Department of Biological Sciences

Permanent URI for this collectionhttps://dspace.njala.edu.sl/handle/20.500.144402/136

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Subject: search.filters.subject.Maternal Health

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Now showing 1 - 4 of 4
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    Trends and inequalities in early breastfeeding initiation in Ghana
    (BioMed Central, 2025-10-15) Adeleye, Khadijat
    BACKGROUND: Early breastfeeding initiation is a critical practice for improving neonatal health outcomes, yet little is known about its inequalities. This study examines trends and inequalities in early breastfeeding initiation among women in Ghana. METHODS: We employed an ecological time-trends study design among women of reproductive age, using six waves data from the Ghana Demographic and Health Surveys conducted in 1993, 1998, 2003, 2008, 2014, and 2022. The World Health Organization’s Health Equity Assessment Toolkit (HEAT) was used to compute inequality measures difference (D), prevalence ratio (PR), population attributable fraction (PAF), and population attributable risk (PAR) across six stratifiers: maternal age, child’s sex, household wealth, maternal education, place of residence, and subnational regions. RESULTS: Nationally, the prevalence of early breastfeeding initiation rose significantly from 15.2% in 1993 to 58.1% in 2022. All subgroups recorded improvements, with marginalized populations showing the largest gains. For instance, women in the lowest wealth quintile increased from 13.4% in 1993 to 60.2% in 2022, compared with women in the highest quintile who increased from 16.5% to 49.7% within the same period. Regionally, Bono East recorded the highest early breastfeeding initiation prevalence in 2022 (70.3%), while Greater Accra had the lowest (45%). Inequality assessments showed mixed patterns: wealth- and education-related disparities narrowed over time, with a 2022 prevalence ratio of 0.9, suggesting disadvantaged groups were more likely to adopt early breastfeeding initiation. Similarly, place of residence and child’s sex also narrowed overtime. However, age-related inequalities widened. Regional inequalities also persisted, with a prevalence ratio of 1.6 in 2022, indicating women in underserved regions were still more likely to practice early breastfeeding initiation compared with women in more advanced regions. CONCLUSION: Early breastfeeding initiation rates in Ghana have improved steadily over the past three decades, yet socioeconomic and regional disparities remain. Targeted strategies are needed to sustain gains and close gaps, including policy reforms to expand maternity leave and workplace breastfeeding support, as well as community-based initiatives such as awareness campaigns to promote equitable breastfeeding practices. Addressing these inequities will be vital for advancing maternal and child health outcomes in Ghana.
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    Sierra Leone’s safe motherhood bill: balancing public health, religious values, and cultural traditions
    (BioMed Central, 2025-07-08) Osborne, Augustus
    Sierra Leone’s safe motherhood and reproductive health care act 2024 represents a pivotal moment in the nation’s efforts to address its maternal health crisis while intersecting religious and cultural heritage. This commentary examines the multifaceted challenges and opportunities presented by this landmark legislation, which aims to transform maternal healthcare delivery in a country with one of the world’s highest maternal mortality rates. It analyzes the bill’s key provisions and their intersection with strong religious beliefs and cultural traditions. We highlight the notable opposition from religious organizations, particularly the Inter-Religious Council of Sierra Leone, which has emerged as a powerful voice against certain aspects of the bill, especially those related to reproductive rights. The paper also reveals the need for improved maternal healthcare, the strong influence of religious institutions, and the strong cultural practices surrounding motherhood and childbirth. It identifies key areas of tension, including the integration of traditional birth attendants into the modern healthcare system, the controversial provisions regarding reproductive rights, and the challenge of implementing universal healthcare access while respecting local customs. In addition, it suggests that successfully implementing the safe motherhood bill requires a carefully balanced approach that acknowledges and incorporates religious and cultural perspectives while advancing essential public health objectives. We propose a framework for stakeholder engagement and policy implementation that emphasizes inclusive dialogue, cultural sensitivity, and gradual integration of modern healthcare practices with traditional systems. This paper contributes to the broader understanding of how developing nations can balance healthcare reform while respecting religious values and cultural traditions. It offers valuable insights for policymakers and healthcare professionals implementing similar reforms in culturally diverse settings where traditional practices and modern medicine must find common ground.
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    Inequalities in the use of three-dose of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine among women in Sierra Leone, 2008–2019
    (BioMed Central, 2025-11-25) Osborne, Augustus
    BACKGROUND: Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is a key intervention for preventing malaria during pregnancy in areas with moderate to high malaria transmission. While IPTp-SP coverage has increased in Sierra Leone, disparities in uptake and completion of the recommended three doses persist. Understanding these trends and inequalities is crucial for improving maternal and child health outcomes. This study examined the trends and inequalities in using three doses of IPTp-SP among pregnant women in Sierra Leone between 2008 and 2019. METHODS: The research utilised data from the Sierra Leone Demographic Health Survey conducted in 2008, 2013 and 2019. The World Health Organisation Health Equity Assessment Toolkit software calculated several inequality measures, including simple difference (D), ratio (R), population-attributable risk (PAR), and population-attributable fraction (PAF). Inequality was assessed for four stratifiers: economic status, education level, place of residence, and sub-national province. RESULTS: In Sierra Leone, IPTp-SP coverage among pregnant women increased from 5.2% in 2008 to 35.7% in 2019. Economic inequalities among pregnant women in Quintile 5 (richest) and Quintile 1 (poorest) increased from a difference of -1.4 percentage points in 2008 to -5.2 percentage points in 2019. Disparities in education-related outcomes among pregnant women with secondary or higher education compared to those with no education decreased from a difference of 4.4 percentage points in 2008 to -3.8 percentage points in 2019. The disparities in place of residence among pregnant women in urban versus rural areas decreased from a difference of 1.4 percentage points in 2008 to -6.3 percentage points in 2019. Provincial inequalities increased from a difference of 4.1 percentage points in 2008 to 18.4 percentage points in 2019. CONCLUSION: Despite the overall improvement in IPTp-SP coverage and the decreasing economic, educational and place of residence-related inequalities, continued provincial-level disparities indicate the necessity of tailoring interventions to address provincial-specific barriers. To achieve universal and equitable coverage of IPTp-SP, the study recommends a multifaceted approach that combines strengthening the health system, targeted behaviour change communication and addressing social determinants of health.
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    Mapping the evidence on factors influencing postpartum contraception among sub-Saharan African immigrant and refugee women in the United States: a scoping review
    (BioMed Central, 2026-03-04) Olorunsaiye, Comfort Z
    BACKGROUND: The postpartum period is a critical window for addressing women's contraceptive needs. Sub-Saharan African immigrant and refugee women living in the United State face unique barriers to postpartum contraception due to cultural norms, religious beliefs, migration-related challenges, and systemic inequalities, yet there is limited evidence on their postpartum contraceptive preferences and use. This scoping review mapped the existing literature on postpartum contraception among this population and identified key factors influencing uptake. METHODS: Following Joanna Briggs Institute guidelines, we conducted a scoping review of studies published in English from January 2000-June 2024. Eligible studies focused on sub-Saharan African immigrant and refugee women aged 15-49 living in the US, and examined postpartum contraception, including predisposing factors, facilitators, and barriers. A systematic search of five databases (PubMed/MEDLINE, PsychInfo, CINAHL, EMBASE, Global Health Database) identified 410 studies; 10 studies were included. Data were coded and synthesized thematically using the PEN-3 Model as an analytic framework; findings were interpreted through an intersectionality lens. RESULTS: Postpartum contraceptive behaviors were shaped by predisposing factors, facilitators, and barriers. Cultural and religious norms favored natural methods like lactational amenorrhea, due to religious support for birth spacing but not limiting. Migration experiences were influential barriers, with challenges including language barriers, limited health literacy, and loss of insurance, postpartum. Facilitators were inclusive Medicaid policies, long-acting methods availability, and culturally sensitive counseling. CONCLUSIONS: Culturally responsive, equity-focused policies are essential to meet the postpartum contraceptive needs of sub-Saharan African immigrant and refugee women. Expanding Medicaid coverage, training providers in cultural competency, and engaging community leaders can improve access and trust.