Ketema Daniel Bekele, Shifti Desalegn Markos, Tegegne Teketo Kassaw, Odo Daniel Bogale, Thapa Subash, Dadi Abel, Hassen Tahir Ahmed, Kibret Getiye Dejenu, Kassa Zemen Y, Amsalu Erkihun, Mesfin Yonatan M, Bizuayehu Habtamu Mellie, Belachew Sewunet Admasu, Bore Meless Gebrie, Seid Abdulbasit, Ahmed Kedir Y
College of Medicine and Health science, School of Public Health, Debre Markos University, Debre Markos, Ethiopia.
Child Health Research Centre, The University of Queensland, South Brisbane, Australia.
PLOS Glob Public Health. 2025 Jul 2;5(7):e0004738. doi: 10.1371/journal.pgph.0004738. eCollection 2025.
Hypertension is a significant public health issue in sub-Saharan Africa, especially among reproductive-aged women. This study aims to assess and decompose socioeconomic inequalities in hypertension across five SSA countries using DHS data. Our study analyzed the latest Demographic and Health Survey data from five SSA countries, including Benin, Cameroon, Ghana, Kenya, and Lesotho. We selected these five SSA countries based on data availability and conducted analyses using the Erreygers normalized concentration index (ECI) and concentration curve to measure and decompose inequalities.A weighted total sample of 52,076 reproductive-age women in SSA were included. The overall weighted ECI was estimated to be 0.06 (95% confidence interval (CI):0.049; 0.065). Key contributors to socioeconomic inequalities in hypertension include wealth quantile (126%), media exposure (19%), and educational attainment (2.3%), marital status (-34.3%), and residence (-31.7).In conclusion, there is a clear pro-rich socioeconomic inequality in hypertension among reproductive-age women in Sub-Saharan Africa. Wealth index, marital status, media exposure, and place of residence are the primary drivers of this disparity. Addressing these socioeconomic disparities through targeted interventions can significantly reduce hypertension rates among reproductive-aged women in SSA.
高血压是撒哈拉以南非洲地区一个重要的公共卫生问题，在育龄妇女中尤为突出。本研究旨在利用人口与健康调查（DHS）数据评估和分解撒哈拉以南非洲五个国家高血压方面的社会经济不平等情况。我们的研究分析了来自五个撒哈拉以南非洲国家（包括贝宁、喀麦隆、加纳、肯尼亚和莱索托）的最新人口与健康调查数据。我们根据数据可得性选择了这五个撒哈拉以南非洲国家，并使用埃雷格斯归一化集中指数（ECI）和集中曲线进行分析，以测量和分解不平等情况。纳入了撒哈拉以南非洲52076名育龄妇女的加权总样本。总体加权ECI估计为0.06（95%置信区间（CI）：0.049；0.065）。高血压社会经济不平等的主要影响因素包括财富分位数（126%）、媒体曝光率（19%）、受教育程度（2.3%）、婚姻状况（-34.3%）和居住地（-31.7%）。总之，撒哈拉以南非洲育龄妇女在高血压方面存在明显的有利于富人的社会经济不平等。财富指数、婚姻状况、媒体曝光率和居住地是这种差异的主要驱动因素。通过有针对性的干预措施解决这些社会经济差异，可以显著降低撒哈拉以南非洲育龄妇女的高血压发病率。
