | - Steven J Howard
- Early Start and School of Education, University of Wollongong, Wollongong, New South Wales, Australia
| | - Hleliwe Makaula
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ebrima Mbye
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Keneba, The Gambia
| | - Samantha McCann
- Department of Women and Children's Health, King's College London, London, UK
| | - Rebecca Merkley
- Department of Cognitive Science, Carleton University, Ottawa, Canada
| | - Mbulelo Mshudulu
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mariama Saidykhan
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Keneba, The Gambia
| | - Ebou Touray
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Keneba, The Gambia
| | - Nosibusiso Tshetu
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Clare Elwell
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Sophie E Moore
- Department of Women and Children's Health, King's College London, London, UK
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Catherine E Draper
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sarah Lloyd-Fox
- Department of Psychology, University of Cambridge, Cambridge, UK
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK
| |
Collapse
|
4
|
Davies B, Olivier J, Amponsah-Dacosta E. Health Systems Determinants of Delivery and Uptake of Maternal Vaccines in Low- and Middle-Income Countries: A Qualitative Systematic Review. Vaccines (Basel) 2023; 11:vaccines11040869. [PMID: 37112781 PMCID: PMC10144938 DOI: 10.3390/vaccines11040869] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
Maternal vaccination is considered a key component of the antenatal care package for improving maternal and child health. Low- and middle-income countries (LMICs) fall short of global targets to prevent maternal and neonatal deaths, with a disproportionate burden of vaccine-preventable diseases. Strategies towards ending preventable maternal mortality necessitate a health systems approach to adequately respond to this burden. This review explores the health systems determinants of delivery and uptake of essential maternal vaccines in LMICs. We conducted a qualitative systematic review of articles on maternal vaccination in LMICs, published between 2009 and 2023 in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Thematic analysis was conducted to identify key themes in the literature, interpreted within a conceptual framing that explores the systems determinants influencing maternal vaccines. Our search yielded 1309 records, of which 54 were included, covering 34 LMICs. Most of the included studies were from South America (28/54) and included pregnant women as the primary study population (34/54). The studies explored influenza (25/54) and tetanus toxoid (20/54) vaccines predominantly. The findings suggest that systems hardware (lack of clear policy guidelines, ineffective cold-chain management, limited reporting and monitoring systems) are barriers to vaccine delivery. Systems software (healthcare provider recommendations, increased trust, higher levels of maternal education) are enablers to maternal vaccine uptake. Findings show that formulation, dissemination and communication of context-specific policies and guidelines on maternal vaccines should be a priority for decision-makers in LMICs.
Collapse
Affiliation(s)
- Bronte Davies
- Health Policy and Systems Division, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town 7925, South Africa
- Vaccines for Africa Initiative, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Jill Olivier
- Health Policy and Systems Division, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Edina Amponsah-Dacosta
- Vaccines for Africa Initiative, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town 7925, South Africa
| |
Collapse
|
5
|
Demir R, Kaya Odabaş R. A systematic review to determine the anti-vaccination thoughts of pregnant women and the reasons for not getting vaccinated. J OBSTET GYNAECOL 2022; 42:2603-2614. [PMID: 36018038 DOI: 10.1080/01443615.2022.2114327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The aim of this study was to determine the anti-vaccination thoughts of pregnant women and the reasons for not getting vaccinated. In this study, data was obtained by retrospectively scanning the cross-sectional and qualitative studies published in the databases of 'PubMed, Cochrane, EBSCOhost, ULAKBİM and Google Scholar' in Turkish and English languages between 2011-2021. The PRISMA method was used in the preparation of the systematic review. In the studies reviewed, it was determined that the rate of pregnant women who were against the vaccine ranged from 6.2% to 98.6%, and the opinions of pregnant women against vaccination and the reasons for not getting vaccinated are presented under seven themes. The results of the study were considered important in terms of showing that quality and important studies were carried out in the literature on the subject and that the data were presented.IMPACT STATEMENTWhat is already known on this subject? Today, with the global coronavirus pandemic, vaccines and their effects are on the agenda again. Especially in pregnant women, opposition to vaccination and not getting vaccinated have emerged for various reasons.What do the results of this study add? The anti-vaccine thoughts of the pregnant women and the reasons for not getting vaccinated were mostly as follows: insufficient level of knowledge, mistrust of vaccines, perception of low infection risk, misconceptions and beliefs about the safety, content, side effects and efficacy of vaccines, worry and fear about the side effects of vaccines, the thought that the vaccine will harm herself and the baby, causes arising from healthcare professionals, financial, temporal and logistical barriers.What the implications are of these findings for clinical practice and/or further research? Scientific studies that can provide comprehensive and strong evidence about vaccine hesitancy and its causes, methods of increasing social approval in vaccination, and solutions should be proposed in the light of these researches in the fight against vaccine rejection.
Collapse
Affiliation(s)
- Rukiye Demir
- Department of Midwifery, Faculty of Health Sciences, Canakkale Onsekiz Mart University, Canakkale, Turkiye
| | - Resmiye Kaya Odabaş
- Department of Midwifery, Faculty of Health Sciences, Kocaeli University, Kocaeli, Turkiye
| |
Collapse
|