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. 2021 Sep 3;13(5):436-445.
doi: 10.1093/inthealth/ihaa093.

Trends in obesity by socioeconomic status among non-pregnant women aged 15-49 y: a cross-sectional, multi-dimensional equity analysis of demographic and health surveys in 11 sub-Saharan Africa countries, 1994-2015

Oghenebrume Wariri  1 , Jacob Albin Korem Alhassan  2 , Godwin Mark  3 , Oyinkansola Adesiyan  4 , Lori Hanson  2
Affiliations

Trends in obesity by socioeconomic status among non-pregnant women aged 15-49 y: a cross-sectional, multi-dimensional equity analysis of demographic and health surveys in 11 sub-Saharan Africa countries, 1994-2015

Oghenebrume Wariri et al. Int Health. .

Abstract

Background: Global obesity estimates show a steadily increasing pattern across socioeconomic and geographical divides, especially among women. Our analysis tracked and described obesity trends across multiple equity dimensions among women of reproductive age (15-49 y) in 11 sub-Saharan African (SSA) countries during 1994-2015.

Methods: This study consisted of a cross-sectional series analysis using nationally representative demographic and health surveys (DHS) data. The countries included were Cameroon, Comoros, Congo, Cote d'Ivoire, Ghana, Kenya, Lesotho, Nigeria, Senegal, Zambia and Zimbabwe. The data reported are from a reanalysis conducted using the WHO Health Equity Assessment Toolkit that assesses inter- and intra-country health inequalities across socioeconomic and geographical dimensions. We generated equiplots to display intra- and inter-country equity gaps.

Results: There was an increasing trend in obesity among women of reproductive age across all 11 SSA countries. Obesity increased unequally across wealth categories, place of residence and educational measures of inequality. The wealthiest, most educated and urban dwellers in most countries had a higher prevalence of obesity. However, in Comoros, obesity did not increase consistently with increasing wealth or education compared with other countries. The most educated and wealthiest women in Comoros had lower obesity rates compared with their less wealthy and less well-educated counterparts.

Conclusion: A window of opportunity is presented to governments to act structurally and at policy level to reduce obesity generally and prevent a greater burden on disadvantaged subpopulation groups in sub-Saharan Africa.

Keywords: Equity analysis; Obesity; Women of reproductive age-group; sub-Saharan Africa.

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Figures

Figure 1.
Figure 1.
(A) Country-level trends in the prevalence of obesity; (B) median prevalence of obesity trends across three time periods (1994–2004, 2005–2009 and 2010–2015) in 11 sub-Saharan African countries. First time period: Cameroon (DHS 1998), Cote d'Ivoire (DHS 1994), Ghana (DHS 2003), Kenya (DHS 2003), Lesotho (DHS 2004), Nigeria (DHS 2003), Zambia (DHS 2001) and Zimbabwe (DHS 2005). Second time period: Cameroon (DHS 2004), Comoros (DHS 1996), Congo (DHS 2005), Cote d'Ivoire (DHS 1998), Ghana (DHS 2008), Kenya (DHS 2008), Lesotho (DHS 2009), Nigeria (DHS 2008), Senegal (DHS 2005), Zambia (DHS 2007) and Zimbabwe (DHS 2010). Third time period: Cameroon (DHS 2011), Comoros (DHS 2012), Congo (DHS 2011), Cote d'Ivoire (DHS 2011), Ghana (DHS 2014), Kenya (DHS 2014), Lesotho (DHS 2014), Nigeria (DHS 2013), Senegal (DHS 2010), Zambia (DHS 2013) and Zimbabwe (DHS 2015).
Figure 2.
Figure 2.
Inequalities in the prevalence of obesity among women aged 15–49 y in 11 sub-Saharan African countries, 2010–2015. Cameroon (DHS 2011), Comoros (DHS 2012), Congo (DHS 2011), Cote d'Ivoire (DHS 2011), Ghana (DHS 2014), Kenya (DHS 2014), Lesotho (DHS 2014), Nigeria (DHS 2013), Senegal (DHS 2010), Zambia (DHS 2013) and Zimbabwe (DHS 2015).
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