Spatial Pattern and Associated Factors of ANC Visits in Ethiopia: Spatial and Multilevel Modeling of Ethiopian Demographic Health Survey Data

Tessema, Zemenu Tadesse; Akalu, Temesgen Yihunie

doi:10.1155/2020/4676591

Cited by 12 publications

(14 citation statements)

References 44 publications

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“…Finally, a weighted proportion of home delivery after ANC visit per cluster was used for spatial autocorrelation analysis and hotspot analysis. For spatial scan statistics number of women who had home delivery after ANC visit and the number of women who had institutional delivery were considered as cases and controls respectively to fit the Bernoulli model [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

Spatial variation and factors associated with home delivery after ANC visit in Ethiopia; spatial and multilevel analysis

Ayalew

Liyew²,

Tessema³

et al. 2022

PLoS ONE

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Introduction Institutional delivery is crucial to reduce maternal and neonatal mortality as well as serious morbidities. However, in Ethiopia, home delivery (attended by an unskilled birth attendant) after antenatal care (ANC) visit is highly in practice. Therefore, this study aimed to assess the spatial variation and determinants of home delivery after antenatal care visits in Ethiopia. Method A secondary data analysis was conducted using the 2019 mini Ethiopian demographic and health survey. A total of 2,923 women who had ANC visits were included. Spatial analysis was done by using GIS 10.7 and SaTscan 9.6. The risk areas for home delivery from GIS and spatial scan statistics results were reported. A multi-level logistic regression model was fitted using Stata14 to identify individual and community-level factors associated with home delivery after ANC visit. Finally, AOR with 95% CI and random effects were reported. Result Home delivery after ANC visit was spatially clustered in Ethiopia(Moran’s index = 0.52, p-value <0.01). The primary clusters were detected in Oromia and SNNP region (LLR = 37.48, p < 0.001 and RR = 2.30) and secondary clusters were located in Benishangul Gumuz, Amhara, Tigray and Afar (LLR = 29.45, p<0.001 and RR = 1.54). Being rural resident (AOR = 2.52; 95%CI 1.09–5.78), having no formal education (AOR = 3.19;95% CI 1.11–9.16), being in the poor (AOR = 2.20;95%CI 1.51–3.22) and middle wealth index (AOR = 2.07;95% CI 1.44–2.98), having one ANC visit (AOR = 2.64; 95% CI 1.41–4.94), and living in the agrarian region (AOR = 3.63; 95%CI 1.03–12.77) had increased the odds of home delivery after ANC visit. Conclusion and recommendation Home delivery after ANC visit was spatially clustered in Ethiopia. Factors like maternal education, wealth index, number of ANC visits, residency and region were significantly associated with home delivery after ANC visit. Therefore, it is better to increase the number of ANC contact by giving health education, especially for women with low levels of education and better to improve the wealth status of women. A special strategy is also vital to reduce home delivery after ANC visit in those high-risk regions.

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Section: Methodsmentioning

confidence: 99%

Spatial variation and factors associated with home delivery after ANC visit in Ethiopia; spatial and multilevel analysis

Ayalew

Liyew²,

Tessema³

et al. 2022

PLoS ONE

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“…Studies have demonstrated that sociodemographic factors such as age, wealth index, geographical location, educational status, husband occupation, marital status, and socioeconomic status are significantly associated with ANC utilization [2,4,5,[9][10][11][12]. For instance, a cross-sectional study conducted in Nigeria by Fagbamigbe and Idemudia [4] found a five-fold increase in ANC utilization among women in the wealthiest quintile.…”

Section: Introductionmentioning

confidence: 99%

Spatial Patterns and Multilevel Analysis of Factors Associated with Antenatal Care Visits in Nigeria: Insight from the 2018 Nigeria Demographic Health Survey

et al. 2021

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Despite global progress towards antenatal care (ANC) uptake, ANC utilization in a number of countries in sub-Saharan Africa, such as Nigeria, is low. Although several studies have identified the determinants and factors associated with ANC services utilization in Nigeria, there is a gap in knowledge about the spatial patterns in ANC use. Therefore, this study aims to map the spatial distribution and factors associated with ANC visits in Nigeria. A cross-sectional dataset was obtained from the 2018 Nigeria Demographic and Health Survey. A total of 20,003 women aged 15–49 were considered in this study. Both spatial and multilevel analyses were carried out. The results were presented in spatial maps and adjusted odds ratios (aOR) at a 95% confidence interval (CI). Hot spot areas (high proportion of an incomplete ANC visit) were located in Sokoto, Kebbi, Zamfara, Katsina, Kano, Jigawa, Bauchi, Niger, Borno, Gombe, and Bayelsa. Regional disparities in incomplete ANC visits were found in this study. Maternal age, maternal education, partner’s level of education, working status, ethnicity, parity, religion, exposure to media, place of residence, wealth index, region, and community literacy level were factors associated with incomplete ANC. There is a need to consider these factors in the design and strengthening of existing interventions (e.g., mini-clinics) aimed at increasing ANC visits to help attain maternal health-related Sustainable Development Goals by 2030. The regional disparities in incomplete ANC visits also need to be considered by encouraging pregnant women in hotspot areas to attend ANC visits.

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“…For instance, in Ethiopia, a relatively higher utilization was found in Addis Ababa [ 31 - 37 ], Dire Dawa [ 31 , 34 - 37 ], Tigray [ 31 , 33 - 39 ], and Harari [ 31 , 33 , 35 , 36 ]. A relatively low utilization was found in regions of Somali [ 31 , 33 , 34 , 36 , 37 , 39 ], Afar [ 31 , 33 - 35 , 37 ], Oromia [ 32 , 33 , 35 , 36 , 39 ], most of Amhara [ 33 - 35 , 37 , 40 ], Gambela [ 32 , 33 , 37 , 39 ], Benishangul Gumuz [ 34 , 35 ], and parts of Southern Nations Nationalities and Peoples Region [ 32 , 34 - 36 , 39 , 40 ]. Similarly, a significant north-south divide in the likelihood of maternal health care utilization was reported in Nigeria.…”

Section: Resultsmentioning

confidence: 99%

“…Inequality in maternal health care utilization was also identified at a national level. For instance, in Ethiopia, a relatively higher utilization was found in Addis Ababa [31][32][33][34][35][36][37], Dire Dawa [31,[34][35][36][37], Tigray [31,[33][34][35][36][37][38][39], and Harari [31,33,35,36]. A relatively low utilization was found in regions of Somali [31,33,34,36,37,39], Afar [31,[33][34][35]37], Oromia [32,33,35,36,39], most of Amhara [33][34][35]37,40], Gambela [32,33,37,39], Benishangul Gumuz…”

Section: Identifying Inequalities In Maternal Health Care Utilizationmentioning

confidence: 99%

How applicable is geospatial analysis in maternal and neonatal health in sub-Saharan Africa? A systematic review

et al. 2022

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Background Sub-Saharan Africa (SSA) has the world's highest maternal and neonatal morbidity and mortality and has shown the slowest progress in reducing them. In addition, there is substantial inequality in terms of maternal and neonatal morbidity and mortality in the region. Geospatial studies can help prioritize scarce resources by pinpointing priority areas for implementation. This systematic review was conducted to explore the application of geospatial analysis to maternal and neonatal morbidity and mortality in SSA. Methods A systematic search of PubMed, SCOPUS, EMBASE, and Web of Science databases was performed. All observational and qualitative studies that reported on maternal or neonatal health outcomes were included if they used a spatial analysis technique and were conducted in a SSA country. After removing duplicates, two reviewers independently reviewed each study's abstract and full text for inclusion. Furthermore, the quality of the studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. Finally, due to the heterogeneity of studies, narrative synthesis was used to summarize the main findings, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was strictly followed to report the review results. A total of 56 studies were included in the review. Results We found that geospatial analysis was used to identify inequalities in maternal and neonatal morbidity, mortality, and health care utilization and to identify gaps in the availability and geographic accessibility of maternal health facilities. In addition, we identified a few studies that used geospatial analysis for modelling intervention areas. We also detected challenges and shortcomings, such as unrealistic assumptions used by geospatial models and a shortage of reliable, up-to-date, small-scale georeferenced data. Conclusions The use of geospatial analysis for maternal and neonatal health in SSA is still limited, and more detailed spatial data are required to exploit the potential of geospatial technologies fully.

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Spatial Pattern and Associated Factors of ANC Visits in Ethiopia: Spatial and Multilevel Modeling of Ethiopian Demographic Health Survey Data

Cited by 12 publications

References 44 publications

Spatial variation and factors associated with home delivery after ANC visit in Ethiopia; spatial and multilevel analysis

Spatial variation and factors associated with home delivery after ANC visit in Ethiopia; spatial and multilevel analysis

Spatial Patterns and Multilevel Analysis of Factors Associated with Antenatal Care Visits in Nigeria: Insight from the 2018 Nigeria Demographic Health Survey

How applicable is geospatial analysis in maternal and neonatal health in sub-Saharan Africa? A systematic review

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