Background: Utilization of modern contraceptives is still low in low-and middle-income countries, although fertility and population growth rates are high. In Senegal, modern contraceptive utilization is low, with few studies focusing on its associated factors. This study examined modern contraceptive use and its associated factors among married women in Senegal. Methods: Data from the 2017 Continuous Demographic and Health Survey (C-DHS) on 11,394 married women was analysed. We examined the associations between the demographic and socioeconomic characteristics of women and their partners and modern contraceptive use using multilevel logistic regression models. Adjusted odds ratios with 95% confidence intervals (CI) were estimated. Results: The utilization of modern contraceptives among married women was 26.3%. Individual level factors associated with modern contraceptive use were women’s age (45–49 years-aOR = 0.44, 0.30–0.63), women’s educational level (higher-aOR = 1.88, 1.28–2.76) husband’s educational level (higher-aOR = 1.43, 1.10–1.85)), number of living children (5 or more children-aOR = 33.14, 19.20–57.22), ideal number of children (2 children-aOR = 1.95, 1.13–3.35), desire to have more children (wants no more-aOR = 2.46, 2.06–2.94), ethnicity (Diola-aOR = 0.70, 0.50–0.99), media exposure (yes-aOR = 1.44, 1.16–1.79)), wealth index (richer-aOR = 1.31, 1.03–1.67) and decision making power of women (decision making two-aOR = 1.20, 1.02–1.41). Whereas, region (Matam-aOR = 0.35, 0.23–0.53), place of residence (rural-aOR = 0.76, 0.63–0.93), community literacy level (high-aOR = 1.31, 1.01–1.71) and community knowledge level of modern contraceptives (high-aOR = 1.37, 1.13–1.67) were found as significant community level factors. Conclusions: The findings indicate that both individual and community level factors are significantly associated with modern contraceptive use among married women in Senegal. Interventions should focus on enhancing literacy levels of women, their husbands and communities. Furthermore, strengthening awareness and attitude towards family planning should be given priority, especially in rural areas and regions with low resources.

Background: In Senegal, sub-Saharan Africa, many women continue to die from pregnancy and childbirth complications. Even though health facility delivery is a key intervention to reducing maternal death, utilization is low. There is a dearth of evidence on determinants of health facility delivery in Senegal. Therefore, this study investigated the predictors of health facility-based delivery utilization in Senegal.Methods: Data from the 2017 Senegal Continuous Survey were extracted for this study, and approximately 11,487 ever-married women aged 15–49 years participated. Chi-square test was used to select significant variables and multivariable logistic regression analysis was performed to identify statistically significant predictors at a 95% confidence interval with a 0.05p-value using Stata version 14 software.Results: Facility-based delivery utilization was 77.7% and the main predictors were maternal educational status (primary school Adjusted Odds Ratio [aOR] = 1.44, 95% CI; 1.14–1.83; secondary school aOR = 1.62, 95% CI; 1.17–2.25), husband’s educational status (primary school aOR = 1.65, 95% CI; 1.24–2.20, secondary school aOR = 2.17, 95% CI; 1.52–3.10), maternal occupation (agricultural-self-employed aOR = 0.77, 95% CI; 0.62–0.96), ethnicity (Poular aOR = 0.74, 95% CI; 0.56–0.97), place of residence (rural aOR = 0.57, 95% CI; 0.43, 0.74), media exposure (yes aOR = 1.26, 95% CI; 1.02–1.57), economic status (richest aOR = 5.27, 95% CI; 2.85–9.73), parity (seven and above aOR =0.46, 95% CI; 0.34–0.62), wife beating attitude (refuse aOR =1.23, 95% CI; 1.05–1.44) and skilled antenatal care (ANC) (yes aOR = 4.34, 95% CI; 3.10–6.08).Conclusion: Uptake of health facility delivery services was seen among women who were educated, exposed to media, wealthy, against wife-beating, attended ANC by skilled attendants and had educated husbands. On the other hand, women from ethnic groups like Poular, those working in agricultural activities, living in rural setting, and those who had more delivery history were less likely to deliver at a health facility. Therefore, there is the need to empower women by encouraging them to use skilled ANC services in order for them to gain the requisite knowledge they need to enhance their utilization of health facility delivery, whiles at the same time, removing socio-economic barriers to access to health facility delivery that occur from low education, poverty and rural dwelling.

The COVID-19 pandemic threatens to set back major successes that have been achieved in global vaccine initiatives. We conducted a rapid review and synthesis of the literature on immunization provision and Utilization since the onset of the COVID-19 pandemic. A total of 11 papers comprising peer-reviewed articles and key policies and guidelines, published between January 1 and June 15, 2020, were analyzed. Widespread disruptions of routine immunization and vaccination campaigns were reported leaving millions of children worldwide at risk of measles outbreaks. We present an expanded model of the World Health Organization’s Global Routine Immunization Strategic Plan (GRISP) action areas as a tool to help countries quickly adapt to immunization challenges in the presence of COVID-19 and close the emerging immunization coverage gaps. Key words: • Immunization • Child health • Vaccination • COVID-19 • Essential health services • Corona virus Copyright © 2020 Olorunsaiye et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

Background. Child marriage is a major public health problem globally, and the prevalence remains high in sub‐Saharan African countries, including Mali. There is a dearth of evidence about factors associated with child marriage in Mali. Hence, this studyaimed at investigating the individual/household and community‐level factors associated with child marriage among women in Mali. Methods. Using data from the 2018 Mali Demographic and Health Survey, analysis was done on 8,350 women aged 18‐49 years. A Chi‐square test was used to select candidate variables for the multilevel multivariable logistic regression models. Fixed effects results weree xpressed as adjusted odds ratios (aOR) at 95% confidence intervals (CI). Stata version 14 software was used for the analysis. Results. The results showed that 58.2% (95% CI; 56.3%‐60.0%) and 20.3% (95%; 19.0%‐21.6%) of women aged 18‐49 years were married before their 18^th and 15^th birthday, respectively. Educational status of women (higher education: aOR = 0.25, 95% CI; 0.14‐0.44), their partner’s/husband’s educational status (higher education: aOR = 0.64, 95% CI; 0.47‐0.87), women’s occupation (professional, technical, or managerial: aOR = 0.50, 95% CI; 0.33‐0.77), family size (five and above: aOR = 1.16, 95% CI; 1.03‐1.30), and ethnicity (Senoufo/Minianka: aOR = 0.73, 95% CI; 0.58‐0.92) were the identified individual/household level factors associated with child marriage, whereas region (Mopti: aOR = 0.27, 95% CI; 0.19‐0.39) was the community level factor associated with child marriage. Conclusions. This study has revealed a high prevalence of child marriage in Mali. To reduce the magnitude of child marriage in Mali, enhancing policies and programs that promote education for both girls and boys, creating employment opportunities, improving the utilization of family planning services, and sensitizing girls and parents who live in regions such as Kayes on the negative effects of child marriage is essential. Moreover, working with community leaders so as to reduce child marriage in the Bambara ethnic communities would also be beneficial.

Background: Intimate partner violence remains a major public health problem, especially in countries in sub-Saharan Africa. We examined the factors associated with married women’s attitudes towards wife-beating in sub-Saharan Africa. Methods: We used Demographic and Health Survey data of 28 sub-Saharan African countries that had surveys conducted between 2010 and 2019. A sample of 253,782 married women was considered for the analysis. Bivariate and multivariate logistic regression analyses were carried out, and the results were presented using crude odds ratio (cOR) and adjusted odds ratio (aOR) at 95% confidence interval. Results: The pooled result showed about 71.4% of married women in the 28 countries in this study did not justify wife-beating. However, the prevalence of non-justification of wife-beating varied from 83.4% in Malawi to 17.7% in Mali. Women’s age (40–44 years-aOR = 1.61, 95% CI 1.16–2.24), women’s educational level (secondary school-aOR = 1.47, 95% CI 1.13–1.91), husband’s educational level (higher-aOR = 0.55, 95% CI 0.31–0.95), women’s occupation type (professional, technical or managerial-aOR = 1.66, 95% CI 1.06–2.62), wealth index (richest-aOR = 5.52, 95% CI 3.46–8.80) and women’s decision-making power (yes-aOR = 1.39, 95% CI 1.19–1.62) were significantly associated with attitude towards wife-beating. Conclusion: Overall, less than three-fourth of married women in the 28 sub-Saharan African countries disagreed with wife-beating but marked differences were observed across socio-economic, decision making and women empowerment factors. Enhancing women’s socioeconomic status, decision making power, and creating employment opportunities for women should be considered to increase women’s intolerance of wife-beating practices, especially among countries with low prevalence rates such as Mali.

Background: Maternal mortality remains high in sub-Saharan African countries, including Guinea. Skilled birth attendance (SBA) is one of the crucial interventions to avert preventable obstetric complications and related maternal deaths. However, within-country inequalities prevent a large proportion of women from receiving skilled birth attendance. Scarcity of evidence related to this exists in Guinea. Hence, this study investigated the magnitude and trends in socioeconomic and geographic-related inequalities in SBA in Guinea from 1999 to 2016 and neonatal mortality rate (NMR) between 1999 and 2012.Methods: We derived data from three Guinea Demographic and Health Surveys (1999, 2005 and 2012) and one Guinea Multiple Indicator Cluster Survey (2016). For analysis, we used the 2019 updated WHO Health Equity Assessment Toolkit (HEAT). We analyzed inequalities in SBA and NMR using Population Attributable Risk (PAR), Population Attributable Fraction (PAF), Difference (D) and Ratio (R). These summary measures were computed for four equity stratifiers: wealth, education, place of residence and subnational region. We computed 95% Uncertainty Intervals (UI) for each point estimate to show whether or not observed SBA inequalities and NMR are statistically significant and whether or not disparities changed significantly over time.Results: A total of 14,402 for SBA and 39,348 participants for NMR were involved. Profound socioeconomic- and geographic-related inequalities in SBA were found favoring the rich (PAR = 33.27; 95% UI: 29.85–36.68), educated (PAR = 48.38; 95% UI: 46.49–50.28), urban residents (D = 47.03; 95% UI: 42.33–51.72) and regions such as Conakry (R = 3.16; 95% UI: 2.31–4.00). Moreover, wealth-driven (PAF = -21.4; 95% UI: −26.1, −16.7), education-related (PAR = -16.7; 95% UI: −19.2, −14.3), urban-rural (PAF = -11.3; 95% UI: −14.8, −7.9), subnational region (R = 2.0, 95% UI: 1.2, 2.9) and sex-based (D = 12.1, 95% UI; 3.2, 20.9) inequalities in NMR were observed between 1999 and 2012. Though the pattern of inequality in SBA varied based on summary measures, both socioeconomic and geographic-related inequalities decreased over time.Conclusions: Disproportionate inequalities in SBA and NMR exist among disadvantaged women such as the poor, uneducated, rural residents, and women from regions like Mamou region. Hence, empowering women through education and economic resources, as well as prioritizing SBA for these disadvantaged groups could be key steps toward ensuring equitable SBA, reduction of NMR and advancing the health equity agenda of “no one left behind.”