Abdul-Aziz Seidu

BACKGROUND: Alcohol consumption constitutes a major public health problem as it has negative consequences on the health, social, psychological, and economic outcomes of individuals. Tertiary education presents students with unique challenges and some students resort to the use of alcohol in dealing with their problems. This study, therefore, sought to determine alcohol use, its effects, and associated factors among tertiary students in the Hohoe Municipaility of Ghana. METHODS: An institutional-based cross-sectional study was conducted among 418 tertiary students in the Hohoe Municipality of Ghana using a two-stage sampling technique. Data were collected using structured questionnaires. A binary logistic regression modelling was used to determine the strength of the association between alcohol consumption and the explanatory variables. The level of significance was set at p < 0.05. Stata version 16.0 was used to perform the analysis. RESULTS: The lifetime prevalence of alcohol consumption was 39.5%. Out of them, 49.1% were still using alcohol, translating to an overall prevalence of 19.4% among the tertiary students. Self-reported perceived effects attributed to alcohol consumption were loss of valuable items (60.6%), excessive vomiting (53.9%), stomach pains/upset (46.1%), accident (40.0%), unprotected sex (35.1%), risk of liver infection (16.4%), depressive feelings (27.3%), diarrhoea (24.2%), debt (15.2%), and petty theft (22.4%). In terms of factors associated with alcohol consumption, students aged 26 years and above were more likely to have consumed alcohol [AOR = 4.4, 95%CI = 1.74, 11.14] than those in 16-20 years group. Muslim students had lower odds of alcohol consumption compared to Christians [AOR = 0.1, 95% CI = 0.02, 0.31]. It was also found that students who had peer influence [AOR = 3.7, 95%CI = 2.31, 5.82] and those who had academic adjustment problems [AOR = 3.6, 95% CI = 2.01, 6.46] were more likely to consume alcohol. CONCLUSION: Lifetime prevalence of alcohol consumption is high among tertiary students in the Hohoe Municipality of Ghana, with several physical, psychosocial and economic consequences. Alcohol-related education should be intensified in tertiary institutions and counseling units should be equipped with relevant assessment tools to assess and help students who are at risk and those who are already consuming alcohol.

Background: The Australian population aged 70 and above is increasing and imposing new challenges for policy makers and providers to deliver accessible, appropriate and affordable health care. We examine pre-COVID patterns of health loss between 1990 and 2019 to inform policies and practices. Methods: Using the standardised methodology framework and analytical strategies from GBD 2019 methodologies, we estimated mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs), life expectancy at age 70 and above (LE-70), and healthy life expectancy (HALE-70) in Australia comparing them globally and with high socio-demographic index (SDI) groups. Findings: DALY rates have been improving steadily over the past 30 years among Australians aged 70 and above. Decreases in DALY rates were primarily attributed to a fall in YLLs attributable to cardiovascular diseases (60%) and chronic respiratory disorders (30.2%) and transport injuries (56.9%), while the non-fatal burden remained stable from 1990 to 2019. According to the DALY rates, the top five leading causes are ischemic heart disease, Alzheimer's disease, COPD, stroke, and falls, where falls exhibited the largest increase since 1990. Interpretation: This study provides an in-depth report on the main causes of mortality and disability in Australia's population aged 70 and above. It sheds light on the shifts in burden over three decades, emphasising the need for the Australian health system to enhance its readiness in addressing the escalating demands of an ageing population. These findings establish pre-COVID baseline estimates for Australia's population aged 70 and above, informing healthcare preparedness. Funding: Bill & Melinda Gates Foundation.

Maternal health is a global public health concern. The paucity of antenatal care (ANC) during pregnancy is directly associated with maternal mortality. This study assessed the individual and community-level determinants of quality ANC in six South-Asian countries. Data were obtained from a Demographic health survey of six South-Asian countries. This study included a sample of 180,567 (weighted) women aged 15-49 who had given birth in the preceding three years prior to the survey. The quality of ANC was determined by assessing whether a woman had received blood pressure monitoring, urine and blood sample screening, and iron supplements at any ANC visits. Frequency, percentage distribution, and inferential analysis (multilevel mixed-effects model) were conducted. The proportion of quality antenatal care utilization in South Asia was 66.9%. The multilevel analysis showed that women aged 35-49 years (AOR = 1.16; 95% CI = 1.09-1.24), higher education (AOR = 2.84; 95% CI = 2.69-2.99), middle wealth status (AOR = 1.55; 95% CI = 1.49-1.62), richest wealth status (AOR = 3.21; 95% CI = 3.04-3.39), unwanted pregnancy (AOR = 0.92; 95% CI = 0.89-0.95) and 2-4 birth order (AOR = 0.86; 95% CI = 0.83-0.89) were among the individual-level factors that were significantly associated with quality ANC utilization. In addition, rural residence (AOR = 0.77; 95% CI = 0.74-0.8), and big problem - distance to health facility (AOR = 0.63; 95% CI: 0.53-0.76) were the among community level factors there were also significantly associated with use of quality ANC. Meanwhile, women who lived in India (AOR: 22.57; 95% CI: 20.32-25.08) and Maldives (AOR: 33.33; 95% CI: 31.06-35.76) had higher odds of quality ANC than those lived in Afghanistan. Educational status, wealth status, pregnancy wantedness, sex of household head, birth order, place of residence, and distance to health facility were associated with quality ANC. Improving educational status, improving wealth status, reducing the distance to health facilities, and providing rural area-friendly interventions are important to increase the quality of ANC in South Asia.

BACKGROUND: Health insurance enrollment is a vital component of universal health coverage and access to essential healthcare services. However, in Sierra Leone, enrollment remains persistently low, posing a major public health challenge. Women of reproductive age (15-49 years) represent a critical population for health insurance enrollment due to their unique healthcare needs, particularly related to reproductive health, pregnancy, and childcare. Despite their importance, women face notable barriers to health insurance enrollment, including financial constraints, gender inequalities, and sociocultural challenges. This study examines the factors associated with health insurance non-enrollment among women aged 15-49 in Sierra Leone. METHODS: We analysed data from a weighted sample of 15,574 women aged 15-49 years from the 2019 Sierra Leone Demographic and Health Survey. Percentages were used to present the proportion of health insurance non-enrollment among the women. Multivariable binary logistic regression analysis was used to examine the factors associated with health insurance non-enrollment among the women. RESULTS: The proportion of health insurance non-enrollment among the women was 96.02%. Women with higher education were less likely to be uninsured (adjusted odds ratio [aOR]: 0.35, 95% CI: 0.18-0.64) compared to those with no education. Being employed also reduced the odds of being uninsured (aOR: 0.47, 95% CI: 0.36-0.62) compared to women who were employed. Listening to the radio less than once a week was associated with lower odds of being uninsured (aOR: 0.71, 95% CI: 0.53-0.97) compared to women who did not listen to the radio at all. On the other hand, women who reported distance to a health facility as a big problem were more likely to be uninsured (aOR: 2.21, 95% CI: 1.03-4.75) compared to those who did not consider it a problem. Regionally, women living in the Northwestern (aOR: 0.07, 95% CI: 0.03-0.14) and Northern (aOR: 0.28, 95% CI: 0.12-0.66) regions were less likely to be uninsured compared to those residing in the Eastern region. CONCLUSIONS: Health insurance non-enrollment was high among women in Sierra Leone. Education, employment, and exposure to listening to the radio were associated with increased health insurance enrollment, highlighting the need to address socioeconomic barriers and leveraging mass media campaigns to educate women on the importance of getting covered by health insurance. Geographic and regional disparities in health insurance enrollment underscore the importance of improving healthcare accessibility and implementing targeted, community-based interventions to promote health insurance uptake. Also, subsiding health insurance subscription fee could increase its enrollment, especially among women from low socioeconomic households.