Department of Biological Sciences

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Author: search.filters.author.Wongnaah, Florence GyembuzieHas files: Yes

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    Progress and inequalities in early initiation of breastfeeding among women in Sierra Leone, 2008–2019
    (BioMed Central, 2025-08-07) Wongnaah, Florence Gyembuzie
    BACKGROUND: Early initiation of breastfeeding, defined as placing a newborn to the breast within the first hour of birth, is vital for improving neonatal survival, strengthening the mother-child bond, and ensuring the delivery of essential nutrients and antibodies. This study examines progress and socioeconomic inequalities in the early initiation of breastfeeding among women in Sierra Leone from 2008 to 2019. METHODS: We used data from the three rounds of the Sierra Leone Demographic and Health Survey conducted in 2008, 2013, and 2019. We used the Health Equity Assessment Toolkit developed by the World Health Organisation to calculate the inequality measures among women 15-49 years, which include simple difference (D), ratio (R), population attributable risk (PAR), and population attributable fraction (PAF). The inequality assessment was conducted based on six stratifiers: age, economic status, level of education, place of residence, sex of the child, and sub-national region. RESULTS: In Sierra Leone, the early initiation of breastfeeding rate increased from 48.7% in 2008 to 75.2% in 2019. Higher rates of early initiation of breastfeeding were observed among mothers (15-19 years), women from the lowest wealth quintile, those without formal education, and those residing in rural areas. However, regional inequalities persisted, with the Eastern region showing the lowest rates. The inequality (D) in age increased from - 0.2 in 2008 to -1.6 in 2019. The economic status disparity increased from - 8.7% in 2008 to -18.4% in 2019. Inequality for education decreased from - 10.6 in 2008 to -4.7 in 2019. The increase in place of residence inequality was from -2.6% in 2008 to -13.4% in 2019. For the sex of the child, the disparity increased from - 1.5% to -3.6% in 2019. Regional disparity increased from 19.7 in 2008 to 28.6 in 2019. PAR also rose from 8.9 to 11.1 percentage points. CONCLUSION: Early initiation of breastfeeding has shown substantial improvement in Sierra Leone, highlighting the effectiveness of recent public health interventions. However, inequalities accross economic status, level of education, sex of the child, and sub-national region still persist. To sustain these gains and ensure equitable progress, continued policy attention and targeted strategies are essential to address persistent socio-economic and regional inequalities disparities.
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    Full vaccination coverage for children aged 12–23 months in Madagascar: Analysis of the 2021 Demographic and Health Survey
    (BioMed Central, 2025-02-21) Wongnaah, Florence Gyembuzie
    BACKGROUND: Vaccination plays a pivotal role in safeguarding the health and wellbeing of children worldwide, preventing the spread of infectious diseases, and reducing mortality rates. Despite significant progress in global immunisation efforts, disparities in vaccination coverage persist in Madagascar. This study examines the factors associated with full vaccination coverage among children aged 12-23 months in Madagascar. METHODS: We analysed a cross-sectional dataset from the 2021 Madagascar Demographic and Health Survey (MDHS). A total of 2,250 mothers with children aged 12 to 23 months were extracted from the children's dataset. Vaccination coverage was evaluated based on maternal self-report and child vaccination card observations. A weighted multivariable binary logistic regression analysis was used to examine the factors associated with full vaccination coverage. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were used to present the results of the factors associated with full vaccination coverage. Stata 13.0 was used to perform all the analyses. RESULTS: We found that 48.9% of children aged 12-23 months were fully vaccinated. Vaccination coverage for Bacille Calmette-Guérin (BCG), third-dose polio, third-dose of diphtheria-tetanus-pertussis (DPT), and measles was 78.1%, 58.6%, 68.4%, and 63.9%, respectively. Mothers aged 35 to 49 (aOR: 1.69; 95% CI: 1.08-2.64) were more likely to have their children fully vaccinated compared to women aged 15-24. Children born to mothers with secondary or higher education (aOR:1.68; 95% CI:1.15-2.45) were more likely to receive full vaccination than those whose mothers had no formal education. Mothers within the middle-class wealth index (aOR: 1.48; 95% CI: 1.04-2.12) were more likely to have their children fully vaccinated compared to the poorest category. Mothers who were working (aOR: 1.45; 95% CI: 1.06-1.98) had higher odds of full childhood vaccination compared to those who were not working. Compared to mothers who delivered their babies at home or other places, those who delivered their babies at the health facility (aOR:1.57; 95% CI: 1.22-2.02) were more likely to vaccinate their children . Mothers who had less than eight (1-7) antenatal care visits (aOR: 3.63; 95% CI: 2.30-5.72) and those with 8 or more visits (aOR: 1.20; 95% CI: 1.35-6.51) were more likely to have their children vaccinated fully compared to those with zero antenatal care visits. Mothers exposed to media (aOR: 1.65; 95% CI: 1.26-2.16) were more likely to fully vaccinate their children than their unexposed counterparts. CONCLUSION: Full childhood vaccination coverage is low in Madagascar. Factors identified to be associated with vaccination coverage were maternal age, education, place of delivery, working status, antenatal care visits, and media access. Collaboration between the Ministry of Health and local authorities is recommended in Madagascar to improve vaccination coverage, promote antenatal care, clean delivery practices and access to skilled birth attendants, raise parental awareness, and enhance healthcare workers' communication about vaccination schedules through various media channels.
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    Barriers to healthcare services utilisation among women in Ghana: evidence from the 2022 Ghana Demographic and Health Survey
    (BioMed Central, 2025-02-25) Wongnaah, Florence Gyembuzie
    BACKGROUND: Access to healthcare is vital to women's health outcomes, as emphasised in the Sustainable Development Goals. This study aimed to assess the factors associated with barriers to healthcare utilisation among women aged 15-49 years in Ghana. METHODS: Data from the 2022 Ghana Demographic and Health Survey was used for the study. The study included 15,014 women. Regional variations in the proportion of respondents with healthcare access were visualised using a spatial map. A multivariable binary logistic regression analysis was conducted. The results were presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). RESULTS: In Ghana, 53.6% \[51.7, 55.5\] of women reported barriers to healthcare utilisation. Women aged 25-29 years \[aOR = 1.245; 95% CI: 1.01, 1.53\] and 45-49 years \[aOR = 1.377; 95% CI: 1.04, 1.82\] had higher odds of facing barriers in healthcare services utilisation than those aged 15-19 years. The odds for experiencing barriers to healthcare utilisation were higher among women with two \[aOR = 1.290; 95% CI: 1.06, 1.56\], three \[aOR = 1.478; 95% CI: 1.20, 1.82\], and four or more children \[aOR = 1.306; 95% CI: 1.05, 1.63\], women of Ewe \[aOR = 1.325; 95% CI: 1.07, 1.63\], or Mole Dagbani ethnicity \[aOR = 1.512; 95% CI: 1.22, 1.87\] compared to those with no children and Akan women respectively. Lower odds were observed among women with higher education \[aOR = 0.642; 95% CI: 0.49, 0.84\], married \[aOR = 0.555; 95% CI: 0.47, 0.66\] or cohabiting women \[aOR = 0.646; 95% CI: 0.55, 0.76\], Muslims \[aOR = 0.770; 95% CI: 0.64, 0.92\], who watched Television \[aOR = 0.776; 95% CI: 0.68, 0.88\], and internet users \[aOR = 0.765; 95% CI: 0.67, 0.87\]. Those in the poorer \[aOR = 0.666; 95% CI: 0.54, 0.82\], middle \[aOR = 0.453; 95% CI: 0.36, 0.58\], richer \[aOR = 0.368; 95% CI: 0.28, 0.48\] and richest \[aOR = 0.247; 95% CI: 0.18, 0.34\] wealth quintile were less likely to experience barriers to healthcare services utilisation compared to the poorest. Regionally, women in Volta \[aOR = 0.478; 95% CI: 0.33, 0.68\], Bono \[aOR = 0.488; 95% CI: 0.32, 0.76\], and Upper East \[aOR = 0.382; 95% CI: 0.21, 0.71\] regions had lower odds of experiencing barriers to healthcare utilisation than those living in the Western region. CONCLUSION: A higher proportion of women in Ghana experience barriers to healthcare utilisation. Older age, higher parity, higher educational attainment or level, access to media, religion, ethnicity, wealth index, marital status, and geographical region were factors identified to be associated with barriers to healthcare utilisation in Ghana. It is recommended that policymakers prioritise interventions aimed at addressing regional disparities in healthcare infrastructure, improving geographic accessibility to healthcare services, and tackling socioeconomic, cultural, and social determinants of health. Efforts should focus on strengthening community-based healthcare initiatives, strengthening health insurance coverage, and promoting health education and literacy programs. These interventions can enhance health outcomes and promote health equity nationwide.