Spatial distribution and determinants of early postnatal discharge among vaginally delivered mothers in Ethiopia: spatial and multilevel analysis of Ethiopian demographic survey data

Abstract

BackgroundPostnatal hospital care is aimed to detect any complications for both mother and child. Postnatal care should start as early as possible, especially during the first 24 hours. No study assessed the hotspot areas of early postnatal discharge and its community and individual level determinants in Ethiopia. Therefore this study aimed to fill the mentioned gap.MethodsThis study used the Ethiopian demographic and health survey 2016. A total of 2443 delivered mothers were included in the analysis. The non-spatial analysis was conducted using Stata V.14. A mixed-effect multilevel logistic regression model was fitted. Model comparison was done using Akaike’s information criterion and log-likelihood ratio. Global Moran’s index, spatial autocorrelations and spatial scan statistics were conducted. Multicollinearity was checked. P values <0.25 and 0.05 were used as a cut-off point to declare statistical significance for the bivariable and multivariable regression models, respectively.ResultsThe early postnatal discharge was spatially clustered (Moran’s index=0.077, p<0.05). Hotspots of early postnatal discharge were detected in most parts of Benishangul Gumuz, central Amhara, north east Southern Nations, Nationalities, and Peoples' Region (SNNPR) and western Oromiya. Being literate, no media exposure, having three to four antenatal care visits, size of child and history of abortion were statistical significant determinants of early postnatal discharge.ConclusionsHotspot areas of early postnatal discharge were detected in parts of central Amhara region, Benishangul gumz, the northeastern parts of SNNPR and western Oromiya. Sociodemographic and reproductive related factors determine early postnatal discharge.