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Prevalence and associated factors of delayed first antenatal care booking among reproductive age women in Ethiopia; a multilevel analysis of EDHS 2016 data.

ABSTRACT: BACKGROUND:Early or timely initiation of antenatal care and regular visits based on the schedule have a tremendous effect on both maternal and fetal health. Despite the paramount benefits of early initiation of ANC within the first 12?weeks of pregnancy, women still do not have adequate and equal access to high-quality early antenatal care. OBJECTIVE:To determine the prevalence and factors associated with delayed first ANC booking in Ethiopia. METHOD:A secondary data analysis was conducted using the 2016 Ethiopian demographic and health survey data. All reproductive age women who gave birth in the five years preceding the survey and who had ANC visit for their last child were included in this study. The total weighted sample size analyzed was 4,741. Due to the hierarchical nature of the EDHS data, Multi-level logistic regression model was used to identify the individual and community level factors associated with delayed first ANC booking. RESULT:In this study, the prevalence of delayed first ANC booking was 67.31% [95% CI: 65.96% to 68.63%]. Women with secondary and higher education [Adjusted Odd Ratio (AOR)? = ?0.78; 95%CI: 0.61, 0.99] and [AOR? = ?0.61; 95%CI: 0.44, 0.83] respectively had lower odds of delayed first ANC booking. But woman who were multiparous and grand multiparous [AOR? = ?1.21; 95%CI: 1.01, 1.45] and [AOR? = ?1.50; 95%CI: 1.16, 1.93] respectively, women with the last pregnancy wanted no more [AOR? = ?1.52; 95%CI: 1.10, 2.09], a woman who was living in the rural area [AOR? = ?1.66; 95%CI: 1.25, 2.21], and a woman who was living in large central regions and small peripheral regions [AOR? = ?2.76; 95%CI: 2.20, 3.47] and [AOR? = ?2.70; 95%CI: 2.12, 3.45] respectively had higher odds of delayed first ANC booking. CONCLUSION:Despite the documented benefits of early antenatal care initiation, late ANC booking is still predominant in Ethiopia as highlighted by this study. Maternal education, parity, wanted the last child, residence and region were significantly associated with delayed first ANC booking. Therefore, taking special attention for these high-risk groups could decrease delayed first ANC booking and this intern decreases maternal and fetal health problems by identifying and intervene early.

SUBMITTER: Teshale AB

PROVIDER: S-EPMC7337309 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Prevalence and associated factors of delayed first antenatal care booking among reproductive age women in Ethiopia; a multilevel analysis of EDHS 2016 data.

Teshale Achamyeleh Birhanu AB Tesema Getayeneh Antehunegn GA

PloS one 20200706 7

<h4>Background</h4>Early or timely initiation of antenatal care and regular visits based on the schedule have a tremendous effect on both maternal and fetal health. Despite the paramount benefits of early initiation of ANC within the first 12 weeks of pregnancy, women still do not have adequate and equal access to high-quality early antenatal care.<h4>Objective</h4>To determine the prevalence and factors associated with delayed first ANC booking in Ethiopia.<h4>Method</h4>A secondary data analys ...[more]

PMID: 32628700

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Project description:BackgroundEven though there is low coverage of maternal health services such as antenatal care and skilled birth attendant delivery as well as poor sanitary practice during delivery in Ethiopia, the proportion of births protected by the tetanus vaccine is low. Thus, this study aimed to investigate the determinants of births protected against neonatal tetanus in Ethiopia.ObjectiveTo assess the determinants of births protected against neonatal tetanus in Ethiopia.MethodThe study was based on secondary data analysis of the Ethiopian Demographic and Health Survey 2016 data. A weighted sample of 7590 women who gave birth within five years preceding the survey was used for analysis. We conducted a multilevel analysis, due to the hierarchical nature of the data. Variables with p-value <0.05 in the multivariable analysis were declared to be significantly associated with having births protected against neonatal tetanus.ResultIn this study, mothers with primary education [adjusted odds ratio (AOR) = 1.23; 95%CI: 1.04, 1.44] and secondary and above education [AOR = 1.36; 95%CI: 1.06, 1.73], media exposure [AOR = 1.35; 95%CI: 1.15, 1.58], not perceiving distance from the health facility as a big problem [AOR = 1.24; 95%CI: 1.08,1.42], one antenatal care (ANC) visit [AOR = 1.56; 95%CI: 2.71, 4.68], two to three ANC visit [AOR = 11.82; 95%CI: 9.94,14.06], and four and more ANC visit [AOR = 15.25; 95%CI: 12.74, 18.26], being in Amhara [AOR = 0.59; 95%CI: 0.38,0.92], Afar [AO = 0.41; 95%CI: 0.25,0.66], and Harari [AOR = 1.88; 95%CI: 1.15,3.07] regions, being in communities with higher level of women education [AOR = 1.25; 95%CI: 1.03,1.52], and higher level of media exposure [AOR = 1.22; 95%CI: 1.01,1.48] were significant predictors of having a protected birth against neonatal tetanus.ConclusionIn this study, both individual level and community level factors were associated with having protected birth against neonatal tetanus. Therefore, strengthening maternal health services such as ANC visits and interventions related to increasing media campaigns regarding tetanus could increase the immunization against tetanus among reproductive-age women. In addition, it is also better to give attention to those reproductive age group women from remote areas and also better to distribute maternal services fairly and equally between regions.

Project description:BackgroundMaternal continuums of care were vital to reducing maternal and neonatal mortalities. While the dropout rate remains high and limited studies were found on risk factors associated with a high dropout rate of the maternal continuum of care.ObjectiveThis study aimed to assess the magnitude of dropout rate and its associated factors of maternity continuum of care in Ethiopia, 2016.MethodsAn in-depth secondary data analysis was conducted from the Ethiopian Demographic and Health Survey 2016 data. A total of 4,693 women who were booked for antenatal care visit were included to the final analysis. A community-based cross-sectional study design and a pre-tested and standardized questionnaire were used to collect the survey data. Data were weighted using women data weighting variables. Chi-square and multicollinearity assumptions were checked for independent variables. Bi-variable and multivariable logistics regression used to identify associated factors with a cut of the p-value of 0.2 and 0.05 respectively. Adjusted Odds Ratio (AOR) with 95%CI was reported for the final model.ResultsOf the total 4,693 women who were booked for antenatal care visits, 2,092(44.58%), 2,183 (46.52%), and 4,086(87.07%) dropped from a recommended number of ANC, Institutional delivery and postnatal care visit respectively. Only 308 (6.56%, 95%CI: 5.89, 7.31) women used all the complete continuum of care. Not married, and poorest wealth index were significantly associated with dropout from ANC visit. Being a protestant religious follower was significantly associated with dropout from PNC after antenatal care booking. While not exposed to media, distance from health facility as a big problem, protestant affiliation, parity of 2 to 4 and above4, Wealth index of the poorest, poorer, middle, and richer significantly associated with dropout from institutional delivery. Not being informed about pregnancy complications during their ANC visit was significantly associated with dropout from ANC, PNC, and institutional delivery.ConclusionsDropout of women from the maternity continuum of care after antenatal care booking was a public health problem in Ethiopia. Socio-demographic, pregnancy, and health service-related factors were significant determinants of dropout from the maternity continuum of care. Improving the family wealth index, increasing access to health facilities, media exposure, and giving more information during the antenatal care visit is important to reduce the dropout rate from the maternity continuum of care.

Project description:BackgroundAcute respiratory infection is an infectious illness caused by acute viral or bacterial infection. According to a 2018 WHO report, exposures to indoor and ambient air environmental pollution were contributing factors to a higher risk of respiratory problems following 7 million deaths of children under five globally. Housing conditions such as wall material, roof type, kitchen location, sanitation condition, and cooking fuel type are household-level predictors of acute respiratory disease among children under five years of age.MethodThis research used EDHS-2016 secondary data, which are nationally representative. The data collection period was from January 18, 2016, to June 27, 2016. Among the 16,650 total surveys, 10,006 households that had children below 5 years of age. The outcome variable for this study was acute respiratory infection symptoms. Analyses were performed using STATA Version 17.1. The data were weighted before performing analysis to reinstate the representativeness of the sample. In the bivariable analysis, a p value <0.2 was used to screen for multivariable. Multicollinearity was checked using the variance inflation factor. Then, a multilevel multivariable regression model was used in this study for the analysis of acute respiratory infection symptoms and possible predictor variables. Variables with a p value <0.05 in multivariable regression analysis were considered statistically significant predictors.ResultsMost (95.00%) households commonly used solid fuel for cooking, and household main construction materials: 81.44 and 91.03% of floors and walls of households were constructed with unprocessed natural materials, respectively. The prevalence of acute respiratory infection symptoms among children under five years of age was 7.955% (7.397, 8.551%). The findings indicated that acute respiratory infection symptoms among children under five years of age were significantly linked with the age of the children, diarrhea status, residence, region, fuel type, stool disposal, wall material, and floor material.ConclusionInterventions should target modifiable factors such as proper stool disposal of the youngest child, informing the health effects of poor housing conditions such as improving wall and floor construction material to reduce acute respiratory infection symptoms among children under five years of age.

Project description:Background:The sharp fertility drop-off in the Amhara region between 2000 and 2011 was due to an increase in modern contraceptive utilization of rural women. However, long-acting contraceptive method utilization was higher among urban than rural women. Therefore, this study aimed to assess rural-urban differentials of long-acting contraceptive method utilization and the contributing factors among reproductive-age women in the Amhara region: analysis of the 2016 EDHS. Methods:The 2016 EDHS data were used. A weighted sample of 2188 (1675 rural and 513 urban) fecund reproductive-age women was used, and a mixed-effects logistic regression model was fitted. Multivariable logistic regression analysis at a P-value <0.05 and adjusted odds ratio with a 95% confidence interval were used to declare significant associations. Results:The overall long-acting contraceptive method use was 13.3% (95% CI=11.6-15.8), and it was 14.8% (95% CI=12.4-17.2) among rural and 8.3% (95% CI=4.5-12.4) among urban women. Among urban women, the odds of long-acting contraceptive method use was higher for women living with a partner (AOR=6.83; 95% CI=1.23-37.84), married women (AOR=5.21; 95% CI=1.95-13.89), women living in a male-headed household (AOR=5.29; 95% CI=1.26-22.38), and women whose partner wanted fewer children (AOR=11; 95% CI=3.46-16.2). Among rural women, the odds of long-acting contraceptive use was higher for women in the richest wealth index (AOR=6.69; 95% CI=3.02-14.83), married women (AOR=30.26; 95% CI=8.81-42.9), women with good knowledge of LACMs (AOR=1.75; 95% CI=1.25-2.46), and women who had no correct knowledge of their ovulatory cycle (AOR=1.93; 95% CI=1.16-3.19). Conclusion:Long-acting contraceptive method use was lower than the national target. LACM use was 8.3% (95% CI=4.5-12.4) among urban and 14.8% (95% CI=12.4-17.2) among rural women. Overall, marital status, educational level, the total number of children, knowledge of LACMs, and correct knowledge of the ovulatory cycle were significantly associated with LACM use.

Project description:ObjectivesAnaemia is a global public health problem with major health and socioeconomic consequences. Though childhood anaemia is a major public health problem in Ethiopia, there is limited evidence on the spatio-temporal variability of childhood anaemia over time in the country. Therefore, this study aimed to assess the spatio-temporal distribution and associated factors of childhood anaemia using the Ethiopian Demographic and Health Survey (EDHS) data from 2005 to 2016.DesignSurvey-based cross-sectional study design was employed for the EDHS.SettingData were collected in all nine regions and two city administrations of Ethiopia in 2005, 2011 and 2016.ParticipantsThe source population for this study was all children in Ethiopia aged 6-59 months. A total of 21 302 children aged 6-59 months were included in this study.Outcome measureThe outcome variable was child anaemia status.ResultsThe prevalence of anaemia declined from 53.9% in 2005 to 44.6% in 2011, but it showed an increase in 2016 to 57.6%. The spatial analysis revealed that the spatial distribution of anaemia varied across the regions. The spatial scan statistics analysis indicated a total of 22 clusters (relative risk (RR)=1.5, p<0.01) in 2005, 180 clusters (RR=1.4, p<0.01) in 2011 and 219 clusters (RR=1.4, p<0. 0.01) in 2016, significant primary clusters were identified. The child's age, mother's age, maternal anaemia status, wealth index, birth order, fever, stunting, wasting status and region were significant predictors of childhood anaemia.ConclusionsIn this study, childhood anaemia remains a public health problem. The spatial distribution of childhood anaemia varied significantly across the country. Individual-level and community-level factors were associated with childhood anaemia. Therefore, in regions with a high risk of childhood anaemia, individual-level and community-level factors should be intensified by allocating additional resources and providing appropriate and tailored strategies.

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:BackgroundReceiving quality antenatal care (ANC) from skilled providers is essential to ensure the critical health circumstances of a pregnant woman and her child. Thus, this study attempted to assess which risk factors are significantly associated with the timing of antenatal care and the number of items of antenatal care content received from skilled providers in recent pregnancies among mothers in Ethiopia.MethodsThe data was extracted from the Ethiopian Demographic and Health Survey 2016. A total of 6645 mothers were included in the analysis. Multilevel mixed-effects logistic regression analysis and multilevel mixed Negative binomial models were fitted to find the factors associated with the timing and items of the content of ANC services. The 95% Confidence Interval of Odds Ratio/Incidence Rate Ratio, excluding one, was reported as significant.ResultsAbout 20% of the mothers initiated ANC within the first trimester, and only 53% received at least four items of antenatal care content. Being rural residents (IRR = 0.82; 95%CI: 0.75-0.90), wanting no more children (IRR = 0.87; 95%CI: 0.79-0.96), and the husband being the sole decision maker of health care (IRR = 0.88; 95%CI: 0.81-0.96), were associated with reduced items of ANC content received. Further, birth order of six or more (IRR = 0.74; 95%CI: 0.56-0.96), rural residence (IRR = 0.0.41; 95%CI: 0.34-0.51), and wanting no more children (IRR = 0.61; 95%CI: 0.48-0.77) were associated with delayed antenatal care utilization.ConclusionsRural residences, the poorest household wealth status, no education level of mothers or partners, unexposed to mass media, unwanted pregnancy, mothers without decision-making power, and considerable distance to the nearest health facility have a significant impact on delaying the timing of ANC visits and reducing the number of items of ANC received in Ethiopia. Mothers should start an antenatal care visit early to ensure that a mother receives all of the necessary components of ANC treatment during her pregnancy.

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.

Dataset Information

Prevalence and associated factors of delayed first antenatal care booking among reproductive age women in Ethiopia; a multilevel analysis of EDHS 2016 data.

Publications

Prevalence and associated factors of delayed first antenatal care booking among reproductive age women in Ethiopia; a multilevel analysis of EDHS 2016 data.

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