Background Globally, over half of maternal deaths are related to pregnancy-related complications. Provision of a continuum of care during pregnancy, childbirth and the postnatal period results in reduced maternal and neonatal morbidity and mortality. Hence this study determined the prevalence of the continuum of care and its determinants among women in Zambia. Methods We used weighted data from the Zambian Demographic and Health Survey (ZDHS) of 2018 for 7325 women aged 15 to 49 years. Multistage stratified sampling was used to select study participants. Complete continuum of care was considered when a woman had; at least four antenatal care (ANC) contacts, utilized a health facility for childbirth and had at least one postnatal check-up within six weeks. We conducted multivariable logistic regression to explore continuum of care in Zambia. All our analyses were done using SPSS version 25. Results Of the 7,325 women, 38.0% (2787/7325) (95% confidence interval (CI): 36.9-39.1) had complete continuum of maternal healthcare. Women who had attained tertiary level of education (adjusted odds ratio (AOR): 1.93, 95% CI: 1.09-3.42) and whose partners had also attained tertiary level of education (AOR: 2.58, 95% CI: 1.54-4.32) were more likely to utilize the whole continuum of care compared to those who had no education. Women who initiated ANC after the first trimester (AOR: 0.46, 95% CI: 0.39-0.53) were less likely to utilize the whole continuum of care compared to those who initiated in the first semester. Women with exposure to radio (AOR: 1.58, 95% CI: 1.27-1.96) were more likely to utilize the whole continuum of care compared to those who were not exposed to radio. Women residing in the Western province were less likely to utilize the entire continuum of care compared to those in the other nine provinces. Conclusion Level of education of the women and of their partners, early timing of ANC initiation, residing in other provinces other than the Western province, and exposure to information through radio were positively associated with utilization of the entire continuum of care. Improving literacy levels and promoting maternity services through radio may improve the level of utilization of maternity services.

Background Women are at risk of undernutrition due to biological, socio-economic, and cultural factors. Undernourished women have higher risk of poor obstetric outcomes. We aimed to determine the prevalence and factors associated with undernutrition among women of reproductive age in Uganda. Methods We used Uganda Demographic and Health Survey (UDHS) 2016 data of 4640 women aged 20 to 49 years excluding pregnant and post-menopausal women. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. We used multivariable logistic regression to determine factors associated with underweight and stunting among 20 to 49 year old women in Uganda. Results The prevalence of underweight and stunting were 6.9% (318/4640) and 1.3% (58/4640) respectively. Women who belonged to the poorest wealth quintile (Adjusted Odds Ratio (AOR) 3.60, 95% CI 1.85–7.00) were more likely to be underweight compared to those who belonged to the richest wealth quintile. Women residing in rural areas were less likely to be underweight (AOR 0.63, 95%CI 0.41–0.96) compared to women in urban areas. Women in Western (AOR 0.30, 95% CI 0.20–0.44), Eastern (AOR 0.42, 95% CI 0.28–0.63) and Central regions (AOR 0.42, 95% CI 0.25–0.72) were less likely to be underweight compared to those in the Northern region. Women belonging to Central (AOR 4.37, 95% CI 1.44–13.20) and Western (AOR 4.77, 95% CI 1.28–17.78) regions were more likely to be stunted compared to those in the Northern region. Conclusion The present study showed wealth index, place of residence and region to be associated with undernutrition among 20 to 49 year old women in Uganda. There is need to address socio-economic determinants of maternal undernutrition mainly poverty and regional inequalities.

Background Early initiation of antenatal care (ANC) within the first trimester is highly recommended in the current 2016 World Health Organization (WHO) guidelines. Mass media has the potential to promote early initiation of ANC because it has been used successfully in several programs. However, there is paucity of literature on the effect of exposure to different types of media on the timing of ANC initiation in Uganda. Our study aimed at exploring associations between exposure to different types of mass media and timing of ANC initiation among women in Uganda. Methods We used a cross sectional study design, to conduct a secondary analysis of data collected in the 2016 Uganda Demographic and Health Survey (UDHS). We included weighted data of all the 10,152 women of reproductive age (15–49 years). Multistage stratified sampling was used to select study participants. Multivariable logistic regression was used to determine the association between exposure to different types of mass media and early initiation of ANC. Results Almost a third of the women (2953/10,152, 29.1%, 95% CI 27.9–29.6) initiated their first ANC contact in the first trimester. Women who listened to radio at least once a week (adjusted OR (aOR 1.14, 95% CI 1.01–1.30) and those who watched television less than once a week (aOR 1.28, 95% CI 1.07–1.53) had higher odds of initiating ANC earlier compared to their counterparts not exposed to radio and television respectively. Conclusion Exposure to radio and television is associated with timing of ANC initiation in Uganda. Importantly, the two types of mass media have the potential to reach women with low levels of education and encourage them to utilize maternal health services. The Ugandan government needs to prioritize and intensify the use of radio and television to promote the benefits associated with timing of ANC initiation.

Background: Undernutrition accounts for at least 50% of the annual global under-five mortality burden. Although disparities in the childhood stunting between urban and rural areas in Sierra Leone have been documented, information on factors associated with these differences is lacking. We aimed to determine rural-urban correlates of stunting among children under the age of 5 in Sierra Leone. Methods: We analyzed data from 2019 Sierra Leone demographic and health survey (SLDHS) focusing on under-five children. We conducted multivariable logistic regression to examine rural-urban factors associated with childhood stunting. Results: Prevalence of stunting was 31.6% (95% CI 29.8-33.2) in rural areas and 24.0% (95% CI 21.6-26.1) in urban areas. Within the rural areas, children of stunted mothers (aOR = 2.37; 95% CI 1.07-5.24, P < .05), younger mothers aged 15 to 19 years (aOR = 2.08; 95% CI 1.17-3.69, P < .05), uneducated mothers (aOR = 1.87; 95% CI 1.28-2.71, P < .01), as well as older children (24-59 months) (aOR = 1.83; 95% CI 1.48-2.27, P < .001), and boys (aOR = 1.37; 95% CI 1.12-1.66, P < .01) were more likely to be stunted compared to those of non-stunted, older, post-primary education mothers and those who were less than 24 months and girls respectively. While urban children whose fathers had lower education (aOR = 1.94; 95% CI 1.10-3.42, P < .05), whose mothers were more parous (para 2-4) (aOR = 1.74; 95% CI 1.03-2.95, P < .05), and boys (aOR = 1.48; 95% CI 1.06-2.08, P < .05) were more likely to be stunted compared to their counterparts with fathers that had tertiary education, mothers of low parity and girls, respectively. Conclusions: Stunting is more prevalent in the rural areas compared to the urban areas. Sex of the child was the only significant factor in both rural and urban areas. Our study findings suggest that programs designed to reduce stunting should aim for integrated yet context specific interventions in rural and urban areas.

Background: Women are at risk of undernutrition due to biological, socio-economic, and cultural factors. Undernourished women have higher risk of poor obstetric outcomes. We aimed to determine the prevalence and factors associated with undernutrition among women of reproductive age in Uganda.Methods: We used Uganda Demographic and Health Survey (UDHS) 2016 data of 4,640 women aged 20 to 49 years excluding pregnant and post-menopausal women. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. We used multivariable logistic regression to determine factors associated with underweight and stunting among 20 to 49 year old women in Uganda.Results: The prevalence of underweight and stunting were 6.9% (318/4640) and 1.3% (58/4640) respectively. Women who belonged to the poorest wealth quintile (Adjusted Odds Ratio (AOR) 3.60, 95% CI 1.85–7.00) were more likely to be underweight compared to those who belonged to the richest wealth quintile. Women residing in rural areas were less likely to be underweight (AOR 0.63, 95%CI 0.41–0.96) compared to women in urban areas. Women in Western (AOR 0.30, 95% CI 0.20–0.44), Eastern (AOR 0.42, 95% CI 0.28–0.63) and Central regions (AOR 0.42, 95% CI 0.25–0.72) were less likely to be underweight compared to those in the Northern region. Women belonging to Central (AOR 4.37, 95% CI 1.44-13.20) and Western (AOR 4.77, 95% CI 1.28-17.78) regions were more likely to be stunted compared to those in the Northern region.Conclusion: The present study showed wealth index, place of residence and region to be associated with undernutrition among 20 to 49 year old women in Uganda. There is need to address socio-economic determinants of maternal undernutrition mainly poverty and regional inequalities.