Background With a population of about 1.1 billion, sub-Saharan Africa is projected to overtake Eastern, Southern and Central Asia to become the most populous region by 2060. One effective approach for slowing this rapid population growth is the use of modern contraception and this may be short-acting or long acting. Previous studies have explored the association between women empowerment indicators contraception use, however, there is limited evidence on how women empowerment indicators associate with type of contraception. Hence the present study investigated the association between women empowerment indicators and type of contraception used by women in 11 sub-Saharan African countries. Methods We utilised Demographic and Health Survey data of 22,637 women from 11 countries, collected between 2018 and 2021. The outcome variable was type of contraception used. Descriptive and inferential analyses were executed. The descriptive analysis reflected women empowerment indicators and the proportion of women using contraceptives. Multinomial logistic regression was considered for the inferential analysis. The results for the multinomial logistic regression were presented as adjusted odds ratios (aORs) along with the respective 95% confidence intervals (CIs) signifying precision. The sample weight (wt) was used to account for the complex survey (svy) design. All the analyses were done with Stata version 13 and SPSS version 25. Results The study showed that on the average, 15.95% of the women do not use modern contraceptives, whilst 30.67% and 53.38% use long-acting and short-acting contraceptives respectively. The adjusted models showed that women who were working had higher odds of using long-acting (aOR = 1.44, CI 1.28–1.62) and short-acting (aOR = 2.00, CI 1.79–2.24) methods compared with those who were not working. The analysis revealed higher likelihood of long-acting method use among women with high decision-making capacity (aOR = 1.27, CI 1.09–1.47) compared with women with low decision-making capacity. Women with medium knowledge level had a higher likelihood (aOR = 1.54, 1.09–2.17) of using long-acting methods than their counterparts with low knowledge level. Conclusion Our findings show that most women in the 11 countries use modern contraceptives, however, different empowerment indicators align with different contraceptive type. It therefore behoves governments of the studied countries to review current interventions and embrace new ones that are more responsive to the peculiar contraception needs of empowered and non-empowered women.

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This paper examines the link between income per capita, adult life expectancy and mortality rates for children. We estimate a dynamic panel model using data from 128 developing countries and find that all else equal external (i.e., non-country specific) factors have a positive and significant impact on health outcomes, and this effect has increased over time; countries in Sub-Saharan Africa (SSA) have a higher mortality rate and lower life expectancy than non-SSA countries and the effect of income per capita on health outcomes is different for SSA countries.

Background and Aims Early initiation of breastfeeding (EIB) remains one of the promising interventions for preventing neonatal and child deaths. EIB is positively associated with healthcare delivery or childbirth. Meanwhile, no study in sub‐Saharan Africa (SSA) appears to have investigated the relationship between health facility delivery and EIB; thus, we assessed the correlation between health facility delivery and EIB. Methods We used data from the Demographic and Health Survey (DHS) of 64,506 women from 11 SSA countries. The outcome variable was whether the respondent had early breastfeeding or not. Two logistic regression models were used in the inferential analysis. With a 95% confidence interval (CI), the adjusted odds ratios (aORs) for each variable were calculated. The data set was stored, managed, and analyzed using Stata version 13. Results The overall percentage of women who initiated early breastfeeding was 59.22%. Rwanda recorded the highest percentage of early initiation of breastfeeding (86.34%), while Gambia recorded the lowest (39.44%). The adjusted model revealed a significant association between health facility delivery and EIB (aOR = 1.80, CI = 1.73–1.87). Compared with urban women, rural women had higher likelihood of initiating early breastfeeding (aOR = 1.22, CI = 1.16–1.27). Women with a primary education (aOR = 1.26, CI = 1.20–1.32), secondary education (aOR = 1.12, CI = 1.06–1.17), and higher (aOR = 1.13, CI = 1.02–1.25), all had higher odds of initiating early breastfeeding. Women with the richest wealth status had the highest odds of initiating early breastfeeding as compared to the poorest women (aOR = 1.33, CI = 1.23–1.43). Conclusion Based on our findings, we strongly advocate for the integration of EIB policies and initiatives with healthcare delivery advocacy. Integration of these efforts can result in drastic reduction in infant and child mortality. Essentially, Gambia and other countries with a lower proclivity for EIB must reconsider their current breastfeeding interventions and conduct the necessary reviews and modifications that can lead to an increase in EIB.

26Background: Pregnancy intention is a critical factor for both short and long term maternal and 27 child health outcomes. Some evidence show that wealth status has varying implications on 28 unintended pregnancy. In this study, we investigated wealth and unintended pregnancy among 29 women of reproductive age in Ghana. 30 Methods: Our descriptive analysis comprised calculation of wealth status and unintended 31 pregnancy. The same calculation was done for socio-demographic characteristics and 32 unintended pregnancy. Due to the binary nature of the outcome variable (unintended 33 pregnancy), Binary Logistic Model was used for the inferential analysis. The first model 34 (Model I), constituted wealth quintile and unintended pregnancy. The second model (Model II) 35was developed by adjusting for five key socio-demographic variables. 36Results: Women in the richest wealth quintile had less likelihood of experiencing unintended 37 pregnancy (OR=0.740, CI=0.42-1.28). Considering women aged 15-19 as the reference 38 category, women in all other age categories had less likelihood of unintended pregnancy 39 especially those aged 45-49 (AOR=0.26, CI=0.04-1.58). The findings revealed that those who 40 listened to radio at least once a week (AOR=0.56, CI=0.36-0.89) were less probable to report 41 unintended pregnancy, having those not listening to radio at all as the reference category. 42Women in urban settings were less likely to have unintended pregnancies (AOR=0.74, 43 CI=0.46-1.19). 44Conclusions: This study has indicated that unintended pregnancy to larger extent is poverty 45 driven. The study suggests that the mass media, particularly radio, is valuable in 46 communicating birth control measures and messages on unintended pregnancies. Efforts to 47 halt unintended pregnancies must target poor women, especially those in the rural locations. 48 49 Plain English summary 52Unintended pregnancies have a number of adverse implications on women and newborns. 53These pregnancies consist of those that are not needed at all or were expected earlier or later 54 than when they happened. Some research have suggested that wealth status of women affect 55 their chances of experiencing unintended pregnancy. In Ghana, a number of studies have been 56 conducted on various aspects of unintended pregnancy. Yet, our search indicated that no study 57 have been carried out on the relationship between wealth and unintended pregnancy. 58In this study we explored how wealth status of women affect unintended pregnancy. Using 59Binary Logistic Regression analysis, the study revealed that wealth is associated with 60 unintended pregnancy. Women in the richest wealth quintile had less likelihood of 61 experiencing unintended pregnancy compared with poorest women. After adjusting for 62 covariates, we realised that compared with poorest women, the rich were more likely to 63 experience unintended pregnancy. 64In conclusion, richest women generally have lower chances of experiencing unintended 65 pregnancies, however, this can be compromised b...