Déterminants des coûts directs de la maladie en soins ambulatoires dans les ménages à Kinshasa analyse comptable et économétrique / Determinants of the direct costs of the disease in outpatient care in households in Kinshasa: accounting and econometric analysis

Contexte et objectif. Avec une grande majorité d'habitants sans couverture-maladie, l'inaccessibilité aux soins pour manque d'argent est un problème réel parmi les habitants de Kinshasa en raison des paiements directs. La présente étude a évalué le coût direct de la maladie du point de vue des ménages et identifié les facteurs déterminants dudit coût. Méthodes. Une enquête a été menée dans la commune de Limete auprès de 150 ménages choisis de manière aléatoire dans huit quartiers. Les données collectées ont été soumises d'abord à un traitement comptable, puis à l'analyse statistique et à l'analyse économétrique. Résultats. Le coût total direct moyen était de 145.258,88 CDF (environ 88 US $) par épisode-patient en ambulatoires. Dominés largement par les médicaments, les frais médicaux représentent 86,57 % du total (76 US $) contre 13,43 % de frais non médicaux (12 US $). Excepté la consultation, les autres frais médicaux influent positivement sur le total des frais médicaux. De même, tous les frais non médicaux, sauf les frais d'appel téléphonique, influent sur le total des frais non médicaux. Conclusion. Le coût médical en ambulatoire par patient-épisode est dominé à 65 % par les frais de médicaments mais dont l'impact sur le coût médical de la maladie reste plus faible.

Prevalence of sexual harassment and its relationship with family birth order among female undergraduates: New findings from institutional-based cross-sectional study in the south east, Nigeria

Family is the microcosm of a larger society that provides care that shapes the behavior of children. However, the different levels of attention children receive from their parents may affect their behaviour and self-esteem, which can lead to them being more vulnerable to sexual harassment. An institutional-based cross-sectional survey was conducted from March ­ August 2021, to assess the relationship between family birth order and prevalence of sexual harassment. The multistage sampling procedure was used to draw 1070 participants. The data was analyzed using percentages, mean, and multivariate logistic regression statistics. The multivariate logistic regression was used to estimate adjusted odds ratios (AOR) along with 95% confidence intervals (CIs). The level of significance was set at P < 0.05. The findings revealed prevalence (73.6%) of sexual harassment, and the two forms such as verbal (x= 2.63) and non-verbal sexual harassment (x= 2.56) were high. The multivariate logistic regression odds ratios adjusted shows that the middle born were approximately 2 folds (AOR = 1.62; CI = 1.14 ­ 2.30; P = 0.008 0.05) more likely to predict sexual harassment. The study recommended amongst others that parents in South Eastern Nigeria should refrain from given special attention to a particular child as this may predispose the unfavoured child to sexual harassment

Provincial differentials of the effect of internal migration on teenage fertility in South Africa

This study investigated the association between internal migration and teenage fertility in South Africa. Data were from the 2007 and 2016 South African community surveys, N2007= 89800 and N2016=239733, age range 12 to 19, black teenagers= 81.5% and 89.4%, respectively. Results showed that between 2007 and 2016 internal migration levels decreased by 2% nationally, but increased for Gauteng, Western Cape and KwaZulu Natal provinces. Teenage fertility levels decreased in all provinces except the Northern Cape in the study period. In both years teenage fertility was observed at higher levels among girls that were older, heads of households, and who were in secondary schooling. Random-intercept multilevel binary logistic regression revealed that the risk of teenage fertility differed between more rural and urban provinces. In provinces that were predominantly rural the risk of teenage pregnancy increased as community-levels of internal migration increased while the risk decreased as internal migration increased in provinces that were predominantly urban. Findings suggest that the effects of internal migration on teenage pregnancy are largely dependent on the local context making it necessary to create interventions that are context-specific at sub-national levels.

Determinants of sex differentials in mortality: an assessment of household-level factors in South Africa

Background: Increasingly high male mortality hinders progress towards improving overall life expectancy. Data Source & Method: The study used data from South Africa's 2016 Community Surveyto examine the household-level determinants of male mortality. Chi square tests and binary logistic regression were used. Results: Out of the 30,022 deaths in the sample, males comprised 52.8%. Male deaths were high at all ages except for age group 75+ years. Odds of male mortality were higher (OR:2.08; CI:1.98-2.18) among those that lived in female headed households or White-headed households (OR:1.50;CI:1.29-1.73). There was less likelihood of male deaths (OR:0.91;CI:0.87-0.97) in households that were not involved in agriculture. Conclusion: Overall, mortality differentials were largely explained by household demographics including age, race and gender dynamics of heads of households. We recommend a multi-sectoral policy and programme implementation that promotes deliberate inclusiveness of household characteristics in their delivery

A weighted bootstrap approach to logistic regression modelling in identifying risk behaviours associated with sexual activity

The latest population estimates released by Statistics South Africa indicate that 25.03% of all deaths in 2017 in South Africa were AIDS-related. Along with these results, it is also reported that 7.06% of the population were living with HIV, with the HIV-prevalence among youth (aged 15­24) at 4.64% for 2017 (STATSSA. (2018). Retrieved from Statistics South Africa: http://www.statssa.gov.za/publications/P0302/P03022017.pdf). The data used in the study contained information related to the risk-taking behaviours associated with the sexual activity of entering first-year students at the University of the Western Cape. In this study, a logistic regression modelling procedure was carried out on those students that were determined to be sexually active, therefore, in the modelling procedure significant risk behaviours of sexually active first-year students could be identified. Of the 14 variables included in the modelling procedure, six were found to be significantly associated with sexually active students. The significant variables included; the age and race of the student, whether the student had ever taken an HIV test, the importance of religion in influencing the sexual behaviour of the student, whether the student consumed alcohol and lastly whether the student smoked. This study further investigated the impact of introducing sample weighting, bootstrap sampling as well as variable selection methods into the logistic regression modelling procedure. It is shown that incorporating these techniques into the modelling procedure produces logistic regression models that are more accurate and have an increased predictive capability. The bootstrapping procedure is shown to produce logistic regression models that are more accurate than those produced without a bootstrap procedure. A comparison between 200, 500 and 1000 bootstrap samples is also incorporated into the modelling procedure with the models produced from 200 bootstrap samples shown to be just as accurate those produced from 500 or 1000 bootstrap samples. Of the five variable selection methods used, it is shown that the Newton­Raphson and Fisher methods are unreliable in producing logistic regression models. The forward, backward and stepwise variable selection methods are shown to produce very similar results

Statistical modelling of social risk factors for sexually transmitted diseases among female youths in Nigeria

INTRODUCTION: Sexually Transmitted Diseases (STDs) are avertable, but the social risks factors connected to these infections are often unnoticed by many, particularly female youths. Previous studies on STDs among youths in Nigeria only focused on its risk factors but failed to model these risk factors as evidenced in this study.METHODOLOGY:The study is retrospective cross-sectional in design which utilized Nigeria Demographic and Health Survey, 2008. It focused on female youths aged 15-24 (n=8093) who ever had sexual intercourse (vaginal, oral and anal). Data analysis was done using Chi-square and logistic regression models. The logistic regression on the data was performed at two stages. These stages generated three and eight different models respectively.RESULTS:Data analyses revealed that the mean age of the respondents was 20.2 ± 2.5. Female youths who were aged between 20-24 years contacted STDs in the last 12 months (2.5%) than those between the ages of 15-19 months (1.4%). A year prevalence of STDs among female youths in Nigeria was 2.1%. Socio-demographic factors such as age, educational status, wealth index, marital status, toilet shared, place of residence, contraceptive use and total life-time number of sexual partners were found to be associated significant risk factors for contacting STDs (P<0.05).CONCLUSIONS:The data confirmed the considerable impact of wealth index and contraceptive use as important predictors of STDs acquisition. Constant use of condoms, abstinence and having one uninfected sexual partner can help reduce the risk of STDs transmission

Determinants of Extramarital Sex by Men in Tanzania: A Case Study of Mbeya Region

This paper attempts to identify some factors associated with extramarital sex by men in the Mbeya region of Tanzania using data from a survey conducted in 2003/2004. The choice of Mbeya region was prompted by the fact that it has been found by previous studies to be one of the regions with the highest HIV prevalence rate in Tanzania. Correlates of extramarital sex that were considered include current age; education; residence; age at first sexual intercourse; age at first marriage and sex before marriage. A bivariate analysis of the survey data; which comprised a sample size of 568 married men aged between 15 and 62 years revealed statistically significant association between extramarital sex with current age; education; age at first intercourse and sex before marriage. The effect of these variables was tested through a multivariate logistic regression analysis and all the four independent variables were found to be statistically significant predictors of extramarital sex in Mbeya region

Determinants of child mortality in south-west Uganda

Anthropometric and sociodemographic variables were taken from 4320 children in a baseline survey carried out in March-April 1988 in the district of Mbarara; south-west Uganda. After 12 months a follow-up survey assessed the mortality of the children during the preceding year. Lack of ownership of cattle; recent arrival in the village; using candles for lighting; being of birth order higher than 5 and having a father with less than 8 years of schooling were significantly associated with child mortality. The addition of mid-upper arm circumference significantly improved the logistic model of socioeconomic variables and mortality and did not diminish the predictive power of socioeconomic variables in relation to increased mortality. This suggests that nutritional status and specific socioeconomic factors are both; independently; important predictors of child mortality