Prevalence and factors associated with condom use among women aged 15-49 years in Rwanda using a survey logistic regression model: evidence from the 2019/20 Rwanda Demographic and Health Survey.

Introduction: although Rwanda's HIV prevalence has declined, many people are still acquiring or living with it. Among other methods of HIV prevention, condoms are a safe and reliable method in addition to preventing pregnancy and other sexually transmitted infections, especially when used properly. This study aimed to determine the prevalence and determinants of condom use during last sexual intercourse among reproductive-aged women in Rwanda. Methods: using data from the cross-sectional, nationally representative Rwanda Demographic and Health Survey (RDHS) conducted in 2019/2020, we carried out secondary data analysis. A multivariable logistic regression model was applied to determine the factors associated with condom use. All analyses from the model were adjusted for unequal sampling probabilities using survey weights. Results: results showed a 10.8% prevalence of condom use. The odds of condom use during last sex were significantly lower for women who lived with a man (adjusted odds ratio [aOR]= 0.10, CI=0.08: 0.13) and those from the Southern region (aOR=0.69, CI= 0.52 to 0.92) but were significantly higher for those with primary education (aOR=1.38, CI= 1.00: 1.88). Also, the rich were more significantly associated with condom use compared to the poor (aOR=1.53, 95% CI= 1.20: 1.93). Those who had three or more sexual partners had higher odds of condom use than those with one partner (aOR=3.12, CI= 2.50: 3.89). Conclusion: based on the results, health promotion interventions aimed at raising awareness on HIV prevention should, therefore, target the groups that were found to have a high risk of not using condoms.

Factors affecting child malnutrition in Ethiopia.

BACKGROUND: One of the public health problems in developing countries is child malnutrition. An important factor for children's well-being is good nutrition. Therefore, the malnutrition status of children under the age of five is an important outcome measure for children's health. This study uses the proportional odds model to identify risk factors associated with child malnutrition in Ethiopia using the 2016 Ethiopian Demographic and Health Survey data. METHODS: This study uses the 2016 Ethiopian Demographic and Health Survey results. Based on weight-for-height anthropometric index (Z-score) child nutrition status is categorized into four levels namely- underweight, normal, overweight and obese. Since this leads to an ordinal variable for nutrition status, an ordinal logistic regression (OLR)proportional odds model (POM) is an obvious choice for analysis. RESULTS: The findings and comparison of results using the cumulative logit model with and without complex survey design are presented. The study results revealed that to produce the appropriate estimates and standard errors for data that were obtained from complex survey design, model fitting based on taking the survey sampling design into account is better. It has also been found that for children under the age of five, weight of a child at birth, mother's age, mother's Body Mass Index (BMI), marital status of mother and region (Affar, Dire Dawa, Gambela, Harari and Somali) were influential variables significantly associated with underfive children's nutritional status in Ethiopia. CONCLUSION: This child's age of a child, sex, weight of child at birth, mother's BMI and region of residence were significant determinants of malnutrition of children under five years in Ethiopia. The effect of these determinants can be used to develop strategies for reducing child malnutrition in Ethiopia. Moreover, these findings show that OLR proportional odds model is appropriate assessing thedeterminants of malnutrition for ordinal nutritional status of underfive children in Ethiopia.