Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

Abdul Aziz SEIDU; Joseph Kojo ODURO; Bright Opoku AHINKORAH; Eugene BUDU; Francis APPIAH; Linus BAATIEMA; Edward Kwabena AMEYAW; Francis SAMBAH

doi:10.1186/s12889-020-09660-y

Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

Abdul Aziz SEIDU, Joseph Kojo ODURO, Bright Opoku AHINKORAH, Eugene BUDU, Francis APPIAH, Linus BAATIEMA, Edward Kwabena AMEYAW, Francis SAMBAH^*

^*Corresponding author for this work

Research output: Journal Publications › Journal Article (refereed) › peer-review

11 Citations (Scopus)

Abstract

Background

Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment, as these efforts play major roles in mother-to-child transmission. We examined the association between women’s healthcare decision-making capacity and uptake of HIV testing in sub-Saharan Africa.

Methods

We used data from the current Demographic and Health Surveys (DHS) of 28 countries in sub-Saharan Africa, conducted between January 1, 2010 and December 31, 2018. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression assess the likelihood of HIV testing uptake by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value < 0.05.

Results

We found that prevalence of HIV testing uptake in the 28 sub-Saharan African countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare decisions alone [COR = 3.183, CI = 2.880–3.519] or with their partners [COR = 2.577, CI = 2.335–2.844] were more likely to test for HIV, compared to those whose healthcare decisions were taken by others, and this persisted after controlling for significant covariates: [AOR = 1.507, CI = 1.321–1.720] and [AOR = 1.518, CI = 1.334–1.728] respectively.

Conclusion

Sub-Saharan African countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with decision to test for their HIV status.

Original language	English
Article number	1592
Number of pages	11
Journal	BMC International Health and Human Rights
Volume	20
DOIs	https://doi.org/10.1186/s12889-020-09660-y
Publication status	E-pub ahead of print - 22 Oct 2020
Externally published	Yes

Bibliographical note

We wish to thank Measure DHS for providing us free access to the data. We also acknowledge Mr. Ebenezer Agbaglo of the Department of English, University of Cape Coast, who thoroughly copy-edited this manuscript for language usage, spelling, and grammar.

Keywords

Healthcare decision-making capacity
HIV
Sub-Saharan Africa
Testing
Women

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s12889-020-09660-yLicence: CC BY

Cite this

SEIDU, A. A., ODURO, J. K., AHINKORAH, B. O., BUDU, E., APPIAH, F., BAATIEMA, L., AMEYAW, E. K., & SAMBAH, F. (2020). Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys. BMC International Health and Human Rights, 20, Article 1592. Advance online publication. https://doi.org/10.1186/s12889-020-09660-y

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title = "Women{\textquoteright}s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys",

abstract = "BackgroundGlobal commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment, as these efforts play major roles in mother-to-child transmission. We examined the association between women{\textquoteright}s healthcare decision-making capacity and uptake of HIV testing in sub-Saharan Africa.MethodsWe used data from the current Demographic and Health Surveys (DHS) of 28 countries in sub-Saharan Africa, conducted between January 1, 2010 and December 31, 2018. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression assess the likelihood of HIV testing uptake by women{\textquoteright}s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value < 0.05.ResultsWe found that prevalence of HIV testing uptake in the 28 sub-Saharan African countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare decisions alone [COR = 3.183, CI = 2.880–3.519] or with their partners [COR = 2.577, CI = 2.335–2.844] were more likely to test for HIV, compared to those whose healthcare decisions were taken by others, and this persisted after controlling for significant covariates: [AOR = 1.507, CI = 1.321–1.720] and [AOR = 1.518, CI = 1.334–1.728] respectively.ConclusionSub-Saharan African countries intending to improve HIV testing need to incorporate women{\textquoteright}s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with decision to test for their HIV status.",

keywords = "Healthcare decision-making capacity, HIV, Sub-Saharan Africa, Testing, Women",

author = "SEIDU, {Abdul Aziz} and ODURO, {Joseph Kojo} and AHINKORAH, {Bright Opoku} and Eugene BUDU and Francis APPIAH and Linus BAATIEMA and AMEYAW, {Edward Kwabena} and Francis SAMBAH",

note = "We wish to thank Measure DHS for providing us free access to the data. We also acknowledge Mr. Ebenezer Agbaglo of the Department of English, University of Cape Coast, who thoroughly copy-edited this manuscript for language usage, spelling, and grammar. ",

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Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys. / SEIDU, Abdul Aziz; ODURO, Joseph Kojo; AHINKORAH, Bright Opoku et al.
In: BMC International Health and Human Rights, Vol. 20, 1592, 22.10.2020.

Research output: Journal Publications › Journal Article (refereed) › peer-review

TY - JOUR

T1 - Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

AU - SEIDU, Abdul Aziz

AU - ODURO, Joseph Kojo

AU - AHINKORAH, Bright Opoku

AU - BUDU, Eugene

AU - APPIAH, Francis

AU - BAATIEMA, Linus

AU - AMEYAW, Edward Kwabena

AU - SAMBAH, Francis

N1 - We wish to thank Measure DHS for providing us free access to the data. We also acknowledge Mr. Ebenezer Agbaglo of the Department of English, University of Cape Coast, who thoroughly copy-edited this manuscript for language usage, spelling, and grammar.

PY - 2020/10/22

Y1 - 2020/10/22

N2 - BackgroundGlobal commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment, as these efforts play major roles in mother-to-child transmission. We examined the association between women’s healthcare decision-making capacity and uptake of HIV testing in sub-Saharan Africa.MethodsWe used data from the current Demographic and Health Surveys (DHS) of 28 countries in sub-Saharan Africa, conducted between January 1, 2010 and December 31, 2018. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression assess the likelihood of HIV testing uptake by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value < 0.05.ResultsWe found that prevalence of HIV testing uptake in the 28 sub-Saharan African countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare decisions alone [COR = 3.183, CI = 2.880–3.519] or with their partners [COR = 2.577, CI = 2.335–2.844] were more likely to test for HIV, compared to those whose healthcare decisions were taken by others, and this persisted after controlling for significant covariates: [AOR = 1.507, CI = 1.321–1.720] and [AOR = 1.518, CI = 1.334–1.728] respectively.ConclusionSub-Saharan African countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with decision to test for their HIV status.

AB - BackgroundGlobal commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment, as these efforts play major roles in mother-to-child transmission. We examined the association between women’s healthcare decision-making capacity and uptake of HIV testing in sub-Saharan Africa.MethodsWe used data from the current Demographic and Health Surveys (DHS) of 28 countries in sub-Saharan Africa, conducted between January 1, 2010 and December 31, 2018. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression assess the likelihood of HIV testing uptake by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value < 0.05.ResultsWe found that prevalence of HIV testing uptake in the 28 sub-Saharan African countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare decisions alone [COR = 3.183, CI = 2.880–3.519] or with their partners [COR = 2.577, CI = 2.335–2.844] were more likely to test for HIV, compared to those whose healthcare decisions were taken by others, and this persisted after controlling for significant covariates: [AOR = 1.507, CI = 1.321–1.720] and [AOR = 1.518, CI = 1.334–1.728] respectively.ConclusionSub-Saharan African countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with decision to test for their HIV status.

KW - Healthcare decision-making capacity

KW - HIV

KW - Sub-Saharan Africa

KW - Testing

KW - Women

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U2 - 10.1186/s12889-020-09660-y

DO - 10.1186/s12889-020-09660-y

M3 - Journal Article (refereed)

C2 - 33092556

AN - SCOPUS:85093834731

VL - 20

JO - BMC International Health and Human Rights

JF - BMC International Health and Human Rights

M1 - 1592

ER -

Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

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