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Background: Sexual coercion is one of the major public health concerns globally. This is even more worrying among young people with disabilities (YPWDs). This study assessed the prevalence and factors associated with sexual coercion among in-school young people with disabilities in Ghana., Methods: Using a cross-sectional study design, pre-tested questionnaires were used to collect data from 979 YPWDs in 15 special schools for the visually and hearing impaired in Ghana. Sexual coercion was the outcome variable. Both descriptive (frequencies and percentages) and inferential analysis (binary logistic regression) were conducted., Results: About 68% reported that they had been sexually coerced at some point in their lifetime. This was higher among males (69.9%) compared to females (66.8%). Those aged 15-19 (72.19%) had the highest prevalence compared to those aged 20-24 (61.74%). YPWDs in Junior High School [JHS] [aOR = 1.722; CI = 1.227,2.417], and those in the coastal zone [aOR = 1.616; CI = 1.068,2.443] had higher odds of being coerced. However, those belonging to the Islamic religion [aOR = 0.266; CI = 0.0764,0.928] and the visually impaired [aOR = 0.477; CI = 0.318,0.716] had lower odds of being coerced compared to those with no religion, and the hearing impaired, respectively., Conclusion: There is a relatively high prevalence of sexual coercion among in- school YPWDs in Ghana. This is significantly associated with level of education, ecological zone, religion, and the type of disability. This calls for a concerted effort by policy makers such as the Ghana Education Service, Ghana Federation of the Disabled, Ministry of Education, Ministry of Gender, Children and Social Protection to intensify sex education and put in pragmatic steps to halt this serious public health issue., (© 2024. The Author(s).)

Background: Suicide represents a major public health concern, affecting a significant portion of individuals. However, there remains a gap in understanding the age and sex disparities in the occurrence of suicide. Therefore, this study aimed to investigate the sex-related inequalities in suicide rates in Ghana from 2000 to 2019., Methods: We utilized data from the WHO Health Equity Assessment Toolkit (HEAT) online software. We analysed sex differences in both crude and age-standardized suicide rates in Ghana spanning from 2000 to 2019. Crude and age-adjusted suicide rates were calculated based on the International Classification of Diseases (ICD) definition and coding of suicide mortality. We measured inequality in terms of sex. Two inequality indicators were used to examine the suicide rates: the difference (D) and the ratio (R)., Results: Age-standardized and crude suicide rates in Ghana were higher among men from 2000 to 2019. Between 2000 and 2007, the age-standardized suicide rate for women rose steadily and declined slightly between 2008 and 2019. Age-standardized suicide rates for men increased consistently from 2000 to 2010, then declined steadily from 2011 to 2019. The crude suicide rates among men and women followed similar patterns. The widest absolute inequality in crude suicide rates (D) was recorded in 2013 (D=-11.91), while the smallest difference was observed in 2000 (D=-7.16). We also found the greatest disparity in age-standardized rates in 2011 (D=-21.46) and the least in 2000 (D=-14.32). The crude suicide rates increased with age for both men and women aged 15-54 years and 55-85+ years respectively. However, the increased rate was higher in men than in women across all age groups surveyed. A similar pattern was observed for relative inequality in both crude and age-standardized rates of suicide., Conclusion: The suicide rate in Ghana has declined over time. Suicide is more common among older men. Inequalities in suicide rates, in both absolute and relative terms, are similar. There is a need to monitor suicide trends in Ghana, especially among older men. Moreover, the findings could serve as a basis for future studies on suicide in Ghana., (© 2024. The Author(s).)

Background: Intimate partner violence has adverse outcomes on the sexual and reproductive health of women. In this study, we examined the association between sexual violence and multiple high-risk fertility behaviours (MHRFB) among women in sub-Saharan Africa (SSA)., Methods: We conducted a cross-sectional analysis of data pooled from the most recent Demographic and Health Surveys of 20 countries in SSA. We included countries with most recent datasets conducted from 2015 to 2021 and had data on all variables included in the study. A weighted sample of 88,011 was included in the study. We used a multilevel binary logistic regression to examine the association between sexual violence and MHRFB, controlling for other covariates. The regression results were presented using adjusted odds ratio (aOR) with 95% confidence interval (CI). Statistical significance was set at p < 0.05., Results: The overall prevalence of MHRFB was 22.53% (95% CI: 22.26-22.81), which ranged from 9.94% in South Africa to 30.38% in Chad. For sexual violence, the pooled prevalence was 7.02% (95% CI: 6.86-7.19). Burundi (20.58%) and the Gambia (2.88%) reported the highest and lowest proportions, respectively. Women who experienced sexual violence were more likely to engage in MHRFB compared to those who did not experience sexual violence [aOR = 1.11, 95% CI: 1.02, 1.21]., Conclusion: There is a positive association between sexual violence and the risk of MHRFB. Our findings underscore a need for sub-Saharan African countries to strengthen their efforts to reduce the occurrence of sexual violence in intimate partner relationships. To augment efforts and accelerate social change, sub-Saharan African countries can introduce pro-poor policies and interventions to improve the wealth status of women. Also, empowering women through the encouragement of attaining higher education would be a useful step in lowering the risk of MHRFB in SSA., (© 2024. The Author(s).)

Introduction: This study aimed to investigate the associated factors and changes in childhood vaccination coverage over time in Bangladesh., Methods: Bangladesh's Demographic and Health Surveys from 2011, 2014, and 2017-18 provided data for this study on vaccination coverage among children aged 12 to 35 months. For three survey periods, multilevel binary logistic regression models were employed., Results: The overall prevalence (weighted) of full vaccination among children aged 12-35 months were 86.17% in 2011, 85.13% in 2014, and 89.23% in 2017-18. Children from families with high wealth index, mothers with higher education, and over the age of 24 and who sought at least four ANC visits, as well as children from urban areas were more likely to receive full vaccination. Rangpur division had the highest change rate of vaccination coverage from 2011 to 2014 (2.26%), whereas Sylhet division had the highest change rate from 2014 to 2017-18 (34.34%)., Conclusion: To improve immunization coverage for Bangladeshi children, policymakers must integrate vaccine programs, paying special attention to mothers without at least a high school education and families with low wealth index. Increased antenatal care visits may also aid in increasing the immunization coverage of their children., (© 2023. The Author(s).)

Background: Out of pocket payment for healthcare remains a barrier to accessing health care services in sub-Saharan Africa (SSA). Women's decision-making autonomy may be a strategy for healthcare access and utilization in the region. There is a dearth of evidence on the link between women's decision-making autonomy and health insurance enrollment. We, therefore, investigated the association between married women's household decision making autonomy and health insurance enrollment in SSA., Methods: Demographic and Health Survey data of 29 countries in SSA conducted between 2010 and 2020 were analyzed. Both bivariate and multilevel logistic regression analyses were carried out to investigate the relationship between women's household decision-making autonomy and health insurance enrollment among married women. The results were presented as an adjusted odds ratio (AOR) and the 95% confidence interval (CI)., Results: The overall coverage of health insurance among married women was 21.3% (95% CI; 19.9-22.7%), with the highest and lowest coverage in Ghana (66.7%) and Burkina Faso (0.5%), respectively. The odds of health insurance enrollment was higher among women who had household decision-making autonomy (AOR = 1.33, 95% CI; 1.03-1.72) compared to women who had no household decision-making autonomy. Other covariates such as women's age, women's educational level, husband's educational level, wealth status, employment status, media exposure, and community socioeconomic status were found to be significantly associated with health insurance enrollment among married women., Conclusion: Health insurance coverage is commonly low among married women in SSA. Women's household decision-making autonomy was found to be significantly associated with health insurance enrollment. Health-related policies to improve health insurance coverage should emphasize socioeconomic empowerment of married women in SSA., (© 2023. The Author(s).)

Background: Type of occupation has been linked to early antenatal care visits whereby women in different occupation categories tend to have different timing for antenatal care visits. Different occupations require varying levels of commitment, remuneration and energy requirements. This study, therefore, sought to investigate the association between the type of occupation and early antenatal care visits in sub-Saharan Africa., Methods: This is a secondary analysis of Demographic and Health Survey data from 29 countries in sub-Saharan Africa conducted between 2010 and 2018. The study included 131,912 working women. We employed binary logistic regression models to assess the association between type of occupation and timely initiation of antenatal care visits., Results: The overall prevalence of early initiation of antenatal care visits was 39.9%. Early antenatal care visit was high in Liberia (70.1%) but low in DR Congo (18.6%). We noted that compared to managerial workers, women in all other work categories had lower odds of early antenatal care visit and this was prominent among agricultural workers [aOR = 0.74, CI = 0.69, 0.79]. Women from Liberia [aOR = 3.14, CI = 2.84, 3.48] and Senegal [aOR = 2.55, CI = 2.31, 2.81] had higher tendency of early antenatal care visits compared with those from Angola., Conclusion: The findings bring to bear some essential elements worth considering to enhance early antenatal care visits within sub-Saharan Africa irrespective of the type of occupation. Women in the agricultural industry need much attention in order to bridge the early antenatal care visit gap between them and workers of other sectors. A critical review of the maternal health service delivery in DR Congo is needed considering the low rate of early antenatal care visits., (© 2022. The Author(s).)

Background: Injury is one of the major causes of death and illness among children and adolescents worldwide. We sought to investigate the prevalence of serious injury and its associated factors among in-school adolescents in eight countries in sub-Saharan Africa., Methods: A sample of 14,967 in-school adolescents was drawn from the Global School-based Student Health Surveys conducted from 2012 to 2017 in eight sub-Saharan African countries. Data were collected using self-administered structured questionnaires. The prevalence of serious injuries was calculated using proportions while multivariable binary logistic regression analysis was carried out to determine the factors associated with serious injuries., Results: Approximately 45% of in-school adolescents had experienced serious injuries during the past 12 months to the survey in the eight sub-Saharan African countries, with variations from 32.3% in Mauritius to 68.2% in Liberia. Adolescents who experienced bullying [aOR = 2.37, CI = 2.10, 2.68], those who engaged in physical fight [aOR = 2.14, CI = [1.87, 2.44], those who experienced an attack [aOR = 1.96, CI = [1.73, 2.22], those who felt anxious [aOR = 1.47, CI = 1.22,1.77], those who attempted suicide [aOR = 1.38, CI = 1.14, 1.65], truants [aOR = 1.33, CI = [1.17,1.51], current tobacco users [aOR = 1.42, CI = [1.01, 2.01] and current marijuana users [aOR = 1.78, CI = 1.08, 2.93] had higher odds of experiencing serious injuries. However, those whose parents or guardians respected their privacy had lower odds of experiencing serious injuries [aOR =0.78, CI = [0.68, 0.88] compared to those whose parents or guardians did not respect their privacy., Conclusion: A relatively high prevalence of serious injuries among in-school adolescents was identified in the eight sub-Saharan African countries studied. Programs and interventions that target the reduction of injuries in educational institutions should take a keen interest in the factors identified in this study. To deal with injury victims, first aid services should be provided in school settings., (© 2022. The Author(s).)

Background: To obviate malaria and other healthcare costs and enhance healthcare utilization, the government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2005. Nonetheless, there is dearth of empirical evidence on Ghanaian women's knowledge about whether malaria treatment is covered by the NHIS or not. The current study, therefore, investigated factors associated with knowledge of malaria treatment with the NHIS among women aged 15-49 in Ghana., Methods: The study is a secondary analysis of data from women respondents in the 2014 Ghana Demographic and Health Survey. A total of 2,560 women participated in this study. Descriptive computation of the weighted proportion of women who knew that malaria is covered by NHIS was conducted at 95% confidence interval (CI). A multilevel logistic regression analyses was carried out with Stata's MLwinN package version 3.05. We declared significance at 5% alpha. Findings from the models were reported as adjusted odds ratios (aOR) and credible intervals (CrIs)., Results: In all, 81.0% of Ghanaian women included in the study knew that NHIS covers malaria treatment. Women aged 45-49 had higher odds of knowing that NHIS covers malaria relative to those aged 15-19 age category [aOR=1.5;95%crl=1.2-2.1]. Women with higher education (post-secondary) had higher odds of knowing that NHIS covers malaria treatment compared with women who had no formal education [aOR=1.6;95%Crl=1.2-2.0]. Richest women were more likely to know that NHIS covers malaria treatment compared to the poorest women [aOR=1.3;95%Crl=1.2-1.7]. Women who had subscribed to the NHIS were more likely to report that NHIS covers malaria treatment [aOR=1.5;95%Crl=1.2-1.8]. The study revealed that the variance in the tendency for a woman to be aware that NHIS covers malaria treatment is attributable to 10.8% community level factors., Conclusion: This study has shown that individual, community and regional level factors affect women's knowledge on whether NHIS covers malaria treatment or not. As knowledge that malaria treatment is covered by NHIS may increase use of malaria prevention and treatment services in health facilities, we recommend that the Ghana Health Service intensifies community level education and awareness creation efforts, targeted at women among whom awareness levels are currently low., (© 2021. The Author(s).)

Background: The sense of sight is one of the important human sensory abilities that is required for independent functioning and survival. The highest burden of sight-related problems is recorded in low-and middle-income countries, especially in sub-Saharan Africa. Despite the burden, nationally representative analyses to understand the prevalence and determinants of vision difficulties are hard to find. Therefore, this study addressed this knowledge gap by estimating the prevalence of vision difficulties and its correlates in gender-stratified models in three West African countries: Ghana, Gambia, and Togo., Methods: The study used the most recent Multiple Indicator Cluster Surveys of Ghana (2017-2018), Gambia (2018), and Togo (2017). Summary statistics were used to describe the participants and logistic regression was used to perform the bivariate and multivariate analyses. The analyses were performed using Stata version 14 and the complex survey design of the datasets was accounted for using the 'svyset' command., Results: Gendered differences were observed for vision difficulties. More women than men reported vision difficulties in Ghana (men: 14.67% vs women: 23.45%) and Togo (men: 14.86% vs women: 23.61%), but more men than women reported vision difficulties in Gambia (men: 11.64% vs women: 9.76%). We also observed gender differences in how age, education, marital status, and region of residence were significantly associated with reported vision difficulties. The direction and magnitude of these relationships were different among men and women across the survey data in Ghana, Gambia, and Togo., Conclusion: The findings imply the need to tackle the existing gender inequities that are associated with vision difficulties to promote the quality of life of individuals, especially among older adults., (© 2021. The Author(s).)

Background: Hypertension is one of the leading causes of cardiovascular morbidities in Ghana and represents a major public health concern. There is dearth of information on the rural-urban disparity in hypertension among women in Ghana. Therefore, this study aimed at examining the rural-urban variation in hypertension among women in Ghana., Methods: We extracted data from the women's file of the 2014 Ghana Demographic and Health Survey. The sample included 9333 women aged 15-49 with complete data on hypertension. The analysis was done using Pearson Chi-square and binary logistic regression at 95% confidence interval. The results of the binary logistic regression were presented as Odds Ratios (ORs) and Adjusted Odds Ratios (AORs). Statistical significance was set at p < 0.05., Results: Hypertension prevalence among urban and rural residents were 9.5% and 5.1% respectively. Rural women had lower odds of hypertension [OR = 0.59; 95% CI = 0.52, 0.67] compared to urban women, however, this was insignificant in the adjusted model [aOR = 0.84; 95% CI = 0.70, 1.00]. The propensity to be hypertensive was lower for women aged 15-19 [aOR = 0.07; 95% CI = 0.05, 0.11]. The poorest were less likely to be hypertensive [aOR = 0.63; 95% CI = 0.45, 0.89]. Single women were also less probable to have hypertension [aOR = 0.66; 95% CI = 0.46, 0.97]., Conclusions: Women from urban and rural areas shed similar chance to be hypertensive in Ghana. Therefore, the health sector needs to target women from both areas of residence (rural/urban) when designing their programmes that are intended to modify women's lifestyle in order to reduce their risks of hypertension. Other categories of women that need to be prioritised to avert hypertension are those who are heading towards the end of their reproductive age, richest women and the divorced., (© 2021. The Author(s).)

Background: In sub-Saharan Africa, sexually transmitted infections (STIs) other than HIV are major public health problems. This study, therefore, sought to assess the prevalence and factors associated with self-reported STIsamong sexually active men in Ghana., Methods: Data from the 2014 Ghana demographic and health survey wereused to conduct the study. This research included a total of 3051 sexually active men aged 15-59 years. Self-reported STI was the outcome variable. The data were analyzed using both descriptive (frequencies and percentages) and inferential (binary logistic regression) analysis., Results: The prevalence of self-reported STIs in the past 12 months preceding the survey was 6.0% (CI:4.7-6.8). Compared to men aged 45-59 years, those aged 25-34 (aOR = 2.96, CI: 1.64-5.35), 15-24 (aOR = 2.19, CI: 1.13-4.26), and 35-44 (aOR = 2.29, CI: 1.23-4.24) were more likely to report an STI. Men who had 2 or more sexual partners apart from their spouse were more likely to report an STI compared to those with no other partner apart from spouse (aOR = 4.24, CI: 2.52-7.14). However, those who had their first sex when they were 20 years and above (AOR = 0.66, CI: 0.47-0.93) and men who read newspaper/magazine had lower odds (aOR = 0.53, CI: 0.37-0.77) of reporting STIs compared to those who had sex below 20 and those who did not read newspaper/magazine respectively., Conclusion: The study has revealed a relatively low prevalence of self-reported STI among sexually active men in Ghana. Sexually active men aged 25-34 years, those whose age at first sex is below 20 years and those with two or more sexual partners apart from their spouse had higher odds of reporting STIs. However, reading a newspaper was found to be positive in reducing the odds of reporting STIs. To reduce STIs among sexually active men in Ghana, it is important for health systems and stakeholders to consider these factors and put in place measures to mitigate those that put men at risk of STIs and encourage the adoption of the protective factors. Mass media can be used as a useful avenue for encouraging men to report STIs in order to avoid transmitting them to their partners.

Background: Safe disposal of children's faeces has always been one of the main challenges to good hygiene in Ghana. Although it has been proven that children's faeces are more likely to spread diseases than adults' faeces, people usually mistake them for harmlessness. This study, therefore, sought to determine the prevalence and factors associated with safe disposal of children's faeces in Ghana., Methods: Data from the 2014 Ghana Demographic and Health Survey was used for the analysis. A sample size of 2228 mother-child pairs were used for the study. The outcome variable was disposal of children stools. Both bivariate and multivariable logistic regression analyses were performed to identify the factors with safe child stool disposal., Results: The prevalence of safe child stool disposal in Ghana was 24.5%. Women in the middle [Adjusted odds ratio (AOR) = 4.62; Confidence Interval (CI) = 3.00-7.10], Coastal Zone [AOR = 4.52; CI = 2.82-7.22], mothers whose children were aged 12-17 [AOR = 1.56; CI = 1.15-2.13] and 18-23 months [AOR = 1.75; CI = 1.29-2.39], and mothers whose household had improved type of toilet facility [AOR = 2.04; CI = 1.53-2.73] had higher odds of practicing safe children's faeces disposal. However, women from households with access to improved source of drinking water [AOR = 0.62; CI = 0.45-2.7] had lower odds of practicing safe children's faeces disposal., Conclusion: Approximately only about 25 out of 100 women practice safe disposal of their children's faeces in Ghana. The age of the child, ecological zone, the type of toilet facilities, and the type of drinking water source are associated with the disposal of child faeces. These findings have proven that only improved sanitation (i.e. drinking water and toilet facilities) are not enough for women to safely dispose of their children's faeces. Therefore, in addition to provision of toilet facilities especially in the northern zone of Ghana, there is also the need to motivate and educate mothers on safe disposal of children's stools especially those with children below 12 months. More so, mothers without access to improved toilet facility should also be educated on the appropriate ways to bury their children's stools safely.

Background: Women's health remains a global public health concern, as enshrined in the Sustainable Development Goals. This study, therefore, sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in Ghana., Methods: The study was conducted among 9370 women aged 15-49, using data from the 2014 Ghana Demographic and Health Survey. Barrier to healthcare, derived from four questions- whether a woman faced problems in getting money, distance, companionship, and permission to see a doctor-was the outcome variable. Descriptive and multilevel logistic regression analyses were carried out. The fixed effect results of the multilevel logistic regression analyses were reported using adjusted odds ratios at a 95% confidence interval., Results: More than half (51%) of the women reported to have at least one form of barrier to accessing healthcare. Women aged 45-49 (AOR = 0.65, CI: 0.49-0.86), married women (AOR = 0.71, CI:0.58-0.87), those with a higher level of education (AOR = 0.51, CI: 0.37-0.69), those engaged in clerical or sales occupation (AOR = 0.855, CI: 0.74-0.99), and those who were covered by health insurance (AOR = 0.59, CI: 0.53-0.66) had lower odds of facing barriers in accessing healthcare. Similarly, those who listened to radio at least once in a week (AOR =0.77, CI: 0.66-0.90), those who watched television at least once a week (AOR = 0.75, CI: 0.64-0.87), and women in the richest wealth quintile (AOR = 0.47, CI: 0.35-0.63) had lower odds of facing barriers in accessing healthcare. However, women who were widowed (AOR = 1.47, CI: 1.03-2.10), those in the Volta Region (AOR 2.20, CI: I.38-3.53), and those in the Upper West Region (AOR =2.22, CI: 1.32-3.74) had the highest odds of facing barriers to healthcare accessibility., Conclusion: This study shows that individual and contextual factors are significant in predicting barriers in healthcare access in Ghana. The factors identified include age, marital status, employment, health insurance coverage, frequency of listening to radio, frequency of watching television, wealth status, and region of residence. These findings highlight the need to pay critical attention to these factors in order to achieve the Sustainable Development Goals 3.1, 3.7, and 3.8. It is equally important to strengthen existing strategies to mitigate barriers to accessing healthcare among women in Ghana.

Background: Under-five mortality in Chad reached a minimum value of 119 deaths per 1000 live births in 2018, compared with a maximum of 250 in 1972. Despite this decline in the  mortality trend, for every six children in Chad, one dies before the age of five. This study, therefore, investigated the proximate, intermediate, and distal determinants of under-five mortality in Chad., Methods: We used data from the 2014-15 Chad's Demographic and Health Survey. Data of 7782 children below 5 years were used for the study. Both descriptive and multivariable hierarchical logistic regression analyses were performed. Statistical significance was declared at p < 0.05., Results: Under-five mortality was found to be 130 deaths per 1000 live births in Chad, with variations across the various population sub-groups. For distal predictors, the likelihood of death was higher in children born in the FChari Baguirmi region (AOR = 3.83, 95% CI: 1.81-8.14). Children whose mothers belonged to the Baguirmi/Barma ethnic group (AOR = 8.04, 95% CI: 1.75-36.99) were more likely to die before the age of five. On the contrary, the likelihood of under-five mortality was low among children born in rural areas (AOR = 0.73, 95% CI: 0.55-0.97). With the intermediate predictors, the likelihood of under-five deaths was higher among children whose mothers had no formal education (AOR = 1.72, 95% CI: 1.06-2.77). Regarding the proximate predictors, the odds of under-five deaths was higher among male children (AOR = 1.03, 95% CI: 1.05-1.63) and first rank children (AOR = 1.58, 95% CI: 1.13-2.21)., Conclusion: The study found that the determinants of under-five mortality in Chad are region of residence, place of residence, ethnicity, education, sex of child, and birth rank. These findings show that both socio-economic and proximate factors explain the disparities in under-five mortality in Chad. The identification of these factors can be pivotal towards the design of evidence-based interventions intended to improve child survival. Therefore, improving maternal education while refocusing and re-packaging existing strategies to target selected sub-regional populations with high under-five mortality is urgently required.

Background: Despite the importance of self-reporting health in sexually transmitted infections (STIs) control, studies on self-reported sexually transmitted infections (SR-STIs) are scanty, especially in sub-Saharan Africa (SSA). This study assessed the prevalence and factors associated with SR-STIs among sexually active men (SAM) in SSA., Methods: Analysis was done based on the current Demographic and Health Survey of 27 countries in SSA conducted between 2010 and 2018. A total of 130,916 SAM were included in the analysis. The outcome variable was SR-STI. Descriptive and inferential statistics were performed with a statistical significance set at p < 0.05., Results: On the average, the prevalence of STIs among SAM in SSA was 3.8%, which ranged from 13.5% in Liberia to 0.4% in Niger. Sexually-active men aged 25-34 (AOR = 1.77, CI:1.6-1.95) were more likely to report STIs, compared to those aged 45 or more years. Respondents who were working (AOR = 1.24, CI: 1.12-1.38) and those who had their first sex at ages below 20 (AOR = 1.20, CI:1.11-1.29) were more likely to report STIs, compared to those who were not working and those who had their first sex when they were 20 years and above. Also, SAM who were not using condom had higher odds of STIs (AOR = 1.35, CI: 1.25-1.46), compared to those who were using condom. Further, SAM with no comprehensive HIV and AIDS knowledge had higher odds (AOR = 1.43, CI: 1.08-1.22) of STIs, compared to those who reported to have HIV/AIDS knowledge. Conversely, the odds of reporting STIs was lower among residents of rural areas (AOR = 0.93, CI: 0.88-0.99) compared to their counterparts in urban areas, respondents who had no other sexual partner (AOR = 0.32, CI: 0.29-0.35) compared to those who had 2 or more sexual partners excluding their spouses, those who reported not paying for sex (AOR = 0.55, CI: 0.51-0.59) compared to those who paid for sex, and those who did not read newspapers (AOR = 0.93, CI: 0.86-0.99) compared to those who read., Conclusion: STIs prevalence across the selected countries in SSA showed distinct cross-country variations. Current findings suggest that STIs intervention priorities must be given across countries with high prevalence. Several socio-demographic factors predicted SR-STIs. To reduce the prevalence of STIs among SAM in SSA, it is prudent to take these factors (e.g., age, condom use, employment status, HIV/AIDS knowledge) into consideration when planning health education and STIs prevention strategies among SAM.

Background: Proper sanitation has been one of the topmost priorities on the global public health agenda. In the past few decades, sanitation programs targeting households have often paid little attention to the disposal of children's stools. We assessed the individual and contextual factors associated with disposal of children's faeces in Papua New Guinea., Methods: The data used for this study forms part of the 2016-2018 Papua New Guinea Demographic and Health Survey (PDHS). For this study, we focused on women with children less than five years (n = 2095). Both descriptive and inferential analyses were carried out. Descriptive statistics were used to summarize the data, using frequency counts and percentages. The inferential analysis used multilevel logistic regression models to investigate the individual and contextual factors associated with disposal of children's stools. These models were presented as adjusted odds ratio (AORs), together with their corresponding 95% confidence intervals. Statistical significance was set at p < 0.05., Results: More than half (56%) of the women had disposed of their children's stools unsafely. With the individual level factors, the results showed that women with children < 12 months [AOR =1.71; CI = 1.28-2.29] and women aged 20-24 [AOR =2.58; CI = 1.24-5.37], 35-39 [AOR =2.34; CI = 1.09-5.04], and 40 years and above [AOR =2.51; CI = 1.09-5.79] were more likely to practice unsafe disposal of children's stool. The odds of unsafe disposal of faeces was also higher among women who visited the health facility for child diarrhea [AOR =1.69; CI = 1.25-2.28]. With the contextual factors, the odds of unsafe disposal of children's stool was higher among women who lived in the Southern region [AOR =4.82; CI = 2.08-11.18], those who lived in male-headed households [AOR =1.79; CI = 1.19-2.70], and those who had unimproved toilet facilities [AOR =1.96; CI = 1.39-2.76]. On the contrary, women with unimproved source of drinking water were less likely to dispose of their children's stool unsafely [AOR =0.54; CI = 0.35-0.83]., Conclusion: Both individual and contextual factors predict unsafe disposal of children's faeces in Papua New Guinea. It is recommended that sanitation programs should focus on behavioral change and not only on the extension of water and improved toilet facilities. Such programs should also focus on both individual and contextual factors of women.

Background: Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment, as these efforts play major roles in mother-to-child transmission. We examined the association between women's healthcare decision-making capacity and uptake of HIV testing in sub-Saharan Africa., Methods: We used data from the current Demographic and Health Surveys (DHS) of 28 countries in sub-Saharan Africa, conducted between January 1, 2010 and December 31, 2018. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression assess the likelihood of HIV testing uptake by women's health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value < 0.05., Results: We found that prevalence of HIV testing uptake in the 28 sub-Saharan African countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare decisions alone [COR = 3.183, CI = 2.880-3.519] or with their partners [COR = 2.577, CI = 2.335-2.844] were more likely to test for HIV, compared to those whose healthcare decisions were taken by others, and this persisted after controlling for significant covariates: [AOR = 1.507, CI = 1.321-1.720] and [AOR = 1.518, CI = 1.334-1.728] respectively., Conclusion: Sub-Saharan African countries intending to improve HIV testing need to incorporate women's healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with decision to test for their HIV status.