Conectar
Maternal anaemia remains a pressing global health challenge, with a notable burden in low- and middle-income countries. Existing studies in sub-Saharan Africa have largely relied on average associations, thereby concealing key variation among women and failing to account for heterogeneity.
To assess the association between completing at least eight antenatal care (ANC) contacts and maternal anaemia in Ghana and to explore heterogeneity in this association using causal machine learning.
An institution-based cross-sectional study was conducted using a retrospective review of medical records and causal machine learning analysis.
Juaben Government Hospital.
Of 2326 women who delivered at the hospital, 2114 with complete data on the main exposure and outcome variables were included in the analysis.
Completion of at least eight ANC contacts. ANC contact was defined as the in-person visit to the clinic with a healthcare professional for routine ANC services and follow-up.
Maternal anaemia, defined as a haemoglobin level below 11 g/dL in the last ANC before delivery.
A causal forest model was used to estimate the association between completing at least eight ANC contacts and maternal anaemia. Conditional average treatment effects were used to explore individual-level variation in these associations, providing policy-relevant insights.
Completing ≥8 ANC contacts was associated with a 6 percentage-point lower probability of maternal anaemia compared with having fewer visits (average treatment effect: -0.06, 95% CI –0.11 to –0.02). Predicted individual-level effects ranged from –0.21 to 0.09. Participants’ age, malaria prophylaxis, marital status, parity and educational level were the five most important contributors to the observed heterogeneity.
This study demonstrated that completing ≥8 ANC contacts is associated with a lower probability of maternal anaemia, with heterogeneity across subgroups. We recommend differentiated, context-specific ANC interventions that focus on high-impact subgroups while strengthening the effectiveness and quality of care delivered at each visit.
by Evelyn Aboagye Addae, Moses Adjei, Uchechi Shirley Anaduaka, David Kyetuo Wuollah-Dire, Regobert Bondong
Though the impact of COVID-19 pandemic’s effects on individuals’ life domains and quality of life has been widely researched, there remains unanswered questions on the mechanisms that explain the impact of fear of COVID-19 on different measurements of adolescents’ subjective well-being (SWB) particularly in the sub-Saharan African context. In a mediation model, we employed data collected during the pandemic to examine the mediating mechanisms that links fear of COVID-19 and COVID-19-induced changes in multiple life domains (subjective feelings of unsafety, positive affect and peer relationships) to different measurements of adolescents’ SWB (overall life satisfaction, overall happiness, subjective happiness, and composite SWB). Findings revealed significant negative correlations between fear of COVID-19 and all employed measurements of SWB as well as between the proposed mediating variables – changes in peer relationship, positive affect, subjective feelings of unsafety and the different measurements of SWB. Adolescents who reported negative changes in peer relationship, positive affect and subjective feelings of unsafety were more likely to report poorer SWB including lower life satisfaction and happiness. For instance, adolescents who experienced increase in peer relationship were more likely to experience higher overall life satisfaction (B = .169, p B = .172, p B = .056, p B = .416, p B = .381, p B = −1.350, p
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