Utilization of Proximate Healthcare Facilities and Children's Wait Times in Senegal: An IV-Tobit Analysis.

Universal health coverage (UHC) defines individuals' timely access to healthcare services without suffering any health-related financial constraints. The Senegalese government has shown commitments towards achievement of UHC as a way of improving access by the population to quality healthcare services. This is very pertinent for promoting some indicators of under-five health in Senegal. Therefore, this study analyzed the factors influencing sick children's utilization of the nearest healthcare facilities and their wait times in Senegal. The data were from the Service Provision Assessment (SPA) survey, which was conducted in 2018. The instrumental Tobit regression model was used for data analysis. The results showed that 63.50% and 86.01% of the children utilized health posts and publicly owned facilities, respectively. Also, 98.46% of the children utilized urban facilities. The nearest facilities were utilized by 74.55%, and 78.19% spent less than an hour in the facilities. The likelihood of using the nearest healthcare facilities significantly reduced (p < 0.05) with caregivers' primary education, higher education, residence in some regions (Fatick, Kaokack, Saint Louis, Sediou, and Tambacounda), and use of private/NGO not-for-profit facilities, but increased with not having visited any other providers, residence in the Kaffrie region, vomiting symptoms, use of health centers, and use of health posts. Moreover, treatment wait times significantly increased (p < 0.05) with the use of nearest facilities, residence in some regions (Diourbel, Kaokack, Matam and Saint Louis), use of private for-profit facilities, use of private not-for-profit facilities, and urban residence, but decreased with secondary education, use of health centers, use of health posts, vomiting symptoms, and showing other symptoms. It was concluded that reduction in wait times and utilization of the nearest healthcare facilities are fundamental to achieving UHC in Senegal. Therefore, more efforts should be integrated at promoting regional and sectoral equities through facilitated public and private healthcare investment.

Effect of Health Insurance Uptake on Hesitancy toward COVID-19 Vaccines in Nigeria: A Recursive Bivariate Probit and Decomposition Estimation.

Moral hazard remains one of the major challenges of health insurance administration. This paper recursively analyzed the effect of health insurance on the willingness to take COVID-19 vaccines in Nigeria. The data comprised 1892 unvaccinated respondents in the 2021/2022 National Longitudinal Phone Survey (NLPS). The data were analyzed with Coban's recursive probit regression and decomposition approaches. The results revealed that 5.87% were health insured, and 7.93% were willing to take COVID-19 vaccines. Health insurance uptake significantly increased (p < 0.05) with an adult being the decision-maker on vaccination, requiring family planning, and urban residence, while it reduced with loss of jobs and residence in the southeast and southwest zones. In addition, health insurance significantly (p < 0.01) increased the willingness to take COVID-19 vaccines, along with each adult, all adults, and households' heads being the major vaccination decision-makers, loss of jobs, and support for making COVID-19 vaccines compulsory. The average treatment effects (ATEs) and average treatment effect on the treated (ATET) of health insurance were significant (p < 0.01), with positive impacts on willingness to be vaccinated. It was concluded that policy reforms to promote access to health insurance would enhance COVID-19 vaccination in Nigeria. In addition, hesitancy toward COVID-19 vaccines can be reduced by targeting adults and household heads with adequate information, while health insurance uptake should target southern states and rural areas.

Indicators of Mental Health Disorder, COVID-19 Prevention Compliance and Vaccination Intentions among Refugees in Kenya.

Background and Objectives: COVID-19 remains a major development challenge in many developing countries. This study analysed the effect of mental health disorder and indicators of COVID-19 preventive practices on vaccination intentions among refugees in Kenya. Materials and Methods: The data were the fourth and fifth waves of the High Frequency Phone Surveys on the impacts of COVID-19 that were collected by the Kenyan National Bureau of Statistics (KNBS) between May 2020 and June 2021. The data were collected from Kakuma, Kalobeyei, Dadaab and Shona camps using the stratified random sampling method. The data were analysed with random effects instrumental variable Probit regression model. Results: The results showed that 69.32% and 93.16% of the refugees were willing to be vaccinated during the 4th and 5th waves, respectively. The fear of dying was reported by 85.89% and 74.19% during the 4th and 5th waves, respectively. COVID-19 contact prevention and immune boosting indicators were differently influenced by some demographic and anxiety index variables, while being endogenous influenced vaccine hesitancy along with urban residence, age, knowing infected persons, days of depression, days of anxiety, days of physical reactions, members losing job, searching for jobs, accepting job offers and being employed. Conclusions: It was concluded that efforts to promote COVID-19 vaccination should address mental health disorder and compliance with existing COVID-19 contact and immune boosting behaviour with a focus on urban residents and youths.

Determinants of Cocoa Farmers' Compliance with Agrochemical Safety Precautions in Ogun and Osun States, Nigeria.

Cocoa is one of the major cash crops in Nigeria and its production is directly related to the effective utilization of agrochemicals. This paper analysed the factors influencing cocoa farmers' compliance with agrochemical safety regulations. The data were collected from 326 cocoa farmers from Ogun and Osun states, using multi-stage sampling procedures. The data were analysed with Principal Component Analysis (PCA) and an Endogenous Tobit Regression model. The results showed that majority of the farmers were primarily growing cocoa and average ownership of personal protective equipment (PPE) was less than two. Awareness of manufacturers' instructions was high for insecticides and fungicides, while majority of the farmers were not eating or drinking while handling agrochemicals. Safety compliance indicators were significantly influenced (p < 0.10) by farmers' ownership of PPE, education, age, awareness of manufacturers' safety instructions and health status. It was concluded that utilization of PPE was very low among the farmers and efforts to facilitate safety training on the use of different agrochemicals will facilitate safety compliance through proper understanding of manufacturers' instructions.

Career Aspiration Fulfillment and COVID-19 Vaccination Intention among Nigerian Youth: An Instrumental Variable Approach.

COVID-19 is a pandemic of economic significance in the world. Vaccination has been identified as one of the veritable means to address the problem. Few studies have focused on youths' vaccination intentions and the role of career aspiration fulfillment. This study therefore analyzed the effect engagement with dream jobs has on the willingness to get vaccinated for COVID-19. The data were from the 12th wave of the Nigeria COVID-19 National Longitudinal Phone Survey (NLPS) collected from 974 youths 15−25 years old. Instrumental Variable Probit regression was used for data analysis. The results showed that 86.57% and 80.34% of the rural and urban youths were willing to take the vaccines, respectively. Moreover, 31.18% and 25.94% of urban and rural youths, respectively, were engaged in their dream jobs. The Probit regression results showed that engagement with dream jobs was positively and significantly influenced (p < 0.01) by knowing someone who has a dream job, age and residence in the Southwest zone, while having a formal education reduced it. Instrumental Variable Probit regression results showed that willingness to take COVID-19 vaccine was positively influenced (p < 0.05) by having a dream job and intending to migrate to rural areas, while urban residence, age and residence in southern geopolitical zones decreased it. It was concluded that having a dream job promotes acceptance of COVID-19 vaccines among the youths, and there is a need for interventions to address hesitancy among urban youths and those in the southern geopolitical zones.

Factors Influencing Willingness to Be Vaccinated against COVID-19 in Nigeria.

Vaccines have been historically used to address some pressing health problems in the world. COVID-19 presents no exception, although vaccine hesitancy remains a major bottleneck in some countries. This study analyzed the factors influencing willingness to be vaccinated against COVID-19 in Nigeria. The data are from the 10th wave of COVID-19 National Longitudinal Phone Survey (COVID-19 NLPS) that was conducted in 2021. The data were analyzed with Logit regression. The result showed that the national acceptance rate of COVID-19 vaccine was 85.29%. The North East had the highest acceptance rate (96.14%), while the South East (71.80%) had the lowest value. Rural areas had higher vaccine acceptance rates of 87.80% as compared against 81.41% for urban areas. Logit regression result showed that urban residents in the South East zone and the South South zone were not too worried about contracting COVID-19 or not worried at all about contracting COVID-19, saw COVID-19 as not much of a threat to household finance or COVID-19 as not a threat at all to households' finances, which significantly reduced the log odds of residents' willingness to be vaccinated against COVID-19 (p < 0.05). However, age, the COVID-19 preventive compliance index and needing medical services significantly increased the log odds of the willingness to be vaccinated against COVID-19 vaccines (p < 0.05). Addressing the COVID-19 pandemic in Nigeria through vaccination requires significant interventions for ensuring regional and sectoral balances in vaccine acceptability through interventions and programmes for promoting individuals' perception of health risk and vulnerability.

An Instrumental Variable Probit Modeling of COVID-19 Vaccination Compliance in Malawi.

COVID-19 remains a pressing development concern in Malawi. The third wave of viral infection upsurge raised significant concerns on people's compliance with preventive methods already introduced by the government, among which vaccination is notable. This study analysed the factors influencing COVID-19 vaccination compliance in Malawi. The data were the ninth round of the telephone-based survey that was conducted by Malawi National Statistical Office (NSO) in 2021. The data were analysed with Instrumental Variable Probit model. The results showed that awareness of COVID-19 vaccines arrival was very high (98.19%). Additionally, 11.59% and 60.71% were already vaccinated and planning to be vaccinated, respectively. The Probit regression results showed that age of household heads, need of medical services, being worried of contracting COVID-19 and wearing of masks increased the probability of vaccination compliance, while stress indicators, being employed and not worried at all of contracting COVID-19 reduced it. It was concluded that drastic behaviour change would be needed to address corona virus pandemic in Malawi. There is the need to ensure equity across different age groups in access to vaccines. Further, interventions to ensure proper assessment of an individual's COVID-19 risk and address psychological and emotional stress that are associated with ongoing pandemic would enhance vaccination compliance.

Compliance Indicators of COVID-19 Prevention and Vaccines Hesitancy in Kenya: A Random-Effects Endogenous Probit Model.

Vaccine hesitancy remains a major public health concern in the effort towards addressing the COVID-19 pandemic. This study analyzed the effects of indicators of compliance with preventive practices on the willingness to take COVID-19 vaccines in Kenya. The data were from the COVID-19 Rapid Response Phone Surveys conducted between January and June 2021 during the fourth and fifth waves. The data were analyzed with the random-effects endogenous Probit regression model, with estimated parameters tested for robustness and stability. The results showed that willingness to take vaccines increased between the fourth and fifth waves. Compliance with many of the preventive practices also improved, although the utilizations of immune system-promoting practices were very low. The panel Probit regression results showed that compliance indicators were truly endogenous and there was existence of random effects. Immune system-boosting and contact-prevention indicators significantly increased and decreased the willingness to take vaccines, respectively (p < 0.01). The experience of mental health disorders in the form of nervousness and hopelessness also significantly influenced vaccine hesitancy (p < 0.10). Willingness to take vaccines also significantly increased among older people and those with a formal education (p < 0.01). Different forms of association exist between vaccine hesitancy and the prevention compliance indicators. There is a need to properly sensitize the people to the need to complement compliance with COVID-19 contact-prevention indicators with vaccination. Addressing mental health disorders in the form of loneliness, nervousness, depression, hopelessness and anxiety should also become the focus of public health, while efforts to reduce vaccine hesitancy should focus on individuals without formal education, males and youths.

Willingness to Take COVID-19 Vaccines in Ethiopia: An Instrumental Variable Probit Approach.

This paper analyzed the factors influencing the willingness of Ethiopia's population to take COVID-19 vaccines. The data included the COVID-19 High Frequency Phone Survey of Households in Ethiopia that were collected in 2021. This paper relied on the 10th round of the survey, which was comprised of 2178 households. The Instrumental Variable Probit regression model was used to analyze the data. The results showed that majority of the respondents (92.33%) would receiveCOVID-19 vaccines, while 6.61% and 1.06% were, respectively, unwilling and unsure. Across the regions of Ethiopia, Southern Nations, Nationalities, and Peoples' Region (SNNPR) (99.30%), Oromia (97.54%), Tigray (97.04%) and Gambela (95.42%) had the highest proportions of respondents willing to have the vaccine. Vaccine safety concern was the topmost reason for those unwilling to receive the vaccine. The results of the Instrumental Variable Probit regression showed that currently working, age, engagement with non-farm businesses and region of residence significantly influenced the population's willingness to take the vaccine (p < 0.05). It was concluded that although the willingness be vaccinated was impressive, without everyone being receiving the COVID-19 vaccine, infection risk can still be high; this is due to the persistent mutation of the viral strains. Thus, there is a need to intensify efforts toward addressing the safety issues of COVID-19 vaccines, while efforts to enhance acceptability should focus on the youth population and those who are unemployed.

Dataset on cocoa production and climate change adaptation strategies in Ahafo Ano North District, Ghana.

Sustainable cocoa production is susceptible to changes in some climatic parameters. This survey was carried out to understand the perceptions of cocoa farmers on climate change, its impacts on cocoa production and their adaptation methods. Stratified sampling method was used to select the farmers and data were collected with structured questionnaires. Stratification of the district was done based on existing seven administrative divisional offices which comprise of six area councils and one town council. Cocoa farmers were sampled within each stratum with sample size proportional to estimated number of farmers. During the survey, 378 cocoa farmers were interviewed from Abu-Bone (60), Anyinasuso (65), Biakoye (42), Kwasu-Abu (89), Subriso (35), Suponso (20) and Tepa (67). The dataset had been shared with this article and it is valuable for understanding the perceptions of cocoa farmers on climate change, cocoa production efficiency and determinants of climate change adaptation choices.

Dataset on cocoa farmers' agrochemical handling practices and safety compliance in Ahafo Ano North district, Ashanti region, Ghana.

Agrochemicals are essential but hazardous inputs being utilized at different stages in cocoa production. Safeguarding the health of workers handling these chemicals is therefore of utmost importance. Although Ghanaian government implemented mass spraying of cocoa with every essential occupational safety being followed, non-workability of the programme in many parts of the cocoa producing areas necessitates supplementary application of agrochemicals by many farmers. Therefore, a survey was conducted in Ahafo Ano North district of the Ashanti region in 2015 to understand the compliance of farmers to safety guidelines in handling agrochemicals. The survey was conducted with structured questionnaires that were written in English language and translated into the local language in the course of the interviews. A total of 246 cocoa farmers were interviewed using stratified sampling procedures. The questionnaire, which was divided into four sections solicited information on farmers' socioeconomic characteristics, safeguard measures being taken by the farmers in the course of handling agrochemicals, health complaints after handling agrochemicals and stress and occupational hazards. The dataset is herewith made available and it is considered of vital usefulness given some serious policy implications of occupational health hazards among cocoa farmers.

Effect of Obesity and Other Risk Factors on Hypertension among Women of Reproductive Age in Ghana: An Instrumental Variable Probit Model.

Background: The growing incidence of mortality as a result cardiovascular diseases (CVDs) is a major public health concern in several developing countries. In Ghana, unhealthy food consumption pattern and sedentary lifestyle are promoting overweight and obesity, with significant consequences on the incidence of CVDs. Specifically, hypertension morbidity is now a public health concern among Ghanaian health policy makers. This paper analysed the effect of body mass index (BMI)/arm circumference and other associated factors on hypertension risk among women of reproductive ages in Ghana. Methods: The data were collected as Demographic and Health Survey (DHS) in 2014. This paper analysed the subset of the data that were collected from eligible women 15-49 years of age. The total sample was 9396, while 9367 gave consents to have their blood pressure measured. Data were analysed with instrumental probit regression model with consideration of potential endogeneity of BMI and arm circumference. Results: The results showed that 25% of the women were either overweight or obese, while 13.28% were hypertensive. Women from the Greater Accra (18.15%), Ashanti (15.53%) and Volta (15.02%) regions had the highest incidences of hypertension. BMI and arm circumferences were truly endogenous and positively associated with the probability of being hypertensive. Other factors that influenced hypertension were age of women, region of residence, urban/rural residence, being pregnant, access to medical insurance, currently working, consumption of broth cubes, processed can meats, salted meat and fruits. Conclusion: It was concluded that hypertension risk was positively associated with being overweight, obesity, age and consumption of salted meat.It was inter aliaemphasized that engagement in healthy eating with less consumption of salted meats, and more consumption of fruits would assist in controlling hypertension among Ghanaian women.

Maternal Education, Fertility, and Child Survival in Comoros.

Reduction in child mortality is a demographic progress of significant socioeconomic development relevance in Africa. This paper analyzed the effect of maternal education and fertility on child survival in the Islands of Comoros. The 2012 Demographic and Health Survey (DHS) data were used. A two-stage probit regression method was used for data analysis. The results showed that about 75% of the children's mothers had given birth to between one and five children, while more than half did not have any form of formal education. The results of the two-stage probit regression showed that while child survival reduced significantly (p < 0.05) with the age of the heads of households, residence in the Ngazidja region, being born as twins, mother's number of business trips, and number of marital unions, it increased with maternal education, fertility, male household headship, and the child being breastfed immediately after birth. It was concluded that efforts to enhance maternal education would reduce child mortality. It is also critical to promote child breastfeeding among women, while regional characteristics promoting differences in child mortality in Comoros Islands should be properly addressed with keen focus on the Ngazidja region.

Cocoa Farmers' Compliance with Safety Precautions in Spraying Agrochemicals and Use of Personal Protective Equipment (PPE) in Cameroon.

The inability of farmers to comply with essential precautions in the course of spraying agrochemicals remains a policy dilemma, especially in developing countries. The objectives of this paper were to assess compliance of cocoa farmers with agrochemical safety measures, analyse the factors explaining involvement of cocoa farmers in the practice of reusing agrochemical containers and wearing of personal protective equipment (PPE). Data were collected with structured questionnaires from 667 cocoa farmers from the Centre and South West regions in Cameroon. Data analyses were carried out with Probit regression and Negative Binomial regression models. The results showed that average cocoa farm sizes were 3.55 ha and 2.82 ha in South West and Centre regions, respectively, and 89.80% and 42.64% complied with manufacturers' instructions in the use of insecticides. Eating or drinking while spraying insecticides and fungicides was reported by 4.20% and 5.10% of all farmers in the two regions, respectively. However, 37.78% and 57.57% of all farmers wore hand gloves and safety boots while spraying insecticides in the South West and Centre regions of Cameroon, respectively. In addition, 7.80% of all the farmers would wash agrochemical containers and use them at home, while 42.43% would wash and use them on their farms. Probit regression results showed that probability of reusing agrochemical containers was significantly influenced (p < 0.05) by region of residence of cocoa farmers, gender, possession of formal education and farming as primary occupation. The Negative Binomial regression results showed that the log of number PPE worn was significantly influenced (p < 0.10) by region, marital status, attainment of formal education, good health, awareness of manufacturers' instructions, land area and contact index. It was among others concluded that efforts to train farmers on the need to be familiar with manufacturers' instructions and use PPE would enhance their safety in the course of spraying agrochemicals.

Healthcare waste management practices and safety indicators in Nigeria.

BACKGROUND: Adequate management of healthcare waste (HCW) is a prerequisite for efficient delivery of healthcare services. In Nigeria, there are several constraints militating against proper management of HCW. This is raising some environmental concerns among stakeholders in the health sector. In this study, we analyzed the practices of HCW management and determinants of risky/safe indices of HCW disposal. METHODS: The study used the 2013/2014 Service Delivery Indicator (SDI) data that were collected from 2480 healthcare facilities in Nigeria. Descriptive statistics, Principal Component Analysis (PCA) and Ordinary Least Square (OLS) regression were used to analyze the data. RESULTS: The results showed that 52.20% and 38.21% of the sampled healthcare facilities from Cross River and Bauchi states possessed guidelines for HCW management, respectively. Trainings on management of HCW were attended by 67.18% and 53.19% of the healthcare facilities from Cross River and Imo states, respectively. Also, 32.32% and 29.50% of healthcare facilities from rural and urban areas previously sent some of their staff members for trainings on HCW management, respectively. Sharp and non-sharp HCW were burnt in protected pits in 45.40% and 45.36% of all the sampled healthcare facilities, respectively. Incinerators were reported to be functional in only 2.06% of the total healthcare facilities. In Bauchi and Kebbi states, 23.58% and 21.05% of the healthcare facilities respectively burnt sharp HCW without any protection. Using PCA, computed risky indices for disposal of sharp HCW were highest in Bayelsa state (0.3070) and Kebbi state (0.2172), while indices of risky disposal of non-sharp HCW were highest in Bayelsa state (0.2868) and Osun state (0.2652). The OLS results showed that at 5% level of significance, possession of medical waste disposal guidelines, staff trainings on HCW management, traveling hours from the facilities to local headquarters and being located in rural areas significantly influenced indices of risky/safe medical waste disposal (p < 0.05). CONCLUSION: The study concluded that there was low compliance with standard HCW management. It was recommended that possession of HCW management guidelines, staff training on HCW disposal and provision of requisite equipment for proper treatment of HCW would promote environmental safety in HCW disposal.

Assessment of primary health care facilities' service readiness in Nigeria.

BACKGROUND: Effective delivery of healthcare services requires availability of adequate infrastructure, diagnostic medical equipment, drugs and well-trained medical personnel. In Nigeria, poor funding and mismanagement often characterize healthcare service delivery thereby affecting coverage and quality of healthcare services. Therefore, the state of service delivery in Nigeria's health sector has come under some persistent criticisms. This paper analyzed service readiness of Primary Health Care (PHC) facilities in Nigeria with focus on availability of some essential drugs and medical equipment. METHODS: Service Delivery Indicator (SDI) data for PHC in Nigeria were used. The data were collected from 2480 healthcare facilities from 12 states in the Nigeria's 6 geopolitical zones between 2013 and 2014. Data were analyzed with descriptive statistics, Principal Component Analysis (PCA) and Ordinary Least Square regression. RESULTS: Medical disposables such as hand gloves and male condoms were reported to be available in 77.18 and 44.03% of all the healthcare facilities respectively, while immunization services were provided by 86.57%. Functional stethoscopes were reported by 77.22% of the healthcare facilities, while only 68.10% had sphygmomanometers. In the combined healthcare facilities, availability of some basic drugs such as Azithromycin, Nifedipine, Dexamethasone and Misoprostol was low with 10.48, 25.20, 21.94 and 17.06%, respectively, while paracetamol and folic acid both had high availability with 74.31%. Regression results showed that indices of drug and medical equipment availability increased significantly (p < 0.05) among states in southern Nigeria and with presence of some power sources (electricity, generators, batteries and solar), but decreased among dispensaries/health posts. Travel time to headquarters and rural facilities significantly reduced indices of equipment availability (p < 0.05). CONCLUSION: It was concluded that for Nigeria to ensure better equity in access to healthcare facilities, which would facilitate achievement of some health-related sustainable development goals (SDGs), quality of services at its healthcare facilities should be improved. Given some differences between availability of basic medical equipment and their functionality, and lack of some basic drugs, proper inventory of medical services should be taken with effort put in place to increase funding and ensure proper management of healthcare resources.

Do ownership of mosquito nets, dwelling characteristics and mothers' socio-economic status influence malaria morbidity among children under the age of 5 in Cameroon?

OBJECTIVES: This study analyzed the effect of the number of mosquito nets that are owned by households, dwelling characteristics and maternal demographic characteristics on malaria infections. MATERIAL AND METHODS: The 2011 Demographic and Health Survey (DHS) data for children under 5 years of age were used. The children were subjected to haemoglobin test and rapid diagnostic test (RDT) to ascertain the presence of malaria parasites. Data were analyzed using probit regression method. RESULTS: It was found that 2.43% and 8.68% of the children were living in houses that were prone to landslide and flooding, respectively. Also, 19.93%, 17.08% and 16.26% of the children lived in houses without windows, with broken windows, and with a hole in the roof, respectively. Only 5.59% and 23.96% of the children lived in houses with window and door nets, respectively. Mosquito nets were owned by 64.03% of the households, where Adamawa Region had the lowest coverage (52.23%). Reasons for not owning mosquito nets by all the households included: lack of financial means (25.17%), using something else (1.80%) and not having many mosquitoes in the vicinity (5.53%). In the probit regression, variables that significantly reduced malaria infections among the children (p < 0.05) included: the number of mosquito nets, urban residence, improved toilet, ownership of a radio, residence in flood-prone area, mother's secondary education, mother's tertiary education and residence in areas with not many mosquitoes, while infections increased along with the household size, residence in areas prone to landslide, severe anaemia, moderate anaemia, mild anaemia and age of the children. CONCLUSIONS: Ownership of mosquito nets and dwelling characteristics are critical factors influencing infections with malaria. There is a need to ensure compliance with its use since there are disparities between access and actual usage. Also, addressing malaria problem in Cameroon should consider regional disparity in malaria incidence rates and more engagement of the media, among others, for appropriate sensitization.

Climate change induced occupational stress and reported morbidity among cocoa farmers in South-Western Nigeria.

INTRODUCTION AND OBJECTIVE: Climate change is one of the major development hurdles in many developing countries. The health outcome of farm households are related to climate change, which is related to several external and internal health-related issues, such as management of occupational stressors. This study seeks, inter alia, to determine the climate related occupational stress and factors influencing reported sick times among cocoa farmers. MATERIAL AND METHOD: Data were collected from selected cocoa farmers in South-Western Nigeria. Descriptive statistics and Negative Binomial regression were used for data analyses. RESULTS: The results showed that cocoa farmers were ageing, and that the majority had cultivating cocoa for most of their years of farming. Cocoa was the primary crop for the majority of the farmers, while 92.00% of the farmers in Osun state owned the cultivated cocoa farms. The forms of reported climate change induced occupational stresses were increase in pest infestation (74.5% in Ekiti state), difficulties in weed control (82.1% in Ekiti state), missing regular times scheduled for spraying cocoa pods (45.7% in Ondo state), inability to spray cocoa effectively (58.5% in Ondo state), and reduction in cocoa yield (71.7% in Ekiti state). The Negative Binomial regression results showed that the age of farmers (0.0103), their education (-0.0226), years of cocoa farming (-0.0112), malaria infection (0.4901), missed spraying (0.5061), re-spraying of cocoa (0.2630), reduction in cocoa yield (0.20154), contact with extension (0.2411) and residence in Ondo state (-0.2311) were statistically significant (p<0.05). CONCLUSION: Climate change influences the farm operations of cocoa farmers with resultant occupational stresses. Efforts to assist cocoa farmers should include, among others, provision of weather forecasts and some form of insurance.

Assessment of Malawian mothers' malaria knowledge, healthcare preferences and timeliness of seeking fever treatments for children under five.

Malaria is one of the major public health problems in Malawi, contributing to the majority of morbidity and mortality among children under five. Ignorance of malaria symptoms results in delayed treatment, which often degenerates into fatal emergencies. This study analyzed the impact of maternal malaria knowledge on healthcare preferences and timeliness of treating children with reported fever. The Malaria Indicator Survey data for 2012, which were adequately weighted, were analyzed using multinomial logit and Poisson regression models. The results showed low maternal average years of formal education (3.52) and average mothers' age was 27.97 years. Majority of the women (84.98%) associated fever with malaria, while 44.17% associated it with chilling. Also, 54.42% and 32.43% of the children were treated for fever on the same day and the following day that fever started, respectively. About 9.70% paid for fever treatment from their regular incomes, while 51.38% sought treatment from either public or private health centers. Multinomial Logit regression results showed that relative to using of other treatments, probabilities of selecting private hospitals and public health centers increased with age of the household heads, resident in urban areas, mothers' years of education, number of days taken off for treatment, paying medical bills from regular, occasional and borrowed incomes, and knowledge of diarrhea and shivering as symptoms of malaria. In the Poisson regression results, timeliness of seeking treatment was significantly enhanced by knowledge of fever as malaria symptom, residence in northern and central regions of Malawi and use of income from sale of assets to pay medical bills (p < 0.10).However, delays in treating children was motivated by age of the household heads, number of days taken off to care for sick child and usage of regular, borrowed and other incomes to pay medical bills. (p < 0.05). It was concluded that efficiency of public sector in treating malaria holds significant prospects for fighting malaria in Malawi. However, adequate efforts should be channeled in enhancing the knowledge of women on malaria symptoms, among others.

Assessment of sex-related behaviours, human immunodeficiency virus (HIV) knowledge and sexually transmitted infections (STIs) among men of reproductive age in Cameroon.

Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), are among the major public health challenges in Cameroon. This paper determined the effect of men's sex-related behaviors and HIV knowledge on reported STIs. The data came from the 2012 Cameroon's Demographic and Health Survey (DHS) that were collected from 7191 respondents in 2012. Descriptive and logistic regression methods were used for data analysis. Results showed that majority of the respondents were aware of STIs and Acquired Immune Deficiency Syndrome (AIDS), while 3.96% reported STIs. Also, 49.45% of the men had no wife, while 75.58% and 84.58% noted that condoms and keeping of one partner could be used to prevent HIV transmission, respectively. Wrong impressions that mosquito bites and sharing of food could lead to HIV infection were held by 31.94% and 12.44% of the men, respectively. Among those that reported STIs, 33.33%, 30.18% and 13.33% respectively used condom during sex with most recent partner, second to most recent partner and third to most recent partner, compared to 24.69%, 15.04% and 4.17% among those that did not report STIs. Logistic regression results showed that probability of STI increased significantly (p < 0.05) with condom use with third most recent partners, being married, wrong knowledge that mosquito bites cause HIV and being away for more than one month, while it significantly reduced (p < 0.05) with number of children, knowledge that having one partner prevents STIs. It was concluded that policy initiatives and programmes to enhance right sexual knowledge and behavior among men would go a long way in reducing STI incidence in Cameroon.