Dataset Information

Why Too Soon? Early Initiation of Sexual Intercourse Among Adolescent Females in Ethiopia: Evidence from 2016 Ethiopian Demographic and Health Survey.

ABSTRACT: Background:Early sexual initiation - sexual activity that begun earlier than 18 years of age - is among risky sexual behaviors which may be associated with increased risks of adverse outcomes such as sexually transmitted infections (STIs), unwanted pregnancy and unsafe abortions. However, there is no nationally representative evidence on early initiation of sexual intercourse and its determinant factors among adolescent females in Ethiopia. Methods:Data were extracted from the 2016 Ethiopian Demographic and Health Survey (EDHS) to assess early initiation of sexual intercourse and factors contributing to it in adolescent females. The analysis included a weighted sample of 3881 adolescent females aged 15-19 years. A multivariable logistic regression analysis was conducted and the results were presented as adjusted odds ratio (AOR) at 95% confidence interval (CI), declaring statistical significance at a p-value <0.05 in all analyses. Results:About 1 in 5 (21.9%, 95% CI: 20.5%, 23.33%) adolescent females experienced early sexual debut. Administrative regions (Amhara, AOR = 2.3, 95% CI: 1.30, 4.09 and Gambella, AOR = 4.89, CI 95%: 1.08, 22.07), religion (Muslim, AOR = 1.76, 95% CI: 1.24, 2.49), substance use (e.g., ever chewed khat, AOR = 2.02, 95% CI: 1.47, 2.77, ever drunk alcohol, AOR = 1.83, 95% CI: 1.35, 2.48) and having no knowledge on family planning (AOR = 4.47, 95% CI: 2.22, 8.99) were found to have statistically significant association with early sexual debut in adolescent females. Whereas any levels of formal education decreased the odds of early sexual debut (primary, AOR = 0.44, 95% CI: 0.35, 0.56; secondary, AOR = 0.19, 95% CI: 0.13, 0.28, and higher, AOR= 0.31, 95% CI: 0.15, 0.63). Similarly, all categories of wealth indices as compared to the poorest were protective of early sexual initiation in adolescent females (AOR = 0.40-0.57) as was for education as compared to no education (AOR = 0.19-0.44). Conclusion:A significant proportion of adolescent females initiate early sexual intercourse in Ethiopia and multifaceted factors appear to determine their early sexual experiences. Contextualized interventions including strengthening information, education and communication on adverse consequences of early sexual initiation in regions and improving contraceptive knowledge of teenagers will play a paramount role.

SUBMITTER: Turi E

PROVIDER: S-EPMC7152534 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Why Too Soon? Early Initiation of Sexual Intercourse Among Adolescent Females in Ethiopia: Evidence from 2016 Ethiopian Demographic and Health Survey.

Turi Ebisa E Merga Bedasa Taye BT Fekadu Ginenus G Abajobir Amanuel Alemu AA

International journal of women's health 20200408

<h4>Background</h4>Early sexual initiation - sexual activity that begun earlier than 18 years of age - is among risky sexual behaviors which may be associated with increased risks of adverse outcomes such as sexually transmitted infections (STIs), unwanted pregnancy and unsafe abortions. However, there is no nationally representative evidence on early initiation of sexual intercourse and its determinant factors among adolescent females in Ethiopia.<h4>Methods</h4>Data were extracted from the 201 ...[more]

PMID: 32308501

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Project description:BackgroundThough the consequences of teenage pregnancy and early motherhood has been studied very well, little is known about the magnitude as well as the determinants of adolescent fatherhood. Unlike adolescent motherhood, limited public health programs are working on adolescent fatherhood. Currently, in developed countries, there is an increased work to acknowledge teen fathers in clinical practice and in the research forum, but still, there are more issues that need to be addressed in developing countries including Ethiopia. Therefore, this study aimed to investigate the prevalence and associated factors of adolescent fatherhood in Ethiopia based on the nationally representative survey.MethodsThis study used the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total weighted sample of 4455 adolescent men was included for the final analysis. For the associated factors, multilevel logistic regression analysis was conducted to consider the hierarchical nature of the EDHS data. Intra-class Correlation Coefficient (ICC), and deviance (-2LLR) were used for model comparison and for assessing model fitness. The model with the largest adjusted R2, lowest Bayesian Information Criteria (BIC) and the smallest cross-validation prediction error were considered as the best-fitted model. In the multivariable analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the presence of statistically significant factors associated with adolescent fatherhood, and variables with p-value <0.05 were considered as a significant variable.ResultsThe prevalence of adolescent fatherhood in Ethiopia was 6.79% [95%CI; 6.08%, 7.56%]. Adolescent men with contraceptive knowledge [AOR = 4.25; 95%CI = 1.23, 14.69], age in 20 to 24 years [AOR = 7.93; 95%CI = 3.66, 17.27] and being Muslim [AOR = 1.84; 95%CI = 1.02, 3.39] were significantly associated with Higher odds of adolescent fatherhood. Individuals who initiate sex lately [AOR = 0.35; 95%CI = 0.22, 0.54], being in female-headed family [AOR = 0.46; 95%CI; 0.26, 0.82] and being from Amhara region [AOR = 0.35; 95%CI = 0.14, 0.84] were significantly associated with lower odds of adolescent fatherhood.ConclusionIn this study, adolescent fatherhood was a common public health problem in Ethiopia as it is closely linked with poor quality of life and premature death (year of potential life lost). Age of respondent, knowledge of respondent about contraceptive methods, early initiation of sex, religion, sex of household head, and region were significantly associated with adolescent fatherhood. Therefore, program planners and decision-makers should give special attention to adolescent men through enhancing reproductive health services utilization and their knowledge towards it to decrease the incidence of adolescent fatherhood.

Project description:BackgroundDespite continued efforts to address malnutrition, there is minimal reduction in the prevalence rates of stunting in developing countries, including Ethiopia. The association between nutritional and socioeconomic factors collected from a national survey in Ethiopia and stunting have not been rigorously analyzed. Therefore, this study aims to model the effect of nutritional and socioeconomic predictors using 2016 Ethiopian Demographic Health Survey (EDHS) data.MethodsThis study is a secondary data analysis of the 2016 EDHS survey, which included 7909 children aged 6 to59 months. Descriptive statistics using frequency and percentage for categorical data and mean and standard deviation for metric data were conducted. Linearity, confounding, and multicollinearity were checked. Bivariable and multivariable logistic regression were carried out. The adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated. A receiver operative curve was built to estimate the sensitivity and specificity of the model.ResultsThe study identified that 39.2% of children included in this analysis were stunted. Furthermore, 76.47, 84.27, and 92.62% of the children did not consume fruits and vegetables, legumes and lentils, or meat and its products, respectively. Children aged 24 months to 59 months were found to be at 9.71 times higher risk of being stunted compared to their younger counterparts aged 6-24 months (AOR: 9.71; CI: 8.07, 11.6 children). Those children weighing below 9.1 kg were at 27.86 odds of being stunted compared to those weighing 23.3 kg and above. Moreover, mothers with a height below 150 cm (AOR: 2.01; CI: 1.76, 2.5), living in a rural area (AOR: 1.3, CI: 1.09, 1.54), and being male (AOR: 1.4; CI: 1.26, 1.56) were factors associated with stunting. The predictive ability of the model was 77%: if a pair of observations with stunted and non-stunted children were taken, the model correctly ranks 77% of such pair of observations.ConclusionThe model indicates that being born male, being from a mother of short stature, living in rural areas, small child size, mother with mild anemia, father having no formal education or primary education only, having low child weight, and being 24-59 months of age increases the likelihood of stunting. On the other hand, being born of an overweight or obese mother decreases the likelihood of stunting.

Project description:BackgroundEarly initiation of breast feeding has great importance for both mothers and newborns. Despite, recommendations for exclusive and early initiation of breast feeding within one hour of birth, Ethiopia reports that 58% of infants under six months of age are exclusively breastfed. Cesarean deliveries may affect timing of breastfeeding initiation, establishment of milk supply and infant breastfeeding interest compared to vaginal deliveries. The aim of this study was to assess the impact of cesarean delivery on breastfeeding initiation.MethodsA cross-sectional study was conducted with a total of 7115 study participants from the 2016 Ethiopian Demographic Health Survey (EDHS). Both descriptive and analytical statistical analysis was employed. Univariable and multivariable logistic regression analyses were used to identify anyassociations between variables. Odds ratios with its corresponding 95% confidence intervals (CI) were reported. During multivariable analysis, variables with p-value <?0.05 were considered as statistically significant.ResultsThe prevalence of late initiation of breast feeding among women with their last live birth was 25.03% (95%CI; 20.5-32.2). Significant factors associated with late initiation of breastfeeding were cesarean delivery [AOR = 4.06 (95%CI, 2.66-6.2)], primipara mother [AOR = 1.45(95%CI, 1.13-1.7)], and having an unplanned pregnancy [AOR = 1.35(95%CI, 1.1-1.65)]. Positively associated with early initiation of breastfeeding was the mother's age, for women between 20-34 years-old. This association, reported as a negative association of late initiation of breast feeding was [AOR = 0.77(95%CI, 0.61-0.98)].ConclusionCesarean delivery adversely affects the initiation of breast feeding. Cesarean delivery, unplanned pregnancy, and being primiparous, were associated with late initiation of breastfeeding. Women between the ages of 20-34 years of age had a reduced chance of late initiation of breastfeeding. Providing counseling regarding the strategy and importance of early initiation of breast feeding, could have crucial importance for the mother and her newborn.

Project description:BACKGROUND:HIV counseling and testing are key to control and prevent the spread of the virus and improve the lives of people living with HIV. Although the risk of acquiring the virus is high, only 27% of young Ethiopian women age 15 to 24 years old were tested and counseled for HIV. This coverage is low to achieve the 90-90-90 goal. Identifying factors associated with low utilization of HIV testing and counseling services among young females (aged 15 to 24 years) is important to identify the barriers and improve uptake. Therefore, this analysis was done to identify factors associated with low utilization of HIV counseling and testing services among young Ethiopian women. METHODS:The study used the 2016 Ethiopian demographic and health survey data. The data was downloaded from The DHS program with permission. A total of 2661 young women (aged 15 to 24 years) were included in the final model. Data was weighted to consider disproportionate sampling and non-response. A Complex data management technique was applied to consider the complex sampling technique used in the DHS. Multivariable logistic regression was used to identify factors associated with HIV testing among young women. RESULT:Among sexually active young women, 33.5% (95%CI; 30.1, 37.1) were tested for HIV. Young women who attended primary ((AOR 2.8; (95% CI; 2.0, 3.9)), secondary (AOR 4.7; (95% CI; 3.1, 7.3)) or higher education (AOR; 5.6; 95% CI; 2.6, 12.0), those who had multiple sexual partners (AOR 5.5; 95% (CI; 1.3, 23.3)), young women who ever used alcohol (AOR 1.46; 95% (CI; 1.1, 2.0)) and young women who visited health care facilities (AOR 1.8; (95% CI; 1.4, 2.3)) had higher odds of being tested for HIV. On the other hand, young women from the rural areas had lower odds (AOR 0.5; (95% CI; 0.3, 0.7)) of being tested for HIV. CONCLUSION:HIV testing among sexually active young women in Ethiopia was low. Educational status, place of residence, alcohol intake, number of sexual partners and visiting health facility 12 months before the survey were found significant predictors of HIV testing. Therefore, the Ethiopian government should encourage girls to complete secondary education to improve HIV testing and counseling. Young women should be encouraged to visit health facilities to improve HIV testing service uptake.

Project description:BackgroundThe perinatal mortality rate in Ethiopia is among the highest in Sub Saharan Africa. The aim of this study was to identify the spatial patterns and determinants of perinatal mortality in the country using a national representative 2016 Ethiopia Demographic and Health Survey (EDHS) data.MethodsThe analysis was completed utilizing data from 2016 Ethiopian Demographic and Health Survey. This data captured the information of 5 years preceding the survey period. A total of 7230 women who at delivered at seven or more months gestational age nested within 622 enumeration areas (EAs) were used. Statistical analysis was performed by using STATA version 14.1, by considering the hierarchical nature of the data. Multilevel logistic regression models were fitted to identify community and individual-level factors associated with perinatal mortality. ArcGIS version 10.1 was used for spatial analysis. Moran's, I statistics fitted to identify global autocorrelation and local autocorrelation was identified using SatSCan version 9.6.ResultsThe spatial distribution of perinatal mortality in Ethiopia revealed a clustering pattern. The global Moran's I value was 0.047 with p-value <0.001. Perinatal mortality was positively associated with the maternal age, being from rural residence, history of terminating a pregnancy, and place of delivery, while negatively associated with partners' educational level, higher wealth index, longer birth interval, female being head of household and the number of antenatal care (ANC) follow up.ConclusionsIn Ethiopia, the perinatal mortality is high and had spatial variations across the country. Strengthening partner's education, family planning for longer birth interval, ANC, and delivery services are essential to reduce perinatal mortality and achieve sustainable development goals in Ethiopia. Disparities in perinatal mortality rates should be addressed alongside efforts to address inequities in maternal and neonatal healthcare services all over the country.

Project description:BackgroundUnderweight is one form of indicators of under-nutrition, which results from the poor nutrient intake and underlying health problems. Its impact is beyond an individual and extends to a country level. It has been known from the literature that underweight has a negative effect on income and development of a country. In the context of Ethiopia, factors predicting underweight remain unknown and there is a paucity of evidence on geographical distribution of underweight among individuals aged 15-49 years. Therefore, the aim of this study was to examine the geographic distribution of underweight and its associated factors among individuals aged 15-49 years in Ethiopia.MethodsSecondary data analysis was done on a data set consisting of 28,450 individuals and obtained from the Ethiopian Demography and Health Survey (EDHS) 2016. The spatial distribution of underweight across the country was identified by ArcGIS software. Hotspots analysis was done using Getis-Ord Gi* statistic within ArcGIS. In SaTScan software, the Bernoulli model was fitted by Kulldorff's methods to identify the purely spatial clusters of underweight. A binary logistic regression was applied to determine factors associated with being underweight.ResultIn Ethiopia, the spatial distribution of underweight was clustered with Global Moran's I = 0.79 at p-value < 0.0001. The highest underweight clusters were observed in Tigray, Gambella, eastern part of Amhara, and western and central part of Afar regions. Male individuals [AOR = 1.21; 95% CI: (1.15 1.28)], never married [AOR = 1.14; 95% CI: (1.05, 1.24)], rural residents [AOR = 1.32; 95% CI: (1.18, 1.47)], rich [AOR = 0.85; 95% CI: (0.76, 0.94)], cigarette smoking [AOR = 1.25; 95% CI: (1.07, 1.46)], drinking treated water [AOR = 0.91; 95% CI: (0.83, 0.99)] and open filed defecation [AOR = 1.17; 95% CI: (1.08, 1.26)] were found to have a significant association with being underweight.ConclusionsThere was a significant clustering of underweight among individuals aged 15-49 years. Gender, age, marital status, place of residence, wealth index, cigarette smoking, using untreated water and types of toilet were the significant factors of being underweight. Therefore, effective public health interventions like building safe and supportive environments for nutrition, providing socio-economic protection and nutrition-related education for poor and rural resident would be better to mitigate these situations and associated risk factors in hot spot areas. In addition, policymakers should strengthen and promote nutrition sensitive policies and activities in order to alleviate the underlying and basic causes of underweight.

Project description:ObjectiveThis study aimed to assess the trends and factors that had contributed to the change in home delivery in Ethiopia over the last decade.Design, setting and analysisA nationally representative repeated cross-sectional survey was conducted using 2005, 2011 and 2016 Ethiopian Demographic and Health Surveys. Multivariate decomposition logistic regression analysis was employed to identify significant factors that have been contributed to the change in home delivery. Level of statistical significance was declared at a two-sided p value <0.05.Outcome measureTrends of home delivery.ParticipantsA total of 33 482 women were included.ResultsHome delivery has been decreased by 21% over the last decade in Ethiopia. In the last decade, 39% of the decrements in home delivery attributed to change in women's compositional characteristics. Antenatal care visits, educational status of the women and husband, birth order, religion, wealth index and distance from a health facility were the main sources of compositional change factors for the change of home delivery. Behavioural changes towards health facility delivery contributed approximately two-thirds of the decline of home delivery in Ethiopia. Antenatal care visits, birth order and religion have significantly contributed to the change of home delivery resulted from behavioural changes towards healthcare facility utilisation over the last decade.ConclusionDespite the importance of health facility delivery, a significant number of women still deliver at home in Ethiopia. Women's compositional characteristics and behaviour changes were significantly associated with the change in home delivery. Multisectoral educational intervention is needed to change women's attitudes towards home delivery. Antenatal care coverage and healthcare facility coverage should increase thereby to improve healthcare facility based-delivery practice. Further research needs to be done to explore the potential barriers of health facility delivery from a religious perspective.

Project description:BACKGROUND:Contraceptive discontinuations for reasons other than the desire for pregnancy are a public health concern because of their negative effect on reproductive health outcomes. In Ethiopia, the contraceptive discontinuation rate is increasing; however the factors associated are poorly understood. So this study was aimed at assessing reasons and multilevel factors for unscheduled contraceptive use discontinuation. METHODS:This is a cross-sectional study of Ethiopian women who participated in the Ethiopian demographic health survey from January 18, 2016, to June 27, 2016. Ever using any contraceptive with in the calendar of the survey were an inclusion criteria for which 3835 women were found eligible. The data were analyzed using multilevel binary logistic regression in STATA version 14. Variables with p-value less than 0.05 were considered as statistically significant, and reported using adjusted odds ratio and 95% confidence interval. Median odds ratio and interval odds ratio, to quantify the magnitude of the general and specific contextual effect respectively, were used. Receiver operating characteristics curve and akaike's information criterion were used for model comparison. RESULT:The prevalence of unscheduled contraceptive use discontinuation was 46.18% for the principal reason of method related problems (Side effects-45.3%, needing better method-33.6%, and inconvenience-21.1%,). Women heading a household (AOR?=?1.281, 95%CI 1.079-1.520), women who had no work (AOR?=?0.812, 95%CI 0.673, 0.979) compared to professionals, living in poorest house hold income (AOR?=?0.753, 95%CI 0.567, 0.997) compared to middle, residing in community with low contraceptive utilization rate (AOR?=?1.945, 95%CI 1.618, 2.339), residing in poor community (AOR?=?0.763, 95%CI 0.596-0.997), and having more children, and region were found to be significant predictors of unscheduled contraceptive use discontinuation. CONCLUSION:Method related problems were found to contribute for more than half of the contraceptive use discontinuation. Both individual and community level factors were found to significantly influence the Unscheduled contraceptive use discontinuation. The outcome was common in groups who could have more social interactions and knowledge on which myths and rumors are common. So strengthening the efforts to reduce contraceptive use discontinuation and quality of contraceptive service provision could be important.

Dataset Information

Why Too Soon? Early Initiation of Sexual Intercourse Among Adolescent Females in Ethiopia: Evidence from 2016 Ethiopian Demographic and Health Survey.

Publications

Why Too Soon? Early Initiation of Sexual Intercourse Among Adolescent Females in Ethiopia: Evidence from 2016 Ethiopian Demographic and Health Survey.

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