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AbstractAlthough developing countries are experiencing some of the fastest rises in the prevalence of adult overweight and obesity, little is known about the pace of the problem among young people in transition from adolescence to adulthood. This study examined the trend and associated socio-demographic predictors of overweight/obesity (BMI ≥25kg/m2) from 1993 to 2014 among women aged 15–24 years in Ghana and projected the future prevalence from 2019 to 2040. Descriptive statistics, the arithmetic linear change model, and binary logistic regression were applied to data on women aged 15–24 years from five nationally representative Ghana Demographic and Health Surveys conducted in 1993 (N=488), 1998 (N=517), 2003 (N=1832), 2008 (N=1693) and 2014 (N=1491). Overall, overweight/obesity among women aged 15–24 years almost tripled between the 1993 (6.8%; 95% CI=4.9–9.3) and 2014 (19.5%; 95% CI=17.3–21.2) surveys. Based on the arithmetic linear change model, overweight/obesity is projected to increase linearly to over 35% among the 15–24 year cohort of women by 2040. Age, educational level, wealth status, occupation, type of locality, ethnicity, frequency of viewing TV per week, parity and contraceptive use were found to be significant predictors of overweight/obesity among this sub-group of women. The trend of overweight/obesity demonstrated in this group of women could potentially provide momentum for further increases in the prevalence of overweight/obesity and associated health outcomes in the coming years in Ghana. This underscores the need for urgent national-level public health intervention efforts to curtail the problem.

SummaryHypertension is a significant contributor to the global burden of cardiovascular and related target organ diseases such as heart failure, coronary heart disease, stroke and kidney failure, and their associated premature morbidity, mortality and disability. Marital status is an important social characteristic known to predict a range of health outcomes including cardiovascular disease. However, little is known about its impact on hypertension in sub-Saharan Africa. This study explored the relationship between marital status and hypertension among women and men in Ghana. Drawing on data from the 2014 Ghana Demographic and Health Survey (GDHS), descriptive statistics and binary logistic regression models were used to analyse the link between marital status and hypertension. About 13% of women aged 15–49 and 15% of men aged 15–59 were found to be hypertensive. After controlling for lifestyle and socio-demographic covariates, the logistic regression models showed significantly higher odds of hypertension for married (OR=2.14, 95% CI=1.30–3.53), cohabiting (OR=1.94, 95% CI=1.16–3.23) and previously married (OR=2.23, 95% CI=1.29–3.84) women. In contrast, no significant association was found between any of the marital status cohorts and hypertension for men. Other significant predictors of hypertension were age, body mass index and wealth status. The results demonstrate that marital status is an independent risk factor for hypertension in Ghana for women, rather than men. This could have immediate and far-reaching consequences for cardiovascular health policy in Ghana. In particular, the findings could lead to better targeted public health interventions, including more effective risk factor assessment and patient education in clinical settings, which could lead to more effective patient management and improved cardiovascular outcomes.

SummaryThis study aimed to contribute to the evidence on the timing of sexual debut in young people in sub-Saharan African countries. Data were extracted from 34 nationally representative surveys conducted in the region between 2006 and 2014. The study sample comprised unmarried women (n=167,932) and men (n=76,900) aged 15–24 years. Descriptive techniques and Cox proportional regression models were used to estimate the timing of sexual debut, and Kaplan–Meier hazard curves were used to describe the patterns of sexual debut in each country by sex. For the countries studied, sexual debut for both women and men occurred between the ages of 15 and 18 years, with median ages of 16 for women and 17 for men. Overall, education and household wealth provided significant protection against early sexual debut among women, but the reverse was found among men for wealth. Women in rural areas, in female-headed households and in Central, South and West Africa reported higher hazards of early commencement of sexual activity than their counterparts in urban, male-headed households and East Africa. However, the impact of these variables on male sexual debut did not follow a consistent pattern. Varied timing, as well as country-specific risk factors associated with sexual debut for young women and men across sub-Saharan Africa, were identified. Sexual health programmes and interventions for young people may require different approaches for young women and men.