Mass media exposure and its impact on malaria prevention behaviour among adult women in sub-Saharan Africa:results from malaria indicator surveys

Background:Mass media exposure plays a pivotal role in health communication and adoption of a healthy lifestyle.In this study,we aimed to measure the prevalence of malaria prevention behaviour among adult women in eight malariaendemic countries in sub-Saharan Africa(SSA),and assess the influence of mass media exposure in the adoption of those behaviours.Methods:For this study,we collected cross-sectional data on 46,822 women aged between 15 and 49 years from the Malaria Indicator Surveys(MIS)conducted in Burkina Faso,Ghana,Mali,Malawi,Kenya,Nigeria,Sierra Leone and Uganda.As the outcome variable,malaria prevention behaviour was proxied by the use of insecticide treated nets(ITNs)and uptake of antimalarial drugs in last pregnancy.Results:The overall prevalence of sleeping under ITN and that of taking antimalarial drug during the last pregnancy was respectively 67.9%(95%CI=66.6-69.2)and 72.8%(95%CI=71.3-74.2).However,there were disparities in the prevalence of using ITN and antimalarial drug use across the study countries.In the multivariable regression analysis,not receiving malaria related information from radio,poster/billboards,community events,and health workers were found to be significantly associated with reduction in the odds of using ITN the previous night.For the use of antimalarial drugs during last pregnancy,the odds were 23%[OR=0.773,95%CI=0.625-0.956]lower for those who did not receive malaria information on radio compared with those who received.Conclusions:These findings indicate a potentially important role of malaria information received through mass media on utilisation of ITN among women in SSA.More research is needed to explore the factors that limit the accessibility to malaria information through mass media.

Disparities in caesarean section prevalence and determinants across sub-Saharan Africa countries

Background:Access to safe Cesarean section(C-section)in resource-constrained settings such as sub-Sahara Africa(SSA)region is a foremost approach to reduce maternal mortality.C-section is an obstetric operative procedure used appropriately to improve delivery outcomes.However,errors in the procedure have enormous potential harm that may outweigh the benefits.This study assessed the prevalence and determinants of C-section in several SSA countries.This study examined the prevalence and determinants associated with cesarean delivery in SSA countries.Methods:Secondary data of women of reproductive age(15-49 years)from the current Demographic and Health Survey(DHS)in 34 SSA countries was utilized in this study.The mode of delivery among women was the primary outcome variable.Percentage and descriptive statistics were used to conduct univariate analyses.Furthermore,multivariable multilevel logistic regression was used to investigate correlates of C-section among SSA women.Results:Results showed disparities in the percentage of C-section among women from 34 SSA countries.C-section at public healthcare settings ranged from 3%in Burkina Faso to 15.6%in Ghana.However,in private healthcare settings,C-section ranged from 0%in Sao Tome and Principe to 64.2%in Rwanda.Overall,C-section was 7.9%from public healthcare and 12.3%from private healthcare facilities respectively.In the adjusted regression model;women aged 35-49 had increase in the odds of C-section,while a unit increase in the number of children ever born had 17 and 20%significant reduction in the odds of C-section in public and private healthcare respectively.Assessing public healthcare settings;women from richer/richest households,male and large size children at birth had increase in the odds of C-section,while those from rich neighbourhood had reduction in the odds of C-section.In private healthcare settings,women with high decision making power and multiple births had increase in the odds of C-section,while those who attended ANC visits had significant reduction in the odds of C-section.Conclusion:The findings from this study would help formulate health policies and implement actions that would improve the outcome of C-section care.Monitoring of emergency obstetric care services is necessary to address issues connected to poor C-section outcomes in resource-constrained settings.Also training of medical personnel including midwives and nurses in emergency obstetric care,ensuring accessibility to life-saving drugs and supplies should be encouraged in health care system.