Gobopamang Letamo

THE PREVALENCE OF, AND FACTORS ASSOCIATED WITH, OVERWEIGHT AND OBESITY IN BOTSWANA

The aim of this study was to estimate the prevalence of, and socio-demographic factors associated with, overweight and obesity in Botswana. A cross-sectional survey was conducted in 2007 using a multistage sampling method to select a representative sample of 4107 men and 4916 women aged 20-49 years. Logistic regression analysis was used to identify the socio-demographic factors associated with overweight and obesity. Mean BMI values for men and women were 21.7 kg/m2 and 24.4 kg/m2, respectively. Both overweight and obesity levels were higher among women than men. Overall, 23% of women were overweight compared with 13% of men. Obese women constituted about 15% compared with only 3% of men. However, 19% of men were underweight compared with 12% of women. The main socio-demographic factors associated with overweight and obesity were being older, living in a city/town, being married and having attained higher levels of education, and these relationships were statistically significant at the 5% level. Although over-nutrition is prevalent among adult female Botswana, underweight remains an important public health problem for males. Programmes and other interventions aimed at concurrently addressing both under-nutrition and overweight need to be developed.

FACTORS INFLUENCING LOW BIRTH WEIGHT AND PREMATURITY IN BOTSWANA

The purpose of this study was to investigate the socioeconomic, biological and behavioural factors influencing low birth weight and prematurity in Botswana. Data were from the Botswana Obstetric Record covering the years 1990 to 1995, and were analysed with both descriptive statistics and multivariate analysis. The study found that the major positive risk factors for low birth weight were: late and less frequent attendance of antenatal care services, having experienced pregnancy termination before, low or no education, unmarried motherhood and place of birth. With regard to prematurity, age, late and less frequent attendance of antenatal care services, unmarried motherhood and place of birth were found to be the major positive risk factors. The importance of early and regular antenatal care attendance, marriage and place of birth cut across both low birth weight and prematurity.

Misconceptions about HIV prevention and transmission in Botswana

Misconceptions about how HIV can be transmitted or prevented often prevent individuals from making informed choices and taking appropriate action. The purpose of the research was to explore the socio-demographic and behavioural factors in Botswana that are associated with misconceptions about HIV prevention and transmission. The data used were from the Botswana AIDS Impact Survey II conducted in 2004, which constitutes a nationally representative sample. Results from bivariate and multivariate analyses show that young people, males, the less educated, those who did not use a condom during their last instance of sexual intercourse, and those who believe that nothing can be done to reduce HIV infection are most likely to harbour misconceptions about how HIV can be prevented and transmitted. Since misconceptions may prevent people from making informed choices, intervention programmes aimed at HIV prevention should aim to dispel misconceptions about HIV and AIDS as an important part of their strategy. Targeted HIV prevention and education programmes are needed in an effort to dispel such misconceptions and likewise to address the needs of different population sub-groups.

Prevalence and determinants of adult under-nutrition in Botswana.

Background To estimate the prevalence and determinants of adult under-nutrition in Botswana. Methods A cross-sectional survey was conducted where a nationally representative sample of people aged 20 to 49 years was used for the analysis. The outcome measure of under-nutrition was measured as BMI<18.5 kg/m2. Results Of the total sample, 19.5% of males and 10.1% of females were underweight (BMI<18.5 kg/m2). The wealth index showed that 30.9% of the adult population with low a BMI belongs to the poorest 20% of the households while only 9.6% comprised of the richest 20% of the households. Results from logistic regression analysis indicated that both adult men and women who had no education and belonged to the low socioeconomic group had a statistically significant association with low BMI. Among the female adult population, being young and not having watched TV at least once a week were significantly associated with low BMI. For the male adult population, being unmarried was significantly associated with low BMI. Conclusions Programme interventions aimed at improving the nutritional status of adults can use these findings to make appropriate policy, to establish baselines and study nutritional changes over time and its covariates.

Health implications of early childbearing on pregnancy outcome in Botswana: insights from the institutional records

Early childbearing can have deleterious effects on pregnancy outcome. This study in Botswana found that both birth injuries and congenital abnormalities were common among infants born to teenage mothers compared to infants of women aged 20-34 years. This statistically significant relationship disappeared, however, when controls were introduced. Based on the results of this study, it appears that in order to improve pregnancy outcomes, frequent and early prenatal visits and improvements in the socioeconomic environment are needed. Thus, postponement of childbearing beyond teenage years alone would not necessarily improve pregnancy outcomes in Botswana.

Individual, household and contextual factors associated with skilled delivery care in Ethiopia: Evidence from Ethiopian demographic and health surveys

Despite evidence that social contexts are key determinants of health, research into factors associated with maternal health service utilization in Ethiopia has often focused on individual and household factors. The downside is that this underestimates the importance of taking contextual factors into account when planning appropriate interventions in promoting safe motherhood in the country. The purpose of this study is to fill this knowledge gap drawing attention to the largely unexplored contextual factors affecting the uptake of skilled attendance at delivery in a nationally representative sample. Data for the study comes from two rounds of the Ethiopian Demographic and Health Surveys (EDHS) conducted in the year 2005 and 2011. Analysis was done using a two-level multivariable multilevel logistic regression model with data from 14, 242 women who had a live birth in the five years preceding the surveys clustered within 540 (in the year 2005) and 624 (in the year 2011) communities. The results of the study point to multiple levels of measured and unmeasured factors affecting the uptake of skilled delivery care in the country. At community level, place of residence, community level of female education and fertility significantly predict the uptake of skilled delivery care. At individual and household level, maternal age, birth order, maternal education, household wealth and access to media predict the uptake of such service. Thus, there is a need to consider community contexts in the design of maternal health programs and employ multi-sectorial approach to addressing barriers at different levels. For example, improving access and availability of skilled delivery care should eventually enhance the uptake of such services at community level in Ethiopia. At individual level, efforts to promote the uptake of such services should constitute targeted interventions paying special attention to the needs of the youth, the multiparous, the less educated and women in the poorest households.

Levels, trends and reasons for unmet need for family planning among married women in Botswana: a cross-sectional study

Objectives The objectives of this study are: (1) to estimate the prevalence of unmet need for family planning among married women using Botswana Family Health Survey 2007 data and (2) to identify risk factors for unmet need for family planning among married women. Design This study used secondary data from a cross-sectional survey that was conducted to provide a snapshot of health issues in Botswana. Setting Nationally representative population survey data. Participants 2601 married or in union women aged 15–49 years who participated in the 2007 Botswana Family Health Survey were included in the analysis. Primary outcome Unmet need for family planning, which was defined as the percentage of all fecund married women who are not using a method of contraception even though they do not want to get pregnant. Results Married women who had unmet need for family planning were 9.6% in 2007. Most of the unmet need was for limiting (6.7%) compared to spacing (2.9%). Unmet need for family planning was more likely to be among women whose partners disapproved of family planning, non-Christians, had one partner and had never discussed family planning with their partner. Women of low parity, aged 25–34 years, and greater exposure to mass media, were less likely to have experienced unmet need. The patterns and magnitude of covariates differed between unmet need for limiting and for spacing. Conclusions The prevalence of unmet need for family planning was low in Botswana compared to other sub-Saharan African countries. The findings from this study reemphasise the importance of womens empowerment and mens involvement in womens sexual and reproductive healthcare needs and services. Different approaches are needed to satisfy the demand for family planning for spacing and limiting.

Non-residential unmarried biological fathers and parenting: Child support and father-child contact in Botswana

Abstract This paper examines the role of non-residential unmarried biological fathers in the upbringing of their children by focusing on father-child contact and child support. The paper uses a nationally representative sample of single mothers to examine father-child contact and provision of child-support by non-residential unmarried biological fathers. The paper looks at various sources of child support for children of single mothers and the context within which father-child contact and child support occurs. The results show that most of the child support for children of single mothers comes from the childs maternal relatives, especially the womans mother, her father and other relatives. Non-resident unmarried biological fathers were not providing any child support for close to two thirds of women in the sample. More than two-thirds of women in the sample reported that non-resident unmarried fathers were maintaining contact with their children. This study is one of the very few which examines the role played by non-resident unmarried biological fathers in the lives of their children in Botswana.

Complex association between rural/urban residence, household wealth and women's overweight: evidence from 30 cross-sectional national household surveys in Africa

BackgroundWe sought to demonstrate that the relationship between urban or rural residence and overweight status among women in Sub-Saharan Africa is complex and confounded by wealth status.MethodsWe applied multilevel logistic regression to data from 30 sub-Saharan African countries which were collected between 2006 and 2012 to examine the association between women’s overweight status (body mass index ≥ 25) and household wealth, rural or urban place of residence, and their interaction. Macro-level statistics from United Nations agencies were used as contextual variables to assess the link between progress in globalization and patterns of overweight.ResultsHousehold wealth was associated with increased odds of being overweight in nearly all of the countries. Urban/rural living and household wealth had a complex association with women’s overweight status, shown by 3 patterns. In one group of countries, characterised by low national wealth (median per capita gross national income (GNI) = 

Socioeconomic inequalities in the uptake of maternal healthcare services in Ethiopia

660 in 2012) and lower overall prevalence of female overweight (median = 24 per cent in 2010), high household wealth and urban living had independent associations with increased risks of being overweight. In the second group of less poor countries (median per capita GNI =