The influence of socioeconomic factors on choice of infant male circumcision provider in rural Ghana; a community level population based study

Thomas Gyan, Kimberley McAuley, Natalie Strobel, Sam Newton, Seth Owusu-Agyei, Karen Edmond

Research output: Contribution to journalArticle

Abstract

Background: The influence of socio-economic determinants on choice of infant male circumcision provider is not known in areas with high population coverage such as rural Africa. The overall aim of this study was to determine the key socio-economic factors which influence the choice of infant male circumcision provider in rural Ghana. Methods: The study investigated the effect of family income, distance to health facility, and cost of the circumcision on choice of infant male circumcision provider in rural Ghana. Data from 2847 circumcised infant males aged under 12 weeks and their families were analysed in a population-based cross-sectional study conducted from May to December 2012 in rural Ghana. Multivariable logistic regression models were adjusted for income status, distance to health facility, cost of circumcision, religion, maternal education, and maternal age. Results: Infants from the lowest income households (325, 84.0%) were more likely to receive circumcision from an informal provider compared to infants from the highest income households (260, 42.4%) even after adjusting for religious affiliation (adjusted odds ratio [aOR] 4.42, 95% CI 3.12-6.27 p = <0.001). There appeared to be a dose response with increasing risk of receiving a circumcision from an informal provider as distance to a health facility increased (aOR 1.25, 95 CI 1.30-1.38 P = <0.001). Only 9.0% (34) of families in the lowest socio-economic quintile received free circumcision services compared to 27.9% (171) of the highest income families. Conclusions: The Government of Ghana and Non-Government Organisations should consider additional support to poor families so they can access high quality free infant male circumcision in rural Ghana.

Original languageEnglish
Article number185
JournalBMC Pediatrics
Volume17
Issue number1
DOIs
Publication statusPublished - 29 Aug 2017

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Male Circumcision
Ghana
Health Facilities
Population
Economics
Health Care Costs
Logistic Models
Odds Ratio
Maternal Age
Religion
Cross-Sectional Studies
Mothers
Organizations
Education

Cite this

@article{c2799716b130489185f7920f39c66df6,
title = "The influence of socioeconomic factors on choice of infant male circumcision provider in rural Ghana; a community level population based study",
abstract = "Background: The influence of socio-economic determinants on choice of infant male circumcision provider is not known in areas with high population coverage such as rural Africa. The overall aim of this study was to determine the key socio-economic factors which influence the choice of infant male circumcision provider in rural Ghana. Methods: The study investigated the effect of family income, distance to health facility, and cost of the circumcision on choice of infant male circumcision provider in rural Ghana. Data from 2847 circumcised infant males aged under 12 weeks and their families were analysed in a population-based cross-sectional study conducted from May to December 2012 in rural Ghana. Multivariable logistic regression models were adjusted for income status, distance to health facility, cost of circumcision, religion, maternal education, and maternal age. Results: Infants from the lowest income households (325, 84.0{\%}) were more likely to receive circumcision from an informal provider compared to infants from the highest income households (260, 42.4{\%}) even after adjusting for religious affiliation (adjusted odds ratio [aOR] 4.42, 95{\%} CI 3.12-6.27 p = <0.001). There appeared to be a dose response with increasing risk of receiving a circumcision from an informal provider as distance to a health facility increased (aOR 1.25, 95 CI 1.30-1.38 P = <0.001). Only 9.0{\%} (34) of families in the lowest socio-economic quintile received free circumcision services compared to 27.9{\%} (171) of the highest income families. Conclusions: The Government of Ghana and Non-Government Organisations should consider additional support to poor families so they can access high quality free infant male circumcision in rural Ghana.",
keywords = "Circumcision, Community, Ghana, Infant, Male, Population-based, Socio-economic",
author = "Thomas Gyan and Kimberley McAuley and Natalie Strobel and Sam Newton and Seth Owusu-Agyei and Karen Edmond",
year = "2017",
month = "8",
day = "29",
doi = "10.1186/s12887-017-0937-2",
language = "English",
volume = "17",
journal = "BMC Paediatrics",
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T1 - The influence of socioeconomic factors on choice of infant male circumcision provider in rural Ghana; a community level population based study

AU - Gyan, Thomas

AU - McAuley, Kimberley

AU - Strobel, Natalie

AU - Newton, Sam

AU - Owusu-Agyei, Seth

AU - Edmond, Karen

PY - 2017/8/29

Y1 - 2017/8/29

N2 - Background: The influence of socio-economic determinants on choice of infant male circumcision provider is not known in areas with high population coverage such as rural Africa. The overall aim of this study was to determine the key socio-economic factors which influence the choice of infant male circumcision provider in rural Ghana. Methods: The study investigated the effect of family income, distance to health facility, and cost of the circumcision on choice of infant male circumcision provider in rural Ghana. Data from 2847 circumcised infant males aged under 12 weeks and their families were analysed in a population-based cross-sectional study conducted from May to December 2012 in rural Ghana. Multivariable logistic regression models were adjusted for income status, distance to health facility, cost of circumcision, religion, maternal education, and maternal age. Results: Infants from the lowest income households (325, 84.0%) were more likely to receive circumcision from an informal provider compared to infants from the highest income households (260, 42.4%) even after adjusting for religious affiliation (adjusted odds ratio [aOR] 4.42, 95% CI 3.12-6.27 p = <0.001). There appeared to be a dose response with increasing risk of receiving a circumcision from an informal provider as distance to a health facility increased (aOR 1.25, 95 CI 1.30-1.38 P = <0.001). Only 9.0% (34) of families in the lowest socio-economic quintile received free circumcision services compared to 27.9% (171) of the highest income families. Conclusions: The Government of Ghana and Non-Government Organisations should consider additional support to poor families so they can access high quality free infant male circumcision in rural Ghana.

AB - Background: The influence of socio-economic determinants on choice of infant male circumcision provider is not known in areas with high population coverage such as rural Africa. The overall aim of this study was to determine the key socio-economic factors which influence the choice of infant male circumcision provider in rural Ghana. Methods: The study investigated the effect of family income, distance to health facility, and cost of the circumcision on choice of infant male circumcision provider in rural Ghana. Data from 2847 circumcised infant males aged under 12 weeks and their families were analysed in a population-based cross-sectional study conducted from May to December 2012 in rural Ghana. Multivariable logistic regression models were adjusted for income status, distance to health facility, cost of circumcision, religion, maternal education, and maternal age. Results: Infants from the lowest income households (325, 84.0%) were more likely to receive circumcision from an informal provider compared to infants from the highest income households (260, 42.4%) even after adjusting for religious affiliation (adjusted odds ratio [aOR] 4.42, 95% CI 3.12-6.27 p = <0.001). There appeared to be a dose response with increasing risk of receiving a circumcision from an informal provider as distance to a health facility increased (aOR 1.25, 95 CI 1.30-1.38 P = <0.001). Only 9.0% (34) of families in the lowest socio-economic quintile received free circumcision services compared to 27.9% (171) of the highest income families. Conclusions: The Government of Ghana and Non-Government Organisations should consider additional support to poor families so they can access high quality free infant male circumcision in rural Ghana.

KW - Circumcision

KW - Community

KW - Ghana

KW - Infant

KW - Male

KW - Population-based

KW - Socio-economic

UR - http://www.scopus.com/inward/record.url?scp=85028474090&partnerID=8YFLogxK

U2 - 10.1186/s12887-017-0937-2

DO - 10.1186/s12887-017-0937-2

M3 - Article

VL - 17

JO - BMC Paediatrics

JF - BMC Paediatrics

SN - 1471-2431

IS - 1

M1 - 185

ER -