Parental educational homogamy and under-five mortality in sub-Saharan Africa: Clarifying the association's intricacy

Effects of educational management on quality education in rural and urban primary schools in Ghana

To ensure inclusive, equitable quality education, and encourage educational opportunities for lifelong learning worldwide; the United Nations set sustainable development goals (SDG) to achieve quality education. Thus, using SDG 4 quality education and system theory, this research seeks to identify the effects of educational management on quality education in rural and urban primary schools in Ghana. Moreover, the mediating role of internet facilities in educational management and quality education relationhsip has been discussed. Thus, 745 urban and 471 rural head teachers and teachers from Ghana participated in an online survey. The data was compiled and executed by structural equation model using SPSS-AMOS. The result reveals that educational management has a positive effect on quality education in urban and rural schools. In addition, urban schools have more quality education than rural schools. Although internet facilities have a positive effect on quality education their absence weakens the quality of education in urban and rural schools. Moreover, it is recommended that the Ministry of Education should arrange professional training for supervisors and head teachers to boost their monitoring and supervision strategies. Furthermore, Parents Teacher Associations can provide funding to support the monitoring and supervision activities to achieve success. Lastly, quality internet facilities should be built with limited charges in rural and urban schools.

High-risk fertility behaviours among women in sub-Saharan Africa

BACKGROUND

High-risk fertility behaviours such as too early or advanced age at delivery, shorter birth interval, birth order and a higher number of live births to a woman often lead to adverse maternal and child health outcomes. We assessed high-risk fertility behaviours and their associated factors among women in sub-Saharan Africa (SSA).

METHODS

Data on 200 716 women pooled from the demographic and health surveys of 27 countries conducted between 2010 and 2020 in SSA were analysed. High-risk fertility behaviour from four indicators, mother aged <18 years at the time of delivery; mother aged >34 years at the time of delivery; mother of a child born after a short birth interval (<24 months) and mother of high parity (>3 children), was derived. Multi-level multi-variable logistic regression analyses were carried out and the results were presented as adjusted odds ratios at 95% confidence interval.

RESULTS

Women who were in polygamous marriages had higher odds of single and multiple high-risk fertility behaviour compared with their counterparts who were in monogamous marriages. Women with middle or high maternal decision-making power had higher odds of single and multiple high-risk fertility behaviours compared with those with low decision-making power. Single and multiple high-risk fertility behaviours were lower among women with access to family planning, those with at least primary education and those whose partners had at least primary education compared with their counterparts who had no access to family planning, those with no formal education and those whose partners had no formal education.

CONCLUSION

Family structure, women's decision-making power, access to family planning, women's level of education and partners' level of education were identified as predictors of high-risk fertility behaviours in SSA. These findings are crucial in addressing maternal health and fertility challenges. Policy makers, maternal health and fertility stakeholders in countries with high prevalence of high parity and short birth intervals should organize programs that will help to reduce the prevalence of these high-risk factors, taking into consideration the factors that predispose women to high-risk fertility behaviours.

Determinants of under-five mortality in Indonesia: A nationwide study

BACKGROUND

The mortality rate for infants and children under five in Indonesia is an ongoing challenge for the government, with figures exceeding the targets set for the country by the Sustainable Development Goals (SDGs).

OBJECTIVES

This study aims to discover the factors causing under-five mortality in Indonesia.

METHODS

This study will employ a cross-sectional study design with data sourced from the 2017 Indonesian Demographic and Health Survey (IDHS) between July and September 2017. The sample included 10,014 women who had given birth in the five years prior to the survey. The data was analyzed using Binary logistic regression with a significance level of p < 0.05.

RESULTS

The significant factors relating to under-five mortality in Indonesia are: mother's age at birth (AOR = 2.04; 95% CI 95% = 1.11-3.77); birth weight (AOR = 7.60; 95% CI 95% = 5.17-11.19); the sex of the child (AOR = 1.80; 95% CI 95% = 1.28-2.52); frequency of using the internet (AOR = 1.13; 95% CI 95% = 0.02-0.95); residence (AOR = 0.64; 95% CI 95% = 0.33-0.94); and birth interval (AOR = 0.52; 95% CI 95% = 0.29-0.92). Birth weight is the more likely cause for under-five mortality in Indonesia.

CONCLUSIONS

This study revealed that the characteristics of mothers, children, the area of residence, and the behavior of the mother affect the under-five mortality.

PRACTICE IMPLICATIONS

Pediatric nurses can have a role to play in developing knowledge about health for both mothers and families. Additionally, accessible health education on issues from planning a pregnancy to childcare should be promoted in both rural and urban areas as well as a campaign on proper hygiene practices.

Under-5 mortality in sub-Saharan Africa: is maternal age at first childbirth below 20 years a risk factor?

OBJECTIVES

This study aimed at examining the association between young maternal age at first childbirth and under-5 mortality in sub-Saharan Africa (SSA).

DESIGN AND SETTING

This cross-sectional study pooled nationally-representative data from the most recent Demographic and Health Surveys conducted in 30 countries in SSA from 2010 to 2019.

PARTICIPANTS

116 379 mothers of children under 5.

RESULTS

The prevalence of adolescent childbirth and death in children under 5 in SSA were 57.36% (95% CI 53.73% to 60.99%) and 4.10% (95% CI 3.65% to 4.54%), respectively. Children born to mothers whose first childbirth occurred at <20 years were 11% more likely to die before the age of 5 compared with those whose mothers' first childbirth occurred at age ≥20 years (adjusted odds ratio (aOR) 1.11; 95% CI 1.05 to 1.18). In terms of the covariates, the likelihood of under-5 mortality was higher among children born to single (aOR 1.54; 95% CI 1.41 to 1.67) and cohabiting mothers (aOR 1.10; 95% CI 1.01 to 1.21) compared with married mothers. Children born to mothers who were obese were more likely to die before the age of 5 compared with those born to mothers with normal body weight (aOR 1.17; 95% CI 1.09 to 1.26). The odds of under-5 mortality were higher among children whose weight at birth was <2500 g compared with those whose weight was ≥2500 g at birth (aOR 1.83; 95% CI 1.64 to 2.03).

CONCLUSIONS

The findings call for the need to enhance policies aimed at reducing under-5 mortality in SSA by reducing adolescent pregnancy and childbirth through family planning, comprehensive sexuality education, and the elimination of child marriage. Again, Since under-5 mortality among adolescent mothers is linked with their poor socio-economic status, there is the need for government and non-governmental organisations in SSA to introduce poverty alleviation programmes and improve access to both formal and informal education as a way of enhancing the socioeconomic status of adolescent mothers. Public health education, through continuous advocacy programmes should be done to encourage adolescent mothers to access antenatal care and health facility deliveries as a way of enhancing the survival status of their children. These interventions should be implemented, taking into consideration other characteristics of mothers such marital status and BMI and child's characteristics such as child's weight, which were found to be associated with high under-5 mortality.

Trends in the association between educational assortative mating, infant and child mortality in Nigeria

BACKGROUND

Existing knowledge has established the connection between maternal education and child survival, but little is known about how educational assortative mating (EAM), relates to childhood mortality. We attempt to examine this association in the context of Nigeria.

METHODS

Data was obtained from the 2008, 2013, and 2018 waves of the Nigeria Demographic and Health Survey, which is a cross-sectional study. The sample includes the analysis of 72,527 newborns within the 5 years preceding each survey. The dependent variables include the risk of a newborn dying before 12 months of age (infant mortality), or between the age of 12-59 months (child mortality). From the perspective of the mother, the independent variable, EAM, includes four categories (high-education homogamy, low-education homogamy, hypergamy, and hypogamy). The Cox proportional hazard regression was employed for multivariate analyses, while the estimation of mortality rates across the spectrum of EAM was obtained through the synthetic cohort technique.

RESULTS

The risk of childhood mortality varied across the spectrum of EAM and was particularly lowest among those with high-education homogamy. Compared to children of mothers in low-education homogamy, children of mothers in high-education homogamy had 25, 31 to 19% significantly less likelihood of infant mortality, and 34, 41, and 57% significantly less likelihood of child mortality in 2008, 2013 and 2018 survey data, respectively. Also, compared to children of mothers in hypergamy, children of mothers in hypogamous unions had 20, 12, and 11% less likelihood of infant mortality, and 27, 36, and 1% less likelihood of child mortality across 2008, 2013 and 2018 surveys, respectively, although not significant at p < 0.05. Both infant and child mortality rates were highest in low-education homogamy, as expected, lowest in high-education homogamy, and lower in hypogamy than in hypergamy. Furthermore, the trends in the rate declined between 2008 and 2018, and were higher in 2018 than in 2013.

CONCLUSION

This indicates that, beyond the absolute level of education, the similarities or dissimilarities in partners' education may have consequences for child survival, alluding to the family system theory. Future studies could investigate how this association varies when marital status is put into consideration.