Department of Biological Sciences

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    Regional distribution and factors associated with early marriage in Ghana: a cross-sectional study
    (BioMed Central, 2024-10-29) Ahinkorah, Bright Opoku
    BACKGROUND: Early marriage, the formal or informal union before age 18, remains a critical challenge in several low-and middle-income countries. It has adverse health and education-related implications on child brides. This study examined the regional distribution of early marriage and its associated factors in Ghana. METHODS: We performed a cross-sectional analysis of data extracted from the 2022 Ghana Demographic and Health Survey. Our study comprised 10,098 ever married/cohabiting aged 15 to 49. Regional variations in the prevalence of child marriage were visualised using a spatial map. A mixed-effect multilevel binary logistic regression analysis was performed to assess the factors associated with early marriage. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI). RESULTS: The prevalence of early marriage was 29.2% \[27.9, 30.6\] in Ghana. Women in the North East 38.2% \[33.4, 43.2\], Western North 36.7% \[32.1, 41.5\] and Ahafo regions 35.8% \[32.0, 39.8\] had the highest prevalence of early marriage, whilst women in the Western 22.2% \[18.4, 26.5\] and Greater Accra 19.7% \[15.8, 24.3 regions\] had the lowest prevalence of early marriage in Ghana. The odds of early marriage was lower among women aged 20-49 compared to those aged 15-19. Women with secondary \[aOR = 0.40; 95% CI 0.33, 0.48\] and higher education \[aOR = 0.07; 95% CI 0.04, 0.12\], those who belonged to the Gurma ethnic group \[aOR = 0.59; 95% CI 0.41, 0.84\], and women from richer \[aOR = 0.64; 95% CI: 0.47, 0.87\] and richest \[aOR = 0.42; 95% CI 0.28, 0.64\] households were less likely to be married early compared to those with no education, those belonging to the Akan ethnic group, and those from the poorest wealth quintile households, respectively. The odds of early marriage was higher among women whose family size was five or more \[aOR = 1.50; 95% CI 1.31, 1.72\] and women living in the Central \[aOR = 1.72; 95% CI 1.16, 2.54\], Volta \[aOR = 1.97; 95% CI 1.17, 3.30\], Eastern \[aOR = 1.53; 95% CI 1.01, 2.29\], Ashanti \[aOR = 1.98; 95% CI 1.33, 2.97\], Western North \[aOR = 1.77; 95% CI 1.18, 2.65\], and Ahafo regions \[aOR = 1.74; 95% CI 1.18, 2.56\]. CONCLUSION: About one in three marriages were early in Ghana, with variations across the regions. Age, wealth index, ethnicity, level of education, family size, and region were identified as factors associated with early marriages. The government and policymakers in Ghana should increase access to and completion of secondary education for girls, as it is crucial in reducing early marriage. Providing programmes that economically empower women and girls can decrease their vulnerability to early marriage. More vigorous enforcement of laws against early marriage is necessary. Engaging with communities, including tribal leaders, is essential to shift cultural attitudes toward early marriage.
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    Regional disparities and socio-demographic factors associated with eight or more antenatal care visits in Ghana
    (BioMed Central, 2024-10-28) Aboagye, Richard Gyan
    BACKGROUND: Antenatal care is vital for maternal health and wellbeing, with the World Health Organization recommending a minimum of eight visits during pregnancy. In this study, we examined the regional disparities and factors associated with eight or more antenatal care visits in Ghana. METHODS: We performed a cross-sectional analysis of data from the 2022 Ghana Demographic and Health Survey. Our study comprised 3,893 women of reproductive age with birth history in the last two years before the survey. Regional disparities in the proportion of eight or more antenatal care visits were visualised using a spatial map. A mixed-effect multilevel binary logistic regression analysis was conducted to determine the factors associated with eight or more antenatal care visits using a four-modeled approach. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI). RESULTS: The prevalence of eight or more antenatal care visits in Ghana was 38.4% \[95% CI = 36.0-41.0\]. The regions with the highest prevalence were Eastern, Greater Accra, Western, and Volta. Those with the lowest prevalence were Northern, North East, Savannah, and Oti. The odds of eight or more antenatal care visits were lower among women aged 40-49 \[aOR = 0.42, 95% CI = 0.18-0.96\], women with four or more children \[aOR = 0.57, 95% CI = 0.36-0.93\], women who wanted pregnancy later \[aOR = 0.63, 95% CI = 0.46-0.85\], and women in five regions: Western North \[aOR = 0.43, 95% CI = 0.19-0.94\], Bono \[aOR = 0.33, 95% CI = 0.14-0.76\], Northern \[aOR = 0.29, 95% CI = 0.13-0.66\], Savannah \[aOR = 0.30, 95% CI = 0.14-0.65\] and North East \[aOR = 0.33, 95% CI = 0.14-0.75\]. Women in the richer \[aOR = 1.99, 95% CI = 1.19-3.33\] and richest \[aOR = 4.82, 95% CI = 2.45-9.51\] wealth index showed a higher likelihood of completing eight or more antenatal care visits relative to women in the poorest wealth index. CONCLUSION: A significant proportion of women in Ghana fall short of the recommended eight or more antenatal care visits. Age, parity, desired pregnancy timing, wealth status, and region of residence are associated with the number of antenatal care visits. Women in five regions (Bono, Northern, North East, Savannah, and Western North) are significantly less likely to have eight or more antenatal care visits than those in the Western region. The government and policymakers should design programs to address the needs of older women, those with high parity, and women who want to delay pregnancy. Increased healthcare resources, educational campaigns, and addressing regional barriers to antenatal care access are crucial. Promoting public health initiatives to emphasise the importance of completing the recommended number of antenatal care visits for a healthy pregnancy is essential.
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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.