Inequalities and trends in Neonatal Mortality Rate (NMR) in Ethiopia: Evidence from the Ethiopia Demographic and Health Surveys, 2000–2016

Dellie

BioMed Research International

2022

Background. Early initiation of breastfeeding (EIBF) is a costless practice with numerous neonates’ survival benefits. Thus, any disparity results in an unacceptably high neonatal death rate but socioeconomic disparities on EIBF have not been well explored in Ethiopia. Therefore, this study is aimed at assessing the socioeconomic inequalities of EIBF in Ethiopia from 2000 to 2016. Methods. The Ethiopian demographic and health survey data and the World Health Organization’s Health Equity Assessment Toolkit were used to investigate the inequalities in EIBF across the wealth quintile, education, residence, and subnational region. Difference, ratio, slope index inequality (SII), relative index inequality (RII), and population attributable risk (PAR) were used as equity summary measures. Results. In Ethiopia, EIBF practice was 47.4% in 2000, 66.2% in 2005, 51.5% in 2011, and 73.3% in 2016. Wealth-related inequality was observed in the 2000, 2005, and 2011 survey years with SII of -7.1%, -8.8%, and 8.7%, respectively, whereas educational-related inequality was observed in 2005 and 2011 with SII of -11.7% and 6.5%, respectively. However, significant change in wealth-, education-, and residence-related inequalities was detected in 2011. Regional inequality on EIBF was observed in all survey years with a difference of 35.7%, 38.0%, 29.1%, and 48.5% in the 2000, 2005, 2011, and 2016 survey years, respectively. But a significant change in regional inequality was noted in 2016 with a PAR of 17.2%. Conclusions. In Ethiopia, the wealth-, residence-, and educational-related inequalities of EIBF increased significantly between the years 2000 and 2011. However, regional inequality persistently increased from 2000 to 2016. Overall, one-sixth of the national level EIBF was decreased due to regional disparity in 2016. The northern regions of Ethiopia (Tigray, Afar, and Amhara) poorly performed compared to the peer regions. Therefore, interventions targeting them would significantly improve the national level of EIBF.

Section: Discussionmentioning

confidence: 99%

Trends of Inequalities in Early Initiation of Breastfeeding in Ethiopia: Evidence from Ethiopian Demographic and Health Surveys, 2000-2016

Dellie

BioMed Research International

2022

Front. Glob. Womens Health

“…Around 48% of the pregnant women had institutional delivery ( 11 ). Ongoing rates of dropout from their ANC follow-up have a negative impact on the pregnant women's health status and take the lion's share of high morbidity and mortality ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

More Than One-Third of Pregnant Women in Ethiopia Had Dropped Out From Their ANC Follow-Up: Evidence From the 2019 Ethiopia Mini Demographic and Health Survey

Tariku

Tusa²,

Weldesenbet³

et al. 2022

BackgroundIn Ethiopia, the magnitude of antenatal care (ANC) practice and institutional delivery is low as compared with developed countries. The majority of the pregnant women have not completed their ANC follow-up and only 43% of women have reached the four and above ANC. This study was conducted to determine the magnitude of ANC dropout and associated factors among pregnant women in Ethiopia.MethodsSecondary data analysis was conducted using the 2019 Ethiopia Mini Demographic and Health Survey 2019 (2019 EMDHS). The sample was selected using a stratified, two-stage cluster sampling design and the data were analyzed using the binary logistic regression model to identify factors associated with ANC dropout. Adjusted odds ratio (AOR) with 95% CI was reported to declare significance and strength of association. A total weighted sample of 2,143 women who had antenatal care follow-up during pregnancy was included. In the multivariate logistic regression analysis, variables having a p-value < 0.05 were considered to have a significant association with ANC dropout.ResultThe magnitude of ANC dropout was 39.12% (95% CI: 37.07 and 41.20%) among women who had ANC follow-up in Ethiopia. Aged 30–49 years [AOR = 0.71; 95% CI: (0.54, 0.94)], attended primary [AOR = 0.79; 95% CI: (0.62, 0.99)], secondary [AOR = 0.63; 95% CI: (0.44, 0.87)], and higher education [AOR = 0.39; 95% CI: (0.25, 0.62)], were in first trimesters [AOR = 0.49; 95% CI: (0.40, 0.60)] at the time of first ANC visit, and had access to laboratory service [AOR = 0.25; 95% CI: (0.13, 0.51)] were found to be a negative significant associated factors of ANC dropouts, whereas being rural resident [AOR = 1.53; 95% CI: (1.11, 2.10)] has a positive significant association with ANC dropouts.ConclusionMore than one-third of the pregnant women in Ethiopia had dropped out from their ANC follow-up in the study period. Being old-aged, educated, urban resident, having a first ANC visit in the first trimester, and having access to laboratory service were negatively associated with ANC dropouts. Therefore, we recommended encouraging women to have ANC visit at an early stage of pregnancy and conducting basic laboratory investigations during their visit. When undertaking that, due attention should be given to young, uneducated, and rural dweller women.

“…• A baixa escolaridade materna está associada a maior taxa de mortalidade infantil (2)(3)(4)(5)(6)(7)(8)11,(21)(22)(23)(25)(26)(27)32,33,35,(41)(42)(43)(44)(45)49,52,54,(58)(59)(60)(62)(63)(64)(65) , a alta taxa de mortalidade infantil (3,19,36,49,(55)(56)(57) , a mortalidade evitável no primeiro dia (30) e a mortalidade infantil prematura em unidade terapia intensiva neonatal (16) .…”

Section: Aspectos Relacionados àS Características Maternasunclassified

Mortalidade infantil associada às iniquidades sociais: revisão de escopo

Corrêa

Costa²,

Pantoja³

et al. 2022

Rev. Eletr. Enferm.

Objetivo: Mapear e caracterizar pesquisas sobre mortalidade infantil associada às iniquidades sociais em menores de um ano. Método: Revisão de escopo realizada segundo recomendações do Joanna Briggs Institute e o Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR), no período de março a abril/2021, nas bases MEDLINE, LILACS e CINAHL. Foram incluídos estudos primários, revisões sistemáticas, metanálises, guidelines, diretrizes e relatórios descritivos, nos idiomas português, inglês e espanhol, publicados entre 2015 e 2021. Resultados: Das 7.016 publicações, 61 foram selecionadas, e agrupadas segundo o perfil socioeconômico da mãe e a oferta em saúde, evidenciando-se as iniquidades sociais como: baixa escolaridade; baixa renda; domicílio em zona rural e, dificuldade de acesso a assistência de qualidade como determinantes para a mortalidade infantil. Conclusões: Observou-se a ampla produção de estudos acerca da mortalidade infantil associada as vulnerabilidades sociais em um panorama geral.