Objective Ethiopia bears a high stunting burden. However, there is a paucity of evidence on the socioeconomic inequalities of stunting in Ethiopia. Thus, this study was aimed to determine the degree of socioeconomic inequality in stunting and decompose it to the social determinants of stunting. We used a nationally representative sample of 8855 children, aged below 5 years, from the Ethiopian demographic and health survey, conducted in 2016. Subjects were recruited following a two-stage cluster sampling. The socioeconomic status was measured by the household wealth index, categorized into quantiles. The inequality in stunting between the poorest and the richest socioeconomic groups was decomposed into its contributing social factors following the Blinder–Oaxaca decomposition approach. Result The overall prevalence of stunting was 38%, with a significant pro-poor socioeconomic inequality. The prevalence of stunting among the poorest and the richest socioeconomic categories was 45.1% and 26.9%, respectively. Caregivers education status was the main contributor, accounting alone for 33% of the socioeconomic inequality in stunting, followed by region of residence (11%) and birth size (6%). Equity sensitive interventions, which prioritize the vulnerable groups might help to narrow the socioeconomic inequality as well as fasten the progress towards the goal of stunting reduction.

Background Intermittent preventive treatment using Sulphadoxine pyrimethamine (IPTp-SP) for malaria prevention is recommended for all pregnant women in malaria endemic areas. However, there is limited evidence on the level of socioeconomic inequality in IPTp-SP use among pregnant women in Nigeria. Thus, this study aimed to determine the level of socioeconomic inequality in IPTp-SP use among pregnant women in Nigeria and to decompose it into its contributing factors. Methods A secondary data analysis of Nigerian demographic and health survey of 2018 was conducted. A sample of 21,621 pregnant women aged between 15 and 49 years and had live birth in the previous 2 years before the survey were included in this analysis. The study participants were recruited based on a stratified two-stage cluster sampling method. Socioeconomic inequality was decomposed into its contributing factors by concentration index. Result Totally 63.6% of pregnant women took at least one dose of IPTp-SP prophylaxis. Among IPTp-SP users, 35.1% took one dose, 38.6% took two doses and 26.2% took three doses and more. Based on both concentration index of 0.180 (p-value = < 0.001, 95% CI: 0.176 to 0.183) and Erreyger’s normalization concentration index 0.280 (p-value = < 0.001, 95% CI: 0.251 to 0.309), the IPTp-SP utilization was pro-rich. The largest contributors to the inequality in IPTp-SP uptake were wealth index (47.81%) and educational status (28.66%). Conclusion Our findings showed that IPTp-SP use was pro-rich in Nigeria. Wealth index and educational status were the factors that significantly contributed to the inequality. The disparities could be reduced through free IPTp service expansion by targeting pregnant women from low socioeconomic status.

Objective There is a scarcity of evidence on socioeconomic inequalities of childhood anemia in Ethiopia. We determined the magnitude of socioeconomic inequality in anemia and the contribution of dietary and non-dietary factors to the observed inequality, using a nationally representative data of 2902 children included in the 2016 Ethiopian demographic and health survey. The data were collected following a multistage, stratified cluster sampling strategy. We followed the Blinder–Oaxaca regression-based approach to decompose the inequality and determine the relative contribution (%) of the dietary and non-dietary factors to the observed inequality. Result We found a significant pro-poor socioeconomic inequality in childhood anemia in Ethiopia. A third (~ 33%) of the inequality was attributable to compositional differences in the dietary determinants of anemia (dietary diversity, meal frequency, and breastfeeding factors). Non-dietary factors like residence place, maternal education, and birth weight) jointly explained ~ 36% of the inequality. Maternal education was the single most important factor, accounting alone for ~ 28% the inequality, followed by rural residence (~ 17%) and dietary diversity (~ 16%). Efforts to narrow socioeconomic gaps and/or designing equity sensitive interventions by prioritizing the poor in health/nutrition interventions stands worth of consideration to reduce the burden of childhood anemia in Ethiopia and beyond.

Background While the use of sulphadoxine pyrimethamine (SP) is effective in preventing malaria infection during pregnancy, there are challenges limiting its uptake in Nigeria. This study aimed at exploring the barriers to IPTp usage among pregnant women in Kano state - Nigeria. Methods This is a qualitative study. The purposive sampling strategy was used for identification and selection of 14 key informants for interviews. In addition, six focus group discussions (FGDs) were conducted with pregnant women (3 FGDs) and married men (3 FGDs). The conventional content analysis method was used to interpret meaning from the content of the data. MAXQDA 10 software was used for data management and analysis. Results Poor policy implementation, poor antenatal care attendance, inadequate access to intermittent preventive treatment at the community levels, lack of sustainable funding, and poor community engagement emerged as major barriers to IPTp use in Nigeria. Conclusion While the political will to allocate sufficient financial resources could help improve service delivery and IPTp usage among pregnant women, community participation is critical to sustain the gains.

Background: Iran detected its first COVID-19 case in February 2020 in Qom province, which rapidly spread to other cities in the country. Iran, as one of those countries with the highest number of infected people, has officially reported 1812 deaths from a total number of 23049 confirmed infected cases that we used in the analysis. Materials and Methods: Geographic distribution by the map of calculated incidence rates for COVID -19 in Iran within the period was prepared by GIS 10.6 Spatial autocorrelation (Global Moran’s I) and hot spot analysis were used to assess COVID -19 spatial patterns. The ordinary least square method was used to estimate the relationship between COVID -19 and the risk factors. The next step was to explore Geographically Weighted Regression (GWR) models that might better explain the variation in COVID -19 cases based on the environmental and socio-demographic factors. Results: The spatial autocorrelation (Global Moran’s I) result showed that COVID-19 cases in the studied area were in clustered patterns. For statistically significant positive z-scores, the larger the z-score is, the more intense the clustering of high values (hot spot), such as Semnan, Qom, Isfahan, Mazandaran, Alborz, and Tehran. Hot spot analysis detected clustering of a hot spot with confidence level 99% for Semnan, Qom, Isfahan, Mazandaran, Alborz, and Tehran, as well. The risk factors were removed from the model step by step. Finally, just the distance from the epicenter was adopted in the model. GWR efforts increased the explanatory value of risk factor with better special precision (adjusted R-squared=0.44) Conclusion: The highest CIR was concentrated around Qom. Also, the greater the distance from the center of prevalence (Qom), the fewer the patients. Hot spot analysis also implies that the neighboring provinces of prevalence centers exhibited hot spots with a 99% confidence level. Furthermore, the results of OLS analysis showed the significant correlation of CIR is with the distance from epicenter (Qom). The GWR can result in the spatial granularity providing an opportunity to well understand the relationship between environmental spatial heterogeneity and COVID-19 risk as entailed by the infection of CIR with COVID-19, which would make it possible to better plan managerial policies for public health.