- ItemEDUCATION-MALARIA CONTROL NEXUS: THE CASE OF GHANA(University of Ghana , Legon, 2011-06-06) ADJEI, DAVID SEFAMalaria is a global public health issue as well as a national one in Ghana. It is the number one cause of under-five mortality in Ghana. Several attempts have been made to curb the negative effects of this disease which include the use of Insecticide-Treated Nets (ITNs), anti-malarial drugs, indoor-residual spraying, etc. In Ghana, major stakeholders have ensured the provision of ITNs at highly subsidized rates and even in some cases, distributed free of charge. Alongside these interventions, there has been information, education and communication of activities to help Ghanaians understand the malaria burden and its various means of control. Despite these efforts, there has been marginal decline in malaria cases and mortality rates. Usage of ITNs still falls below the 80% coverage of the vulnerable population as recommended by the WHO. Thus, this study sought to investigate the role and extent to which education influences the ownership of ITNs by households and the usage of ITNs by under-five children. Using a Probit Model and a Negative Binomial Distribution Model, the study examined the role of formal and informal education on the usage of ITNs by under-five children and number of ITNs owned by households in Ghana using data gathered from the Ghana Demographic and Health Survey (GDHS, 2008). The study revealed that household heads with higher education had a positive effect on the use of ITNs by under-five children as well as the number of ITNs owned by households. Health workers and community volunteers also played a positive role in the ownership and usage of ITNs by households and under-five children respectively. Results from the study implied that much attention should be paid to the training of health workers and community volunteers to aid them to effectively disseminate information regarding malaria and its means of control. Efforts should also be directed at ensuring high enrolment and completion of basic education which serves as a foundation for attainment of higher education in Ghana. Formal education aids in comprehension of the malaria burden and its means of control.
- ItemHousehold Choice of Diarrhea Treatments for Children under the Age of Five in Kenya(University of Nairobi, 2012-11-06) MURIITHI, GRACE NJERIChildhood diarrhea is one of the leading causes of under-5 deaths in developing countries, including Kenya. Although it is one of the most easily prevented and managed childhood illnesses, it is the third leading cause of under-5 mortality and kills about 86 children in Kenya every day. The World Health Organization recommends the use of oral rehydration therapy (ORT) to manage diarrhea once it occurs as well as the use of zinc supplements to reduce the severity and future recurrence of the illness. This study investigated the factors that influence the household choice of treatments for children suffering from diarrhea across the country using a multinomial logit approach. A sample of 771 under-5 children was drawn from the 2008/2009 Kenya Demographic and Health Survey. It was found that 29.86 percent of the children were not administered with any sort of treatment for their diarrhea. Besides ORT and zinc, other treatments such as antibiotic drugs, antimotility drugs, and herbal medicines were used to manage childhood diarrhea. It was surprising to note that only 4 of the affected children were given zinc supplements. The study also found that prior knowledge/experience of oral rehydration salts, mother’s education level, and place of residence were key determining factors of the use of recommended treatments to manage diarrhea. Factors such as household wealth, mother’s age at birth and number of births in a span of five years were equally important for other treatments. Given the inadequate and low usage of ORT and zinc respectively, the study recommends strengthening awareness on childhood diarrhea and the recommended treatments that can be used to manage it as well as increasing the availability and accessibility of zinc supplements.
- ItemDISAGGREGATED HEALTH FINANCING, GOVERNANCE AND INFANT MORTALITY IN SUB-SAHARAN AFRICA(University of Cape Coast, 2021-05-06) GAMETTE, PIUSDespite evidence on the importance of disaggregated components of health financing (public, private and external health aid), little is known about the role governance performs in the relationship between disaggregated health financing components and infant mortality. Using panel data of 42 sub-Sahara African countries (SSA) for the period 2000-2016, this study analyses the differential effect of disaggregated components of health financing on infant mortality in SSA as well as across its sub-regional groups. The study also examines the confounding effect of governance in the relationship between disaggregated components of health financing and infant mortality. The study uses the Generalised Method of Moment (System-GMM) technique along with the Principal Component Analysis (CPA) to construct a governance index from three governance indicators (government effectiveness, control of corruption and regulatory quality). The study finds that each disaggregated component of health financing has a significant negative effect on infant mortality in SSA, albeit there exists regional disparities across SSA. The study also finds that governance has negative and significant confounding effects on the relationship between each disaggregated health-financing component and infant mortality in SSA. In terms of policy recommendations, Ministries of Health in respective SSA countries should strengthen partnership with foreign donors in the fight against infant mortality. Moreover, audit departments of Ministries of Health in respective SSA countries should strengthen regulations that guide health expenditure to have higher reduction in infant mortality level.
- ItemSOCIAL DETERMINANTS OF HEALTH STATUS IN UGANDA(Makerere University, 2019-12-06) ATUGONZA, RASHIDHealth status of individuals of great significance both because of the direct utility that health can provide and the productivity gain as a result of good health. The purpose of the study was to empirically establish the key factors influencing health status in Uganda. Specifically, examining the relationship between health status and socio-demographic, economic, lifestyle and environmental factors. Government of Uganda has been investing in health through acting on key Social Determinants of Health (SDH) such as household income and infrastructure as marked in the HSDP 2015/16-2019/20. However, evidence shows heavy burden of disease. The relationship between health status and the above SDH is not clear. Therefore, this necessitated the need to investigate the SDH. The study used Uganda National Household Survey (UNHS) 2016/17 data. The study was based on the SDH framework to examine SDH Status. Four logistic regressions models were estimated i.e. model I, II, III and IV focusing on individuals aged 0-5, 6-14,15-59 and 60+ years respectively. The study used adjusted Wald test to test for individual Statistical significance of the regression coefficients and Hosmer-Lemeshow (HL) test, to assess the goodness of fit. In reference to demographic factors the study establishes that Females aged 6-14, 15-59 and 60+ years were 1.29, 1.25, and 1.4 times more likely to be in poor health when compared to the males at P< 0.01 respectively. Individuals aged 6-14 from male headed household were 1.2 times more likely to be in poor health at P< 0.01 when compared to those from femaleheaded households. Rural residents aged 0-5, 6-14 and 15-59 were 1.5, 1.52, and 1.3 times more likely to be in poor health when compared to urban residents at P< 0.01 respectively. Likewise, the married aged 15-56 and 60+ years were 1.6 and 1.7 times more likely to be in poor health when compared with individuals not married at P< 0.01 respectively. Concerning economic factors, individuals with no formal education aged 6-14 years were 1.2 times more likely to be in poor health at P< 0.01 when compared to individuals with secondary level of education. Similarly, individuals aged 6-14 whose mothers have no formal education were 1.1 times more likely to be in poor when compared to those whose mothers have attained secondary level of education at P< 0.01. At P< 0.05 the unemployed aged 60+ were 1.6 times more likely to be in poor health when compared to those employed. Regarding lifestyle factors, current and past alcohol consumers aged 15-59 were 1.3 and 1.9 times likely to be in poor health at P< 0.01 when compared to individuals that do not consume alcohol respectively. Current smokers above 15-59 and 60+years were 1.8 and 1.4 times more likely to be in poor health when compared to the non-smokers at P< 0.01 respectively. As for environmental factors, individuals aged 0-5- and 6-14 using water from unimproved sources were 1.3 and 1.2 times more likely to be in poor health when compared to those that use water from improved sources at P< 0.01 and P< 0.05 respectively. Individuals aged 0-5 using poor and intermediate quality toilet facilities were 1.7 and 1.5 times more likely to be in poor health when compared to those that use high quality toilet facilities at P< 0.01 and P< 0.05 respectively. Individuals aged 6-14 residing in mad and poles houses and houses whose floor material made of earth were 1.2 and 1.3 times more likely to be in poor health when compared to those that reside in brick houses and houses whose floor material made of cement at P< 0.01 respectively. The study findings show that females above 6 years are more likely to be in poor health when compared the males. Therefore, considerable emphasis should be put on health interventions for women. Education of girls and employment opportunities for women will also promote gender equality and more broadly improve upon their health. Interventions to prevent people from smoking and alcohol consumption must also be undertaken or strengthened. More efforts should also be put in promoting health lifestyles especially among the young people. Also, policies should be aimed at closing the gap in health conditions between urban and rural inhabitants through balanced economic and social development to increase the level of income, education and decreasing unemployment amongst people living in the rural areas. From the results, children aged 6 to 14 years whose mothers have no formal education are more likely to be in poor health. Therefore, education especially for the girls should be a priority to enable mothers gain knowledge and skills to be able to make better healthy choices. To address the health problem among unemployed individuals aged 60+ years, it is necessary to put in place insurance scheme for the elderly to ease their access to health care. Regarding the environmental factors, there should be establishment of clear institutional responsibility and specific budget lines for water & sanitation, and ensuring that public sector agencies working in health, in water resources and other utility services work together better to enhancing quality infrastructure (piped water to homes, toilets connected to sewers or septic tanks).
- ItemREGIONAL VARIATIONS IN CHILDHOOD MORTALITY IN ZAMBIA(University of Zimbabwe, 2016-09-22) MICHELO, TOBIASAlthough Zambia has experienced reductions in childhood mortality over the years, wide gaps in childhood mortality rates still exist across the provinces within the country, warranting for a call for an equity focused approach to reducing child mortality. Motivated by this discrepancy, and guided by the Mosley and Chen (1984) conceptual framework, this dissertation aimed at establishing the socioeconomic, demographic and cultural factors that influence childhood mortality in Zambia, as well as the extent to which these factors possibly explain the observed regional variations in childhood mortality across the country. The study established that a number of factors significantly influence childhood mortality rates in the country. The chances of a child dying increased for a child born from: a non-Christian mother, a mother in the age category “45-49”, a mother who was not attended to by a midwife during delivery, and for the child whose mothers used “Pit latrines” or “bush” as their toilet facility. However, the chances of dying reduced for a child born in the rural area, or one in which the spacing between them and the previous sibling was 24 months or longer. In analyzing factors influencing childhood mortality rates in individual provinces, the study revealed that factors associated with child deaths were not homogenous, but differed from province to province. Finally, the study established that factors that have higher magnitudes in terms of their effects on child mortality in Zambia were significant and predominant in high mortality regions. Particularly, these included Religion, Attendence by midwife, Birth Interval, Literacy and Type of residence. And these were more influential in Eastern, Luapula, Northern, Muchinga, Lusaka and Western Provinces. The study therefore concluded that these socio economic, demographic and cultural factors are important in explaining the variations in childhood mortality observed among the different provinces of the country. The implication of these findings demonstrated the fact that ultimately, addressing the problem of childhood mortality effectively in Zambia calls for disaggregated analysis of individual regional problems.