Hazardous alcohol use among female heads-of-household in rural Mozambique

• Published in: Alcohol (Fayetteville, N.Y.) N.Y.), 2018-12, Vol.73, p.37-44
• Main Authors: Wainberg, Milton, Oquendo, Maria A., Peratikos, Meridith Blevins, Gonzalez-Calvo, Lazaro, Pinsky, Ilana, Duarte, Cristiane S., Yu, Qiongru, Green, Ann F., Martinho, Samuel, Moon, Troy D., Audet, Carolyn M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Alcohol; Alcoholism - epidemiology; Cross-Sectional Studies; Female; Food Supply; Hazardous drinking; Health Surveys; Humans; Middle Aged; Mothers; Mozambique; Mozambique - epidemiology; Poverty - statistics & numerical data; Pregnancy; Prevalence; Rural Population; Socioeconomic Factors; Young Adult; Zambézia
• ISSN: 0741-8329; 1873-6823
• DOI: 10.1016/j.alcohol.2018.03.011

Hazardous drinking places individuals at risk for adverse health events, resulting in a major public health burden globally. Patterns of alcohol consumption among women in Africa remain poorly understood. We aimed to describe alcohol consumption in a representative sample of female heads-of-household in Mozambique. A 2014 population-based cross-sectional study of 3892 heads-of-household was conducted in Zambézia Province. Data on alcohol use were collected using the Alcohol Use Disorders Identification Test (AUDIT). Sociodemographic characteristics were summarized by alcohol use. A multivariable proportional odds model adjusted for age, education, Portuguese fluency, marital status, income, social support, depression, food insecurity, currently pregnant, and child mortality was used for the ordinal AUDIT scale as outcomes with robust covariance to account for clustering of respondents. The overall prevalence of current alcohol consumption among female heads-of-household was 15%. The mean PHQ-8 score was 2.7 (SD 4.7). The prevalence of women considered “hazardous drinkers” (score >4) was 8%. In bivariate analyses, depression, marital status, currently being pregnant, food insecurity, and death of a child were associated with higher risk of hazardous drinking. After adjusting for multiple characteristics, depression (aOR: 2.20 [1.28, 3.76] p = 0.004), death of a child (aOR: 2.44 [1.46, 4.07] p = 0.001), and being currently pregnant (aOR: 1.83 [0.99, 3.39] p = 0.002) were associated with hazardous drinking behavior. Being single (aOR: 0.48 [0.29, 0.80], p = 0.017) and food insecure (aOR: 0.96 [0.92, 1.00], p = 0.050) showed a protective effect on hazardous drinking behavior. The percentage of female heads-of-household in north-central Mozambique that regularly drink alcohol was lower than expected. This may be due to the unique characteristics of female heads-of-household and the extreme poverty pervasive in Zambézia. •The hazardous drinking prevalence among female heads-of-household in Zambézia was 5.1%.•Among women who reported drinking any alcohol, 61% were considered hazardous drinkers.•Depression, death of child, and no formal education are associated with increased risk of being a hazardous drinker.