Background: Maternal and child health are important issues for global health policy, and the past three decades have seen a significant progress in maternal and child healthcare worldwide. Immunization is a critical, efficient, and cost-effective public health intervention for newborns. However, studies on these health-promoting indicators in low-income and middle-income countries, especially in sub-Sahara Africa are sparse. We investigated the association between maternal healthcare utilization and complete vaccination in the Republic of Benin. Methods: We analysed data from the 2018 Benin Demographic and Health Survey (BDHS). Specifically, the children’s recode file was used for the study. The outcome variable used was complete vaccination. Number of antenatal care visits, assistance during delivery, and postnatal check-up visits were the key explanatory variables. Bivariate and multilevel logistic regression analyses were carried out. The results were presented as unadjusted odds ratios (uOR) and adjusted odds ratios (aOR), with their corresponding 95% confidence intervals (CIs) signifying their level of precision. Statistical significance was declared at p < 0.05. Results: The prevalence of full immunization coverage in Benin was 85.4%. The likelihood of full immunization was lower among children whose mothers had no antenatal care visits, compared to those whose mothers had 1–3 visits [aOR = 0.11, 95% CI: 0.08–0.15], those who got assistance from Traditional Birth Attendants/other during delivery, compared to those who had assistance from Skilled Birth Attendants/health professionals [aOR = 0.55, 95% CI: 0.40–0.77], and mothers who had no postnatal care check-up visit, compared to those who had postnatal care check-up < 24 h after delivery [aOR = 0.49, 95% CI: 0.36–0.67]. With the covariates, religion, partner’s level of education, parity, wealth quintile, and place of residence also showed significant associations with full immunization. Conclusion: The study has demonstrated strong association between full immunization and antenatal care, skilled attendance at birth, and postnatal care check-up visit. We found that full immunization decreases among women with no antenatal care visits, those who receive assistance from Traditional Birth Attendants during delivery, and those who do not go for postnatal care visits. To help achieve full immunization, it is prudent that the government of Benin collaborates with international organisations such as WHO and UNICEF to provide education to pregnant women on the importance of immunization after delivery. Such education can be embedded in the antenatal care, delivery and postnatal care services offered to pregnant women during pregnancy, delivery, and after delivery.

The current study sought to investigate the joint effect of maternal marital status and type of household cooking fuel on child nutritional status in sub-Saharan Africa. Data in the children’s files of 31 sub-Saharan African countries were pooled from the Demographic and Health Surveys collected between 2010 and 2019. The outcome variables were three child anthropometrics: stunting (height-for-age z-scores); wasting (weight-for-height z-scores); and underweight (weight-for-age z-scores). The joint effect of maternal marital status and type of household cooking fuel on child nutritional status was examined using multilevel regression models. The results were presented as adjusted odds ratios (aORs) at p < 0.05. The percentages of children who were stunted, wasted and underweight in the 31 countries in sub-Saharan Africa were 31%, 8% and 17%, respectively. On the joint effect of maternal marital status and type of household cooking fuel on stunting, we found that compared to children born to married mothers who used clean household cooking fuel, children born to single mothers who use unclean household cooking fuel, children born to single women who use clean household cooking fuel, and children born to married women who used unclean household cooking were more likely to be stunted. With wasting, children born to single mothers who used unclean household cooking fuel and children born to married women who used unclean household cooking fuel were more likely to be wasted compared to children born to married mothers who used clean household cooking fuel. With underweight, we found that compared to children born to married mothers who used clean household cooking fuel, children born to single mothers who used unclean household cooking fuel, children born to single women who used clean household cooking fuel and children born to married women who used unclean household cooking were more likely to be underweight. It is imperative for the governments of the 31 sub-Saharan African countries to double their efforts to end the use of unclean household cooking fuel. This goal could be achieved by promoting clean household cooking fuel (e.g., electricity, gas, ethanol, solar, etc.) through effective health education, and promotion programmes. The attention of policymakers is drawn to the urgent need for children’s nutritional status policies and programmes (e.g., dietary supplementation, increasing dietary diversity, improving agriculture and food security) to be targeted towards at-risk sub-populations (i.e., single mothered households).

Background: Anaemia during pregnancy is a major public health concern in both advanced and less-developed countries including Ghana. The prevalence of anaemia in Ghana has a serious repercussion on the country's social and economic development. This prevalence has been linked to various factors, including educational level and occupational status.Methods: A prospective study was conducted to investigate the factors influencing anaemia among 150 pregnant women, aged 15–49 years, who attended antenatal clinics in the Adaklu District of the Volta region of Ghana. Haemoglobin levels were assessed in the first, second, and third trimesters, and a questionnaire was also used to collect data on demographic information and barriers to maintaining haemoglobin levels. The data were analysed using frequencies, percentages, and binary logistic regression.Results: The prevalence of pregnancy anaemia in the district was 78.5%. The study found that 92% and 8% of pregnant women had excellent and good knowledge on anaemia in pregnancy, respectively. The study also identified several barriers to maintaining an appropriate haemoglobin level during pregnancy, such as long distances to healthcare facilities, non-intake of antimalarial drugs, and lack of nutritious meals. Finally, the study found that low education level, number of pregnancies, and number of children a woman had were significant determinants of anaemia during pregnancy in the district.Conclusion: The findings of the study suggest that targeted interventions are needed to reduce the burden of anaemia during pregnancy in the district. These interventions should address the social and environmental determinants of anaemia during pregnancy, such as improving access to healthcare facilities and promoting healthy eating habits. In addition, interventions that address social determinants of health, such as education and occupation, may be effective in reducing the burden of anaemia during pregnancy in the district.

Introduction: Early-life nutrition related experiences may fuel the emergence of obesity and type 2 diabetes in adolescence. The adoption of unhealthy dietary practices early in life is an indicator of adverse cardiometabolic health in adulthood. In-school adolescents’ dietary practices in Ghana have not been explored extensively despite increasing levels of obesity in adolescents. This study sought to examine dietary practices, socio-demographic disparities and the factors influencing dietary choices among in-school adolescents in Ghana. Methods: A school-based, cross-sectional study was conducted in the Central region of Ghana in 2017. Using multistage sampling procedures, a total of 1,311 in-school adolescents were selected for the study. A modified version of the generic Global School Health Survey questionnaire on dietary practices was adapted and used for data collection. Percentage and frequency counts were used to report on the dietary practices, while Chi-square was used to determine socio-demographic variations in the dietary practices. Binary logistic regression was used to compute the influence of socio-demographic characteristics of respondents on the prevalence of healthy dietary behavior among in-school adolescents. Results: The study revealed the prevalence of healthy dietary practices (49.9%, n = 654) among in-school adolescents in the region. The study also found increased frequency in consumption of soft drinks (93%, n = 1220) and toffees/sweets (90%, n = 1183) among in-school adolescents. However, low intake of breakfast (57%, n = 749) was observed among the adolescents. Significant disparities were observed in relation to gender, age, parental communication, academic performance and geographical location in the dietary practices of in-school adolescents. Furthermore, gender (OR = 1.36, P = 0.007), academic performance (OR = 2.19, P = 0.001) and geographical location (OR = 1.79, P = 0.001) were found to be significantly associated with dietary practices among in-school adolescents in the region. Conclusions: There was low consumption of fruits and vegetables among adolescents. Fruits and vegetables consumption was associated with gender, academic performance and geographical location, and these may be a reflection that knowledge on healthy food choices and availability are important factors influencing dietary choices among in-school adolescents. School health policy interventions aimed at improving nutritional status among adolescents and enhanced fruit and vegetable consumption in the country should take into account the potential benefit of increasing availability of fruits and vegetables in schools, while reducing access to sweets and soft drinks in the schools and communities.

Introduction: To improve detection of undiagnosed diabetes in Africa, there is movement to replace the OGTT with A1C. The performance of A1C in the absence of hemoglobin-related micronutrient deficiencies, anemia and heterozygous hemoglobinopathies is unknown. Therefore, we determined in 441 African-born blacks living in America [male: 65% (281/441), age: 38 ± 10 y (mean ± SD), BMI: 27.5 ± 4.4 kg/m²] (1) nutritional and hematologic profiles and (2) glucose tolerance categorization by OGTT and A1C. Methods: Hematologic and nutritional status were assessed. Hemoglobin <11 g/dL occurred in 3% (11/441) of patients and led to exclusion. A1C and OGTT were performed in the remaining 430 participants. ADA thresholds for A1C and OGTT were used. Diagnosis by A1C required meeting either A1C-alone or A1C&OGTT criteria. Diagnosis by OGTT-alone required detection by OGTT and not A1C. Results: Hemoglobin, mean corpuscular volume and red blood cell distribution width were 14.0 ± 1.3 g/dL, 85.5 ± 5.3 fL, and 13.2 ± 1.2% respectively. B12, folate, and iron deficiency occurred in 1% (5/430), 0% (0/430), and 4% (12/310), respectively. Heterozygous hemoglobinopathy prevalence was 18% (78/430). Overall, diabetes prevalence was 7% (32/430). A1C detected diabetes in 32% (10/32) but OGTT-alone detected 68% (22/32). Overall prediabetes prevalence was 41% (178/430). A1C detected 57% (102/178) but OGTT-alone identified 43% (76/178). After excluding individuals with heterozygous hemoglobinopathies, the rate of missed diagnosis by A1C of abnormal glucose tolerance did not change (OR: 0.99, 95% CI: 0.61, 1.62). Conclusions: In nutritionally replete Africans without anemia or heterozygous hemoglobinopathy, if only A1C is used, ~60% with diabetes and ~40% with prediabetes would be undiagnosed. Clinical Trial Registration: www.ClinicalTrials.gov, Identifier: NCT00001853

Despite a recent shift in school going adolescents’ engagement in health compromising behaviours and their related socio-economic implications on developing societies, it is surprising that baseline information for planned interventions is sparse. The purpose of this study was to investigate the prevalence of alcohol drinking and related behaviours among in-school adolescents in the Junior High Schools (JHS) in the Central Region of Ghana. Descriptive cross-sectional design was employed with multistage sampling procedures to sample 1400 school going adolescents in JHS in the Central Region. Preliminary findings using simple frequencies and percentages revealed 42% alcohol drinking prevalence in the region. High prevalence of drunkenness (73%, n = 406) and early exposure to alcohol drinking when students were in primary school (52%, n = 286) were noted. Community festivals and use of alcohol as a form of medicine were enabling factors of alcohol consumption in the region. Binary logistic regression analysis also showed that geographical location was a significant predictor of alcohol drinking among school going adolescents, with students in the southern and central part of the region at greater risks of drinking alcohol than those from the northern part (OR = .696, 95% CI = 0.52–926, p = .013). However, no statistical significant variations were found in the odds of drinking alcohol for age (OR = 1.13, 95% CI = 0.86–1.48, p = .370), gender (OR = .81, 95% CI = 0.65–1.01, p = .06), religious affiliation (OR = 1.33, 95% CI = 0.94–1.89, p = .10), parental communication (OR = .86, 95% CI = 0.66–1.06, p = .13), academic performance (OR = 1.07, 95% CI = 0.79–1.45, p = .05) and socioeconomic status (OR = 1.20, 95% CI = 0.95–1.53, p = .12). With this baseline data, it was recommended that schools’ curricula should include preventive cognitive-behavioural interventions that teach drug resistance skills and anti-drug norms. These interventions would foster the development of requisite knowledge and social skills (e.g., developing competence) for resisting social and peer influences that may trigger alcohol use and perhaps other drugs. Potentially, the motivation for alcohol use among school going adolescents in the region would be minimized, if not prevented.