Dataset Information

Multilevel analysis of grand multiparity: Trend and its determinants in the Sidama National Regional State of Ethiopia: a cross-sectional study design from demographic and health survey 2000-2016.

ABSTRACT:

Objective

The study was aimed at examining the magnitude, trends and determinants of grand multiparity in the Sidama regional state of Ethiopia.

Design

We retrieved cross-sectional data from the Ethiopia Demographic and Health Survey from 2000 to 2016.

Setting

Community-based demographic and health survey (DHS) was conducted in Ethiopia.

Participants

The study population was women (aged 15-49 years) who had delivered children with the available DHS data set.

Outcomes

Multilevel multivariate logistic regression analyses assessed the relationship between grand multiparity and its determinants.

Results

The magnitude of grand multiparity was 70.8% (95% CI 68.5% to 72.9%). The multilevel multivariable logistic regression model showed illiteracy (adjusted OR (AOR)=2; 95% CI 1.25 to 3.75), non-use of any contraceptive (AOR=3.8; 95% CI 1.2 to 12.2), early marriage (AOR=4.5; 95% CI 2.6 to 7.9), polygamous marriage (AOR=4.2; 95% CI 2.0 to 9.3), short birth intervals (AOR=2.3; 95% CI 1.4 to 3.5) and husband's low education status (AOR=5.8; 95% CI 2.1 to 16.1) were significantly associated with grand multiparity.

Conclusions

This study revealed that 7 of 10 women were grand multipara, and the magnitude did not show significant change over the last 16 years. Early marriage and early age at first birth, low literacy level, low family planning utilisation, polygamy, short interbirth interval and unmet need for family planning were determinants of grand multiparity. We recommended the stakeholders to design new strategies to address the root cause of high fertility factors in communities.

SUBMITTER: Dasa TT

PROVIDER: S-EPMC9386221 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Multilevel analysis of grand multiparity: Trend and its determinants in the Sidama National Regional State of Ethiopia: a cross-sectional study design from demographic and health survey 2000-2016.

Dasa Tamirat Tesfaye TT Okunlola Michael A MA Dessie Yadeta Y

BMJ open 20220816 8

<h4>Objective</h4>The study was aimed at examining the magnitude, trends and determinants of grand multiparity in the Sidama regional state of Ethiopia.<h4>Design</h4>We retrieved cross-sectional data from the Ethiopia Demographic and Health Survey from 2000 to 2016.<h4>Setting</h4>Community-based demographic and health survey (DHS) was conducted in Ethiopia.<h4>Participants</h4>The study population was women (aged 15-49 years) who had delivered children with the available DHS data set.<h4>Outco ...[more]

PMID: 35973699

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Project description:BackgroundContraceptive use is an important and cost-effective intervention to prevent unwanted pregnancies. People with disabilities face discrimination when it comes to using contraception and are doubly burdened by unwanted pregnancies. However, the status of contraceptive use and associated factors among reproductive-aged females with disabilities was not adequately determined in Ethiopia.ObjectiveThis study aimed to assess contraceptive use and associated factors among reproductive-age females with disabilities in Dale and Wonsho districts and Yirgalem city administration of central Sidama National Regional State, Ethiopia.MethodsA community-based cross-sectional study was conducted among randomly selected 620 reproductive-age females with disabilities living in the selected districts from June 20 to July 15, 2022. The data were collected through face-to-face interviewing techniques using a structured questionnaire. A multilevel logistic regression analysis model was employed to analyze the data. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the measures of associations.ResultsIn this study, 27.3% (95% CI [23.8%-31.0%]) of the reproductive-age females with disabilities were current contraceptive users. Regarding the methods, 82 (48.5%) of the reproductive-age females with disabilities used implants. Having good contraceptive knowledge (AOR = 9.03; 95% CI [4.39-18.6]), transport accessibility to health facilities (AOR = 2.28; 95% CI [1.32-3.94]), being an adult (25 to 34 years old) (AOR = 3.04; 95% CI [1.53-6.04]), having a hearing disability (AOR = 0.38; 95% CI [0.18, 0.79]), having paralysis of the extremities (AOR = 0.06; 95% CI [0.03-0.12]), and wheel-chaired disability (AOR = 0.10; 95% CI [0.05-0.22]) were factors associated with contraceptive use.ConclusionContraceptive use among reproductive-age females with disabilities is low. Transport accessibility, contraceptive knowledge, being in the age groups of 25 to 34 years, and the types of disability determine their contraceptive use. Therefore, designing appropriate strategies to provide contraceptive education and information and provide contraceptive services in their homes is important to enhance contraceptive use.

Project description:BackgroundThe world health organization considers cesarean section (CS) prevalence of less than 5% suggests an unmet need. On the other hand, a prevalence of more than 15% may pose to risk to mother and child, however, access to CS in a resource-limited country like Ethiopia was much lower than the aforementioned level, Therefore, this was the first study to determine the trend of CS, and factors that influence it.MethodsThis was done based on the five Ethiopia Demographic and Health Surveys. Trend analysis was done separately for rural and urban. The significance of the trend was assessed using the Extended Mantel-Haenszel chi-square test. The factors on CS delivery were identified based on DHS 2016 data. A multi-level logistic regression analysis technique was used to identify the factors associated with cesarean section delivery. The analysis was adjusted for the different individual- and community-level factors affecting cesarean section delivery. Data analysis was conducted using STATA 14.1 software.ResultThe rate of cesarean section increased from 5.1% in 1995 to 16% in 2019 in an urban area and 0.001 in 1995 to 3% in a rural area, the overall increment of CS rate was 0.7% in 1995 to 2019 at 6%. The odds of cesarean section were higher among 25-34 years (AOR = 2.79; 95% CI: 1.92, 4.07) and 34-49 years (AOR = 5.23;95% CI: 2.85,9.59), among those educated at primary school level (AOR = 1.94; 95% CI: 1.23,3.11), secondary education (AOR = 2.01; 95% CI: 1.17, 3.56) and higher education (AOR = 4.12; 95% CI: 2.33-7.29)with multiple pregnancies (AOR = 11.12; 95% CI: 5.37, 23.), with obesity (AOR = 1.73; 95% CI: 1.22, 2.45), living in an urban area (AOR = 2.28; /95% CI: 1.35-3.88), and increased with the number of ANC visit of 1-3 and 4th(AOR = 2.26; 95% CI: 1.12, 4.58), (AOR = 3.34; 95% CI: 1.12, 4.58), respectively. The odds of cesarean section are lower among parity of 2-4 children (AOR = 0.54; 95% CI: 0 .37, 0.80) and greater than four birth order (AOR = 0.42;95% CI: 0.21,0.84).ConclusionIn Ethiopia, the CS rate is below the WHO recommended level in both urban and rural areas, thus, intervention efforts need to be prioritized for women living in a rural area, empowering women's education, encouraging co-services such as ANC usage could all help to address the current problem.

Project description:IntroductionAccessing affordable and high-quality healthcare remains a persistent challenge in low- and middle-income countries like Ethiopia. Community-based health insurance (CBHI) programs offer a promising solution to expand healthcare coverage and provide financial protection, particularly for vulnerable populations such as women. This study aimed to investigate the factors that influence CBHI enrollment among women in Sidama National Regional State, Ethiopia, using a multilevel analysis.MethodsA community-based cross-sectional study was conducted using a multistage sampling technique from December 15th to January 12th, 2024, in the central Sidama zone, Sidama National Regional State. The study included 835 women aged 18 years and older, residing both in rural and urban areas. Face-to-face interviews were conducted using a pre-tested questionnaire to collect comprehensive data on socio-demographic, economic, and scheme-related factors. Data collection utilized the Open Data Kit mobile application, and data analysis was performed using Stata version 16, employing multilevel modified Poisson modeling to identify determinants of CBHI enrollment.ResultsAmong 845 samples, 835 women were interviewed, resulting in a response rate of 98.8%. Individual-level factors such as older age (APR = 1.02, 95%CI: 1.01-1.03, p<0.001), larger family size (APR = 1.09, 95%CI: 1.03-1.16, p = 0.001), and moderate wealth index (APR = 2.72, 95%CI: 1.28-5.79, p = 0.009) showed positive associations with CBHI enrollment, depicted a higher likelihood of individuals joining the insurance scheme. In addition, at the community level, higher rates of women's literacy (APR = 1.73, 1.18-2.55, p = 0.005), and women's autonomy (APR = 2.64, 95%CI: 1.50-4.65, p = 0.001) were positively correlated with CBHI enrollment.ConclusionsThe study revealed that the enrollment rate among women in the CBHI scheme was 35%, indicating a need for improved outreach efforts. Significant factors that affected enrollment included older age, larger family size, and moderate wealth. Additionally, positive community-level influences such as higher literacy rates and increased autonomy for women contributed to higher enrollment. To improve CBHI enrollment, the target should focus on younger women and those from smaller families. Financial support, such as subsidies for low-income women, can also encourage participation. Investing in women's literacy and empowerment programs will enable them to make informed health choices, thereby increasing enrollment. Finally, ongoing research is necessary to track enrollment trends and identify barriers. Utilizing qualitative methods will yield insights into women's perceptions of CBHI, facilitating more effective strategies. Implementing these recommendations can enhance women's access to healthcare through CBHI.

Project description:The notion of unmet need for family planning indicates the gap between women's contraceptive practice and their reproductive intention. Although universal access to sexual and reproductive health services including contraceptive methods is a bedrock for sustainable development goals, the unmet need for contraception is high among young women in low-income countries including Ethiopia. The unmet need for contraception is associated with unintended pregnancy which most of the time end in unsafe abortion. Hence, this study aimed to assess the determinants of unmet need for family planning among young married women in Ethiopia using nationally representative data. This study utilized secondary data collected in the 2016 Ethiopia Demographic and Health Survey (EDHS). A two-stage cluster sampling method was used. The analysis included a total of 2444 sexually active married young women (15-24 years). Multilevel logistic regression analysis was conducted to identify individual and community level factors associated with unmet need for contraceptives 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. In this study, the prevalence of unmet need for contraceptive method among married young women was 18.4% [95% CI: (16.9, 20.0)]. Female head of the household [AOR: 1.62, CI (1.25, 2.11)], primary level of education [AOR: 1.53, CI: (1.16, 2.03)], family size ≥5 [AOR: 1.53, 95%CI: (1.22, 1.93)], undecided to have child [AOR: 2.86, 95%CI: (1.58, 5.20)] and infecund [AOR: 1.54, 95%CI: (1.08, 2.20)] were factors positively associated with unmet need for family planning. Whereas the odds of unmet need for contraceptive method was lower among women-initiated sex between 15-17 years and >17 years [AOR:0.72, 95%CI (0.53, 0.98)] and [AOR: 0.58, 95%CI: (0.40, 0.85)] respectively and community with high proportion of poverty [AOR: 0.68, 95%CI: (0.46, 0.99)]. The prevalence of unmet need for contraceptive methods among young married women was relatively high. Being female household head, age at first sexual intercourse, educational status of the woman, family size, desire for more children, and community poverty were significantly associated with unmet need for family planning. Hence, interventions targeting these special populations at the individual and community level would play a paramount role in meeting the unmet need for contraception among young married women in Ethiopia.

Project description:ObjectiveSocioeconomic inequalities in child growth failure (CGF) remain one of the main challenges in Ethiopia. This study examined socioeconomic inequalities in CGF and determinants that contributed to these inequalities in Ethiopia.MethodsThe Ethiopia Demographic and Health Surveys 2000 and 2016 data were used in this study. A pooled unweighted sample of the two surveys yielded 21514 mother-child pairs (10873 in 2000 and 10641 in 2016). We assessed socioeconomic inequalities in CGF indicators using the concentration curve and concentration index (CI). We then decomposed the CI to identify percentage contribution of each determinant to inequalities.ResultsSocioeconomic inequalities in CGF have increased in Ethiopia between 2000 and 2016. The CI increased from -0.072 and -0.139 for stunting, -0.088 and -0.131 for underweight and -0.015 and -0.050 for wasting between 2000 and 2016, respectively. Factors that mainly contributed to inequalities in stunting included geographical region (49.43%), number of antenatal care visits (31.40%) and child age in months (22.20%) in 2000. While in 2016, inequality in stunting was contributed mainly by wealth quintile (46.16%) and geographical region (-13.70%). The main contributors to inequality in underweight were geographical regions (82.21%) and wealth quintile (27.21%) in 2000, while in 2016, wealth quintile (29.18%), handwashing (18.59%) and access to improved water facilities (-17.55%) were the main contributors. Inequality in wasting was mainly contributed to by maternal body mass index (-66.07%), wealth quintile (-45.68%), geographical region (36.88%) and paternal education (33.55%) in 2000, while in 2016, wealth quintile (52.87%) and urban areas of residence (-17.81%) were the main driving factors.ConclusionsThis study identified substantial socioeconomic inequalities in CGF, and factors that relatively contributed to the disparities. A plausible approach to tackling rising disparities may involve developing interventions on the identified predictors and prioritising actions for the most socioeconomically disadvantaged groups.

Project description:BackgroundUnemployment is a major problem in both developed and developing countries. In Ethiopia, women unemployment is particularly high, and this makes it a grave socio-economic concern. The aim of this study is to assess the spatial distribution and identify the determinant factors of women unemployment in Ethiopia.MethodsThe data used for the study is the Ethiopian Demographic and Health Surveys of 2016. A total of 15683 women are involved in the study. Global Moran's I statistic and Poisson-based purely spatial scan statistics are employed to explore spatial patterns and detect spatial clusters of women unemployment, respectively. To identify factors associated with women unemployment, multilevel logistic regression model is used.ResultsA spatial analysis showed that there was a major spatial difference in women unemployment in Ethiopia with Global Moran's index value of 0.3 (p<0.001). The spatial distribution of women's unemployment varied significantly across the country. The major areas of unemployment were Afar and Somalia; southwest Tigray; North and west Oromia, and Eastern and southern parts of Amhara. Women with primary level of education(AOR = 0.88, 95%CI: 0.80, 0.98), secondary and above level of education (AOR = 0.71, 95%CI: 0.62, 0.82), women with rich wealth index (AOR = 0.79, 95% CI: 0.70, 0.90), pregnant women (AOR = 1.24, 95% CI: 1.06, 1.5), women with a male household head(AOR = 1.4, 95% CI: 1.28, 1.50), and urban women(AOR = 0.60, 95% CI: 0.50, 0.70) statistically associated with women unemployment.ConclusionThe unemployment rate of women in Ethiopia showed variation across different clusters. Improving entrepreneurship and women's education, sharing business experiences, supporting entrepreneurs are potential tools for reducing the unemployment women. Moreover, creating community-based programs that prioritize participation of poor households and rural women as well as improving their access to mass media and the labor market is crucial.

Project description:BackgroundThe global epidemic of diabetes mellitus continues to grow and affects developed and developing countries alike. Intensive glycemic control is thought to modify the risks for vascular complications, hence the risks for diabetes-related death. We investigated the trend of diabetic vascular complication-related deaths between 2000 and 2016 in the global diabetes landscape.MethodsWe collected 17 years of death certificates data from 108 countries in the World Health Organization mortality database between 2000 and 2016, with coding for diabetic complications. Crude and age-standardized proportions and rates were calculated. Trend analysis was done with annual average percentage change (AAPC) of rates computed by joinpoint regression.ResultsFrom 2000 through 2016, 7,108,145 deaths of diabetes were reported in the 108 countries. Among them, 26.8% (1,904,787 cases) were attributed to vascular complications in damaged organs, including the kidneys (1,355,085 cases, 71.1%), peripheral circulatory (515,293 cases, 27.1%), nerves (28,697 cases, 1.5%) and eyes (5751 cases, 0.3%). Overall, the age-standardized proportion of vascular complication-related mortality was 267.8 [95% confidence interval (95% CI), 267.5-268.1] cases per 1000 deaths and the rate was 53.6 (95% CI 53.5-53.7) cases per 100,000 person-years. Throughout the 17-year period, the overall age-standardized proportions of deaths attributable to vascular complications had increased 37.9%, while the overall age-standardized mortality rates related to vascular complications had increased 30.8% (AAPC = 1.9% [1.4-2.4%, p < 0.05]). These increases were predominantly driven by a 159.8% increase in the rate (AAPC = 2.7% [1.2-4.3%, p < 0.05]) from renal complications. Trends in the rates and AAPC of deaths varied by type of diabetes and of complications, as well as by countries, regions and domestic income.ConclusionDiabetic vascular complication-related deaths had increased substantially during 2000-2016, mainly driven by the increased mortality of renal complications.

Dataset Information

Multilevel analysis of grand multiparity: Trend and its determinants in the Sidama National Regional State of Ethiopia: a cross-sectional study design from demographic and health survey 2000-2016.

Objective

Design

Setting

Participants

Outcomes

Results

Conclusions

Publications

Multilevel analysis of grand multiparity: Trend and its determinants in the Sidama National Regional State of Ethiopia: a cross-sectional study design from demographic and health survey 2000-2016.

Similar Datasets

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