Low birth weight in Angola and its socioeconomic determinants

Abstract Background In low-income nations, low birth weight (LBW) is still a major public health concern, which accounts for 96.5 % of global LBW cases. Any newborn weighing less than 2500g is considered LBW, which is associated with a 20-fold increase in the chance of dying during infancy. Despite the severity of the problem, in Sub-Saharan Africa the high rates of LBW have not diminished in the recent decade. The goal of this study is to evaluate the prevalence of LBW and its risk factors in Angola, as there is a pressing need to address LBW and its substantial health and social implications. Methods We used secondary data from the Angola Children’s Record Database of Demographic and Health Survey from 2015 to 2016. A binomial logistic regression model was used to investigate the prevalence of LBW and its related risk variables. Results From the 3738 children selected, 9.2% were born with LBW. The complete lack of formal maternal education (p = 0.011; adjOR=4.56, 95%CI 1.41-14.74), the absence of maternal iron supplementation during pregnancy (p = 0.017; adjOR=1.42, 95%CI 1.07-1.89) and women living in rural areas (p = 0.016; adjOR=1.37, 95%CI 1.06-1.78) were associated with LBW. Conclusions Education appears to have a significant impact on LBW, emphasizing the importance of addressing literacy in Public Health policies. Lack of iron supplementation and rural residence can also be used as indicators of poor health-care access. Understanding the factors informs decision-makers and should pave the way for more targeted intervention and more efficient LBW policy. Key messages • Intervention in socioeconomic factors and health access during pregnancy might have a high impact on the LBW problem. • Addressing literacy as a major health determinant can guide a more efficient policy making and help stakeholders target their interventions.


Background:
In low-income nations, low birth weight (LBW) is still a major public health concern, which accounts for 96.5 % of global LBW cases. Any newborn weighing less than 2500g is considered LBW, which is associated with a 20-fold increase in the chance of dying during infancy. Despite the severity of the problem, in Sub-Saharan Africa the high rates of LBW have not diminished in the recent decade. The goal of this study is to evaluate the prevalence of LBW and its risk factors in Angola, as there is a pressing need to address LBW and its substantial health and social implications.

Methods:
We used secondary data from the Angola Children's Record Database of Demographic and Health Survey from 2015 to 2016. A binomial logistic regression model was used to investigate the prevalence of LBW and its related risk variables.
Conclusions: Education appears to have a significant impact on LBW, emphasizing the importance of addressing literacy in Public Health policies. Lack of iron supplementation and rural residence can also be used as indicators of poor health-care access. Understanding the factors informs decision-makers and should pave the way for more targeted intervention and more efficient LBW policy. Key messages: Intervention in socioeconomic factors and health access during pregnancy might have a high impact on the LBW problem. Addressing literacy as a major health determinant can guide a more efficient policy making and help stakeholders target their interventions.

Issue:
Suicide continues to present a major public health concern in many societies. Suicide prevention efforts have failed to reduce the rate of suicide in most countries. A change of intervention strategy can help to prevent these deaths from despair. Description of the problem: Suicide prevention strategies are examined through an integrative review combined with more than 30 years of experience conducting research on suicide attempters and psychological autopsy research on adults who had died by suicide. Journal articles published since 2005 were reviewed for strategies designed to prevent death by suicide.

Results:
Suicide risk is examined by confronting the means, motives and opportunities for suicidal behavior. Prevention strategies that limit access to lethal means can have a beneficial impact if the method is easily accessible and not easily replaced. Unfortunately, some individuals merely shift to a different method for their suicidal act. Prevention strategies that restrict the opportunity for self-injury provide time to confront underlying disorders and initiate treatment. Unfortunately, many patients do not continue treatment beyond the acute crisis, and there is often a resurgence of suicidal behavior after discharge from the hospital. Prevention strategies that aim to confront the person's motivation to die may reduce the underlying cause. It is important to provide interventions to help reduce the desperation and isolation that underlie suicidal urges. These intervention strategies hold potential for making lasting changes that could eliminate, instead of temporarily suppressing, the desire to die.

Lessons:
Restricting access to lethal methods and limiting times when a suicidal person is left alone can temporarily block suicidal urges. However, the motive underlying the suicidal urges remains intact. The motivation to die can be addressed through interventions that focuses on helping clients to build a life worth living. Key messages: Suicide prevention strategies can confront the desire for death by helping to build a life that is worth living.
Comprehensive interventions aimed at reducing depression, isolation and addiction hold potential for reducing the rate of suicide.