Non-communicable diseases among children in Ghana: health and social concerns of parent/caregivers.

Background: Globally, there is a progressive rise in the burden of non-communicable diseases (NCDs). This paper examined the health and social concerns of parents/caregivers on in-patient care for children with NCDs in Ghana. Methods: This was a cross-sectional study in three large health facilities in Ghana (the largest in the South, the largest in the North and the largest in the Eastern part of Ghana. Data was collected with a structured questionnaire among 225 caregivers (≥18 years) of 149 children with NCDs in health facilities in the three regions. Data was analyzed with simple descriptive statistics. Results: Most caregivers 169(75.0%) were women, relatively young (median age 35years), mostly married and resided in urban areas. Sickle cell disease was the commonest NCD among the children. All 169(75.0%) caregivers believed children suffer NCDs because of sins of parents/ancestors, 29(12.9%) believed herbalists/spiritualists have insights into treating NCDs and 73(32.6%) have previously used herbs/traditional medicine for child's illness. NCD in children was a burden and caused financial difficulties for families. Most caregivers (>96.0%) indicated NCDs in children should be included in national health insurance benefits package and a comprehensive national NCD policy is needed. Conclusion: Absence of national NCD policy for children is a major challenge. The burden of care rests mainly on the parents/ caregivers. A national strategic intervention on the importance of awareness generation on the causes, risk factors, prevention and treatment of NCDs for families and communities is essential. Government support through national health and social policy initiatives are essential.

Women empowerment and the current use of long acting and permanent contraceptive: Evidence from 2010 Malawi Demographic and Health Survey

Background Both contraceptive use and fertility rates are high fertility in Malawi. Status of women remains low and is believed to affect reproductive health decisions including use of Long Acting and Permanent Contraceptives Method (LAPCM). Objective This study seeks to examine the relationship between women empowerment and LAPCM. A measure of women’s empowerment is derived from the women’s responses to questions on the number of household decisions in which the respondent participates, employment status, type of earnings, women’s control over cash earnings and level of education. Methods The study is based on a sub sample of 5,948 married women from the 2010 Malawi Demographic and Health Survey. Data was analysed using descriptive statistics, Chi-square and multinomial logistic regression models (α=5%). Results The prevalence of current use of LAPCM was 20.0% and increases with increasing empowerment level (p<0.001). Mean age and empowerment score of women who are currently using LAPCM were 38.53±6.2 years and 6.80±2.9 respectively. Urban women (22.2%) were more currently using LAPCM than rural women (19.4%) p<0.001. Women who belong to Seven Day Adventists/Baptist were 1.51(C.I=1.058-2.153; p=0.023) more likely and Muslims were 0.58(C.I=0.410-0.809; p=0.001) less likely to currently use LAPCM than Catholic women. Being in the richest wealth quintile (OR=1.91; C.I=1.362-2.665; p<0.001) promotes current use of LAPCM than poorest. The likelihood of currently using LAPCM was higher among women who have access to FP programmes on media and increases consistently with increasing women empowerment level even when other potential confounding variables were used as control. Conclusion In Malawi, LAPCM is still underutilized and more than half of the women are not adequately empowered. Women empowerment, wealth quintile and access to FP programmes are key factors influencing the use of LAPCM. Programmes that address these determinants are urgently needed in Malawi.

Sociodemographic factors influencing adherence to antenatal iron supplementation recommendations among pregnant women in Malawi: Analysis of data from the 2010 Malawi Demographic and Health Survey

Background and Aim: Maternal morbidity and mortality statistics remain unacceptably high in Malawi. Prominent among the risk factors in the country is anaemia in pregnancy, which generally results from nutritional inadequacy (particularly iron deficiency) and malaria, among other factors. This warrants concerted efforts to increase iron intake among reproductive-age women. This study, among women in Malawi, examined factors determining intake of supplemental iron for at least 90 days during pregnancy. Methods: A weighted sample of 10,750 women (46.7%), from the 23,020 respondents of the 2010 Malawi Demographic and Health Survey (MDHS), were utilized for the study. Univariate, bivariate, and regression techniques were employed. While univariate analysis revealed the percent distributions of all variables, bivariate analysis was used to examine the relationships between individual independent variables and adherence to iron supplementation. Chi-square tests of independence were conducted for categorical variables, with the significance level set at P < 0.05. Two binary logistic regression models were used to evaluate the net effect of independent variables on iron supplementation adherence. Results: Thirty-seven percent of the women adhered to the iron supplementation recommendations during pregnancy. Multivariate analysis indicated that younger age, urban residence, higher education, higher wealth status, and attending antenatal care during the first trimester were significantly associated with increased odds of taking iron supplementation for 90 days or more during pregnancy (P < 0.01). Conclusions: The results indicate low adherence to the World Health Organization’s iron supplementation recommendations among pregnant women in Malawi, and this contributes to negative health outcomes for both mothers and children. Focusing on education interventions that target populations with low rates of iron supplement intake, including campaigns to increase the number of women who attend antenatal care clinics in the first trimester, are recommended to increase adherence to iron supplementation recommendations.