Exploring spatial variations and factors associated with skilled birth attendant delivery in Ethiopia: geographically weighted regression and multilevel analysis

Teshale, Achamyeleh Birhanu; Alem, Adugnaw Zeleke; Yeshaw, Yigizie; Kebede, Sewnet Adem; Liyew, Alemneh Mekuriaw; Tesema, Getayeneh Antehunegn; Agegnehu, Chilot Desta

doi:10.1186/s12889-020-09550-3

Cited by 26 publications

(31 citation statements)

References 42 publications

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“…Despite all efforts made in previous decades and reports of amplified educational status in the country(2), women's education remained lagging behind the expectations. The finding is consistent with the studies conducted in the country with 66.08% participants lacking formal education from EDHS 2016 and poor educational achievement identified in the whole sub-Saharan countries (21,22,23). It might mean that educational achievements cannot be effected in a short time.…”

Section: Descriptive Statisticssupporting

confidence: 91%

Prevalence and Associated Factors of Under-Five Mortality in Ethiopia: Further Analysis of Ethiopian Mini Demographic and Health Surveys 2019

Gilano¹,

Hailegeberael²

2021

Preprint

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Introduction: Over decades, much have been said and done regarding under-five mortality in Ethiopia. The country has been following the lead of sustainable development goals and UNICEF with its transformation plan targets. However, unless the efforts supported by status assessing studies, it might be difficult for the country to progress. Thus, the current study was directed to identify the prevalence and associated factors of under-five mortality in 2019. Methods: According to the study criteria, we extract and cleaned data in STATA v. 15.0. The data then weighted as per the sampling weight, primary sampling unit, and strata before analyzing in STATA 15.0. Data management consisted of descriptive (mean, standard deviation, and proportion or percent) and association statistics. We deliberated binary logistic regression for this analysis and we checked each variable at 0.25 p-values to include in the model. The final p-value to declare association was p <0.05 and AOR with 95% CI was also applied to describe the results. The data source was the Ethiopian Mini Demographic Health Survey (EMDHS) 2019. EMDHS collected the data from 8,885 in a face-to-face manner with a 99% response rate. Results: From 5,527 numbers of weighted women with under-five analysed in this study, the proportion of under-five mortality was 277.23(5.02%). Factors like 2nd birth order 0.52(0.35, 0.79), 3rd-4th 0.49(0.28, 0.84), 1-2 ANC visits 0.24(0.12, 0.49, ANC visit three’ 0.14(0.07, 0.28), ANC visit four and above 0.22(0.14, 0.36), in marriage mother 0.43(0.19, 0.96), ‘1-2 under-five children 0.02(0.011, 0.03), and greater than three under-five children 0.007(0.0007, 0.004) were all negatively associated with under-five mortality rate. Conclusion: To obtain the exalted outcome out of this study, the government might need to increase antenatal care, women education, institutional delivery, and the modern contraceptive methods use through enhanced community mobilization, health education using community health workers, increasing access to essential cares of mothers and children, and the policy commitment for the issues related to family size, birth order, and birth interval.

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Section: Descriptive Statisticssupporting

confidence: 91%

Prevalence and Associated Factors of Under-Five Mortality in Ethiopia: Further Analysis of Ethiopian Mini Demographic and Health Surveys 2019

Gilano¹,

Hailegeberael²

2021

Preprint

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“…This finding is agreed with a study done in Afghanistan [ 19 ]. This could be because mothers of big families are preoccupied with caring for their family and are unable to seek health care, including family planning [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with unmet need for family planning in sub-Saharan Africa: A multilevel multinomial logistic regression analysis

Teshale

2022

PLoS ONE

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Background More than one out of every ten married women in the world, and one out of every five women in Africa, have unmet family planning needs. Despite this, studies concerning sub-Saharan Africa as well as the community-level factors that may influence the unmet need for family planning are scarce. Objective To assess factors associated with unmet need for family planning in sub-Saharan Africa. Methods This study used the nineteen demographic and health surveys (DHS) conducted between 2015 and 2020 in sub-Saharan Africa. A total weighted sample of 175, 820 women of reproductive age who were married during the survey was used for this study. To assess the factors associated with unmet need for family planning, I have employed a multilevel multinomial logistic regression model. After selecting variables using the bivariable analysis, a multivariable model was fitted. Finally, an adjusted relative risk ratio with its 95% Confidence Interval was reported and variables with a p-value less than 0.05 were declared to be significant predictors of unmet need for family planning. Result The overall prevalence of unmet need for family planning in sub-Saharan Africa was 23.70%, of which unmet need for spacing and limiting was 15.81% and 7.90% respectively. In the multivariable multilevel multinomial model, women’s age, women’s education, age at cohabitation, heard about family planning through media, parity, number of under-five children, and knowledge about modern contraceptive methods were among the individual-level factors that were associated with both the unmet need for spacing and limiting. Place of residence, community level of women illiteracy, and region were among the community-level factors that were associated with both unmet needs for spacing and limiting. Household size and visiting the health facility in the last 12 months were associated with unmet need for spacing only and husband education was associated with unmet need for limiting only. Conclusion Unmet need for family planning in sub-Saharan Africa was high. Both individual and community level factors were associated with both unmet need for spacing and limiting. Therefore, it is better to consider interventions at both individual and community levels.

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“…In addition, a study conducted in Rwanda revealed that about 54% of pregnant women did not make the recommended four visits to ANC during pregnancy [ 50 ]. Similarly, different studies conducted in Ethiopia [ 51 – 54 ] and abroad [ 55 – 59 ] revealed that, majority of pregnant women were assisted by non-skilled birth attendant and deliver their baby at home. On the other hand, a study conducted in Western Ethiopia revealed that around 90% women could not utilized appropriate postnatal care according to WHO guidelines [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, poor wealth index, uneducated mothers, and mothers who declare distance as a big problem were factors significantly associated with zero utilization of maternal continuum of care. Different studies conducted in Ethiopia and abroad also revealed that, there is a considerable significant difference of predictors for a certain outcome variable across a geographical area [ 54 , 86 – 89 ].…”

Section: Discussionmentioning

confidence: 99%

Geographical variation and predictors of zero utilization for a standard maternal continuum of care among women in Ethiopia: a spatial and geographically weighted regression analysis

Melaku

Aemro

Aychiluhm

et al. 2022

BMC Pregnancy Childbirth

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Background Maintaining and effectively utilizing maternal continuum of care could save an estimated 860,000 additional mothers and newborn lives each year. In Ethiopia, the number of maternal and neonatal deaths occurred during pregnancy, childbirth, and the postpartum period was very high. It is indisputable that area-based heterogeneity of zero utilization for a standard maternal continuum of care is critical to improve maternal and child health interventions. However, none of the previous studies explored the spatial distribution of zero utilization for maternal continuum of care. Hence, this study was aimed to explore geographical variation and predictors of zero utilization for a standard maternal continuum of care among women in Ethiopia. Methods A total of 4178 women who gave birth five years preceding the 2016 Ethiopian demographic and health survey were included. ArcGIS version 10.7, SaT Scan version 9.6, and GWR version 4.0 Software was used to handle mapping, hotspot, ordinary least square, Bernoulli model analysis, and to model spatial relationships. Finally, a statistical decision was made at a p-value< 0.05 and at 95% confidence interval. Main findings The proportion of mothers who had zero utilization of a standard maternal continuum of care was 48.8% (95% CI: 47.3–50.4). Hot spot (high risk) regions for zero utilization of maternal continuum of care was detected in Afder, Warder, Korahe and Gode Zones of Somali region and West Arsi Zone of Oromia region. Respondents who had poor wealth index, uneducated mothers, and mothers who declared distance as a big problem could increase zero utilization of maternal continuum of care by 0.24, 0.27, and 0.1 times. Conclusion Five women out of ten could not utilize any components of a standard maternal continuum of care. Hot spot (high risk) areas was detected in Afder, Warder, Korahe and Gode Zones of Somali region and West Arsi Zone of Oromia region. Poor wealth index, uneducated mothers, and mothers who declare distance as a big problem were factors significantly associated with zero utilization of maternal continuum of care. Thus, geographical based intervention could be held to curve the high prevalence of zero utilization of maternal continuum of care.

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Exploring spatial variations and factors associated with skilled birth attendant delivery in Ethiopia: geographically weighted regression and multilevel analysis

Cited by 26 publications

References 42 publications

Prevalence and Associated Factors of Under-Five Mortality in Ethiopia: Further Analysis of Ethiopian Mini Demographic and Health Surveys 2019

Prevalence and Associated Factors of Under-Five Mortality in Ethiopia: Further Analysis of Ethiopian Mini Demographic and Health Surveys 2019

Factors associated with unmet need for family planning in sub-Saharan Africa: A multilevel multinomial logistic regression analysis

Geographical variation and predictors of zero utilization for a standard maternal continuum of care among women in Ethiopia: a spatial and geographically weighted regression analysis

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