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Infant mortality rates in 34 Sub-Saharan African countries (1960–2016), obtained from the Federal Reserve Bank of St. Louis database, were examined in this paper by focusing on the degree of persistence and non-linearities in the growth rate series. Persistence deals with the degree of association between the observations. Non-linearity occurs when departing from the linear assumption as in a time trend. These two issues are relevant in this context because they are intimately related. Based on the high degree of persistence observed in the series examined, instead of investigating structural breaks, which produce abrupt changes in the data, a non-linear approach was used based on Chebyshev polynomials in time, producing smooth rather than abrupt changes. This approach has never been examined in a unified framework in the treatment of infant mortality rates. The results indicate that half of the countries examined display non-linearities and the orders of integration of the series are extremely large in all cases, being around two in the majority of them. Looking at the growth rate series, significant negative trends were observed for: Chad, Equatorial Guinea and Mozambique. Evidence of mean reversion and thus transitory shocks, were observed for Lesotho, Rwanda, Botswana and Mozambique. Time dynamics of the series were expected to persist in order to ascertain the decline in mortality rates. Therefore, serious government interventions are required in managing infant health in these countries. ; pre-print ; 314 KB

Background Use of insecticide-treated net (ITN) has been identified by the World Health Organization as an effective approach for malaria prevention. The government of Uganda has instituted measures to enhance ITN supply over the past decade, however, the country ranks third towards the global malaria burden. As a result, this study investigated how individual, community and region level factors affect ITN use among women of reproductive age in Uganda. Methods The 2018-2019 Malaria Indicator Survey of Uganda involving 7798 women aged 15-49 was utilized. The descriptive summaries of ITN use were analysed by individual, community and region level factors. Based on the hierarchical nature of the data, four distinct binomial multilevel logistic regression models were fitted using the MLwiN 3.05 module in Stata. The parameters were estimated using the Markov Chain Monte Carlo (MCMC) estimation procedure and Bayesian Deviance Information Criterion was used to identify the model with a better fit. Results The proportion of women who use ITN was 78.2% (n = 6097). Poor household wealth status [aOR = 1.66, Crl = 1.55-1.80], knowing that sleeping under ITN prevents malaria [aOR = 1.11, Crl = 1.05-1.24] and that destroying mosquito breeding sites can prevent malaria [aOR = 1.85, Crl = 1.75-1.98] were associated with higher odds of ITN use. ITN use attributable to regional and community level random effects was 39.1% and 45.2%, respectively. Conclusion The study has illustrated that ITN policies and interventions in Uganda need to be sensitive to community and region level factors that affect usage. Also, strategies to enhance women's knowledge on malaria prevention is indispensable in improving ITN use.

Background Inequality of opportunity in health and nutrition is a major public health issue in the developing regions. This study analyzed the patterns and extent of inequality of opportunity in health and nutrition among children under-five across three countries sub-Saharan Africa with low Human development index (HDI). Methods We used data from the Multiple Indicator Cluster Survey of the Democratic Republic of Congo (20,792 households, 21,756 women aged 15 to 49 and 21,456 children under five), Guinea Bissau (6601 households, 10,234 women aged 15-49 and 7573 children under five) and Mali (11,830 households, 18,409 women in 15-49 years and 16,468 children under five) to compute the human opportunity index (HOI) and the dissimilarity index (D-index). Secondly, the Shapley decomposition method was used to estimate the relative contribution of circumstances that are beyond the control of children under-five and affecting their development outcomes in later life stages. Results The study revealed that children belonging to the most favorable group had higher access rates for immunization (93.64%) and water and sanitation facilities (73.59%) in Guinea Bissau. In Congo DR, the access rate was high for immunization (93.9%) for children in the most favorable group. In Mali, access rates stood at 6.56% for children in the most favorable group. In Guinea Bissau, the inequality of opportunity was important in access to health services before and after delivery (43.85%). In Congo DR, the inequality of opportunity was only high for the immunization composite indicator (83.79%) while in Mali, inequality of opportunity was higher for access to health services before and after delivery (41.67%). Conclusion The results show that there are efforts in some places to promote access to health and nutrition services in order to make access equal without distinction linked to the socio-economic and demographic characteristics in which the children live. However, the inequalities of opportunity observed between the children of the most favorable group and those of the least favorable group, remain in general at significant levels and call on government of these countries to implement policies taking them into account.

Background. Although deworming pregnant women is one of the strategies to reduce parasites (roundworms and hookworms) causing anemia and related perinatal and maternal complications, utilization of deworming medication among pregnant women in Cameroon is suboptimal. Comprehensive assessment of individual, household (including women's autonomy), and community-level factors associated with utilization of deworming medication has not been done so far. Therefore, we investigated the individual/household and community-level factors associated with deworming among pregnant married women in Cameroon. Methods. Our study was limited to pregnant women because they have a greater risk due to increased chances of anemia. We used data from the 2018/19 Cameroon Demographic and Health Survey. Analysis on 5,013 pregnant married women was carried out using multilevel logistic regression. Odds ratios with a 95% confidence interval (CI) were reported. Results. Our findings showed that about 29.8% of pregnant married women received deworming medications. The individual/household level predictors of deworming medications utilization identified in this study were women's educational level, wealth quintile, and skilled antenatal care. Distance to health facility and region were identified as community-level predictors of deworming medications utilization. Higher odds of receiving deworming medication occurred among educated and wealthier pregnant married women as well as among pregnant married women who had skilled antenatal care or lived in the south region, whereas lower odds were observed among pregnant married women living in the north region. Conclusion. Access to education and economic empowerment of pregnant married women in remote areas and the north region should be the primary focus of the Cameroon government to enhance deworming coverage in the country.

The poor air quality in the London metropolis has sparked our interest in studying the time series dynamics of air pollutants in the city. The dataset consists of roadside and background air quality for seven standard pollutants: nitric oxide (NO), nitrogen dioxide (NO2), oxides of nitrogen (NOx), ozone (O3), particulate matter (PM10 and PM2.5) and sulphur dioxide (SO2), using fractional integration to investigate issues such as persistence, seasonality and time trends in the data. Though we notice a large degree of heterogeneity across pollutants and a persistent behaviour based on a long memory pattern is observed practically in all cases. Seasonality and decreasing linear trends are also found in some cases. The findings in the paper may serve as a guide to air pollution management and European Union (EU) policymakers. ; pre-print ; 455 KB

The poor air quality in the London metropolis has sparked our interest in studying the time series dynamics of air pollutants in the city. The dataset consists of roadside and background air quality for seven standard pollutants: nitric oxide (NO), nitrogen dioxide (NO2), oxides of nitrogen (NOx), ozone (O3), particulate matter (PM10 and PM2.5) and sulphur dioxide (SO2), using fractional integration to investigate issues such as persistence, seasonality and time trends in the data. Though we notice a large degree of heterogeneity across pollutants and a persistent behaviour based on a long memory pattern is observed practically in all cases. Seasonality and decreasing linear trends are also found in some cases. The findings in the paper may serve as a guide to air pollution management and European Union (EU) policymakers. ; pre-print ; 455 KB

Background Globally, intimate partner violence is one of the most common forms of gender-based violence, and wife beating is one component of intimate partner violence, with the problem being more severe among women living in rural settings. Little is known about the factors that explain the urban-rural disparity in the prevalence of wife beating attitude in Senegal. In this paper, we aimed to decompose the urban-rural disparities in factors associated with wife beating attitude among married women in Senegal. Methods Data were derived from the 2017 Senegal Continuous Demographic and Health Survey. We used the Blinder-Oaxaca decomposition method to decompose and explain the variation in the prevalence of disagreement to wife beating between urban and rural areas in Senegal. Results The results show that 48.9% of married women in Senegal disagreed with wife-beating. About 69% of urban women disagreed with wife beating, but only 36% of rural women disagreed with wife beating. About 68.7% of women in the sample reported that they disagreed to wife beating by their husbands for burning food and nearly 50% of women reported that they disagreed with wife beating when they refuse to have sex with their husbands. About 86% of the urban-rural disparities in disagreement with wife beating are explained in this study. Economic status (45.2%), subnational region (22.4%), women's educational status (13.3%), and husband's educational status (10.7%) accounted for 91.6% of the disparities. Conclusions The study shows urban-rural disparities in the prevalence of wife-beating attitude (disagreement with wife beating) and this disfavored rural residents. We suggest the need for the government of Senegal to consider pro-rural equity strategies to narrow down the observed disparities. Moreover, socioeconomic empowerment and attitudinal changing interventions using existing socio-cultural institutions as platforms can be used to deliver such interventions.