scholarly journals Using Multilevel Modeling to Understand Individual and Community-level Determinants of Anemia in Ethiopia (P11-030-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Manisha Tharaney ◽  
Deepali Godha ◽  
Abdulaziz Oumer
Keyword(s):  
Decision Making ◽  
Household Wealth ◽  
Community Level ◽  
Child Marriage ◽  
Individual Level ◽  
Number Of Children ◽  
The Individual ◽  
Average Cluster ◽  
Cluster Age ◽  
Cluster Level

Abstract Objectives Anemia is a public health problem in Ethiopia. There is strong evidence to show that both individual and community level factors play an important role in the prevalence of anemia and should be considered while designing effective programs to reduce anemia. The study aims to explore the determinants of anemia at both individual and community levels and to analyze any differential effect of a predictor at the two levels. Methods Multilevel random intercept model was estimated using Ethiopia DHS 2016 with group mean centered variables at the individual level and grand mean level centering for cluster-level variables. The analysis was conducted in Stata/SE 15.1 using “melogit”. The final sample included 14,489 women of reproductive age group (WRA) belonging to 25 strata with an average cluster size of 580. Results The variation between strata accounted for almost 11 percentage of the variability in the outcome. Woman's age and number of children at the individual level as well as at the cluster level, and religion and education at the individual level are significant predictors. In addition, significant cross-level interactions include mean number of children in cluster versus woman's age and household wealth; religion versus cluster means of household wealth and prevalence of high decision-making power and child marriage; and number of children versus mean age in cluster. Results suggest that women who are younger than the average cluster age and reside in relatively younger clusters have a higher probability of being anemic as compared to women who are older than the average cluster age. On the other hand, the probability of being anemic is the lowest across ages for younger women if they reside in clusters with highest mean age. Similarly, the association of poverty at the individual level reduces with increasing average wealth at cluster level while the opposite is true for number of children. Cluster average of number of children has a differential association with the probability of being anemic across religions. Cluster prevalence of high decision-making power among women and child marriage have a negative association with the probability of being anemic though the association varies by religion. Conclusions Results showed the importance of variation between strata and clusters; and the importance of these when interacting with some individual level characteristics, that are not modifiable. These results have important implications for anemia program and policy Funding Sources FHI 360, Bill & Melinda Gates Foundation. Supporting Tables, Images and/or Graphs

scholarly journals Less than one-fifth of the mothers practised exclusive breastfeeding in the emerging regions of Ethiopia: a multilevel analysis of the 2016 Ethiopian demographic and health survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tsegaye Gebremedhin ◽  
Demiss Mulatu Geberu ◽  
Asmamaw Atnafu
Keyword(s):  
Health Survey ◽  
Exclusive Breastfeeding ◽  
Household Wealth ◽  
Community Level ◽  
Wealth Status ◽  
Individual Level ◽  
Factors Associated ◽  
Breastfeeding Practices ◽  
The Individual ◽  
Low Coverage

Abstract Background The burden of low coverage of exclusive breastfeeding (EBF) has a significant impact on the health of a newborn and also on the family and social economy in the long term. Even though the prevalence of EBF practices in Ethiopia is low, the practices in the pastoral communities, in particular, are significantly low and affected by individual and community-level factors. Besides, its adverse outcomes are mostly unrecognised. Therefore, this study aimed to assess the individual and community-level factors of low coverage of EBF practices in the emerging regions of Ethiopia. Methods In this analysis, data from 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A two-stage stratified sampling technique was used to identify 1406 children aged 0 to 23 months in the emerging regions of Ethiopia. A multilevel mixed-effect binary logistic regression analysis was used to determine the individual and community level factors associated with exclusive breastfeeding practices. In the final model, variables with a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were found to be statistically significant factors that affect exclusive breastfeeding practices. Results Overall, 17.6% (95% CI: 15.6–19.6) of the children aged 0 to 23 months have received exclusive breastfeeding. Employed mothers (AOR: 0.33, 95% CI: 0.21–0.53), richer household wealth status (AOR: 0.39, 95% CI: 0.16–0.96), mothers undecided to have more children (AOR: 2.29, 95% CI: 1.21–4.29), a child with a history of diarrhoea (AOR: 0.31, 95% CI: 0.16–0.61) were the individual-level factors, whereas Benishangul region (AOR: 2.63, 95% CI: 1.44–4.82) was the community-level factors associated with the exclusive breastfeeding practices. Conclusions Less than one-fifth of the mothers have practised exclusive breastfeeding in the emerging regions of Ethiopia. The individual-level factors such as mother’s employment status, household wealth status, desire for more children, presence of diarrhoea and community-level factors such as region have contributed to the low coverage of exclusive breastfeeding. Therefore, the federal and regional health bureaus and other implementers should emphasise to those emerging regions by creating awareness and strengthening the existing community-based health extension program to enhance exclusive breastfeeding practices.

scholarly journals Exploring the determinants of exclusive breastfeeding among infants under-six months in Ethiopia using multilevel analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245034
Author(s):  
Shambel Aychew Tsegaw ◽  
Yeshimebet Ali Dawed ◽  
Erkihun Tadesse Amsalu
Keyword(s):  
Logistic Regression ◽  
Exclusive Breastfeeding ◽  
Odds Ratio ◽  
Maternal Employment ◽  
Wealth Index ◽  
Household Wealth ◽  
Community Level ◽  
Multilevel Logistic Regression ◽  
Individual Level ◽  
The Individual

Introduction Exclusive breastfeeding (EBF) is the safest and healthiest option of feeding among infants in the first 6 months throughout the world. Thus, the promotion of EBF is essential to prevent complex infant health problems even at the adulthood level. But the majority of previous studies focused on individual- level determinants of EBF by using basic regression models in localized areas. This study aimed to identify the determinants of EBF at the individual and community level which would be helpful to design appropriate strategies for improving the practice of EBF. Methods It is a secondary data analysis using the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of 1185 infants under 6 months of age were included in the analysis. A Multilevel logistic regression model was employed to investigate factors significantly associated with EBF among under-six infants in Ethiopia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to measure the association of variables whereas Intracluster correlation (ICC), median odds ratio (MOR), and proportional change in variance (PCV) were used to measure random effects (variation). Result In multilevel logistic regression; 4–5 months age infant (AOR = 0.04, 95%CI:0.02–0.07), female infants (AOR = 2.51, 95%CI:1.61–3.91), infant comorbidities (AOR = 0.35, 95%CI: 0.21–0.57), richest household wealth index (AOR = 10.34, 95%CI: 3.14–34.03) and antenatal care (AOR = 2.25, 95%CI:1.32–3.82) were individual- level determinants significantly associated with exclusive breastfeeding. Whereas, contextual region (AOR = 0.30, 95%CI: 0.10–0.87), community- level of postnatal visit (AOR = 2.77, 95%CI: 1.26–6.58) and community -level of maternal employment (AOR = 2.8, 95%CI: 1.21–6.47) were community level determinants significantly associated with EBF. The full model showed that46.8% of the variation of exclusive breastfeeding was explained by the combined factors at the individual and community levels. Similarly, it showed that the variation in exclusive breastfeeding across communities remained statistically significant (ICC = 8.77% and variance = 0.32 with P<0.001). Conclusion and recommendation Our study showed that both individual and community level determinants were significantly associated with EBF practice among under 6 infants. Based on our findings, it is recommended to promote and enhance antenatal and postnatal care services utilization of mothers to improve exclusive breastfeeding practice and more emphasis should be given to infants with comorbid conditions and those who were living in the pastoralist regions.

scholarly journals Individual-level and community-level factors associated with the family planning use among pastoralist community of Ethiopia: a community-based cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036519 ◽  
Author(s):  
Mussie Alemayehu ◽  
Araya Abrha Medhanyie ◽  
Elizabeth Reed ◽  
Afework Mulugeta
Keyword(s):  
Family Planning ◽  
Cross Sectional Study ◽  
Married Women ◽  
Community Level ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Individual Level ◽  
Pastoralist Community ◽  
The Individual

ObjectiveThe study aimed to identify the effects of the individual-level and community-level factors on the use of family planning (FP) among married women in the pastoralist community of Ethiopia.DesignA community-based cross-sectional study was conducted in September 2018. Data were analysed using R software. To determine the fixed effect of individual-level and community-level factors of FP use, a two-level mixed-effects logistic regression was used. The result was described using the Adjusted OR (AOR), and the variance partition coefficient.Setting and participantsAfar, Ethiopia (2018; n=891) married women of reproductive age (15–49) years.Primary outcome measuresFP use or non-use.ResultsThe current use of FP was 18.7% (16.31%–21.43%). Women who need to walk 1 hour and more to the nearest health facility (AOR 0.14, 95% CI 0.05 to 0.3), have ANC visit of 4 and above (AOR 6.02, 95% CI 1.74 to 20.8), had their last birth at a health facility (AOR 2.71 95% CI 1.27 to 5.81), have five and more children (AOR 4.71, 95% CI 1.86 to 11.9), have high knowledge on FP (AOR 2.74, 95% CI 1.11 to 6.74) and had high intentions to use FP (AOR 10.3, 95% CI 3.85 to 27.6) were more likely to report FP use. The magnitude of the effect of for FP use was smaller than that of 9 of the 13 individual factors. Apart from this 19.4% of the total variance in the odds of using FP attributed to between community difference (intraclass correlation coefficient=0.194). Regarding the community-level characteristics, clusters of having higher electronic media possession (AOR 2.84, 95% CI 1.2 to 6.72) and higher women decision making on FP (AOR 8.35, 95% CI 2.7 to 27.1) were significantly associated with increased FP use compared with clusters with lower reports of these aspects.ConclusionFP use among the pastoralist community is influenced by both individual cluster/community-level characteristics or factors. Even though the effect of clustering in FP use was large in comparison with the unexplained between-cluster variation, it was lower than the individual-level factors.Trail registrtion numberNCT03450564

The Development of Distinct Choice Process Segments over Time: A Stochastic Modeling Approach

1982 ◽  
Vol 46 (2) ◽  
pp. 48-59 ◽  
Author(s):  
Donald R. Lehmann ◽  
William L. Moore ◽  
Terry Elrod
Keyword(s):  
Decision Making ◽  
Problem Solving ◽  
Stochastic Modeling ◽  
Information Acquisition ◽  
Response Behavior ◽  
Model Framework ◽  
Individual Level ◽  
Amount Of Information ◽  
The Individual ◽  
Over Time

This paper examines Howard's (1963) typology dividing decision making into extensive problem solving (ESP), limited problem solving (LSP), and routinized response behavior (RRB). Specifically, the amount of information accessed in a longitudinal experiment is studied. Information acquisition is modeled stochastically at the individual level, and the existence of two segments (LSP and RRB) is tested in a nested-model framework.

Game of hypocrites: Beurs break silence in Faïza Guène’s Kiffe kiffe demain

2019 ◽  
Vol 30 (4) ◽  
pp. 335-346
Author(s):  
Nour Seblini
Keyword(s):  
Community Level ◽  
Immigrant Community ◽  
Individual Level ◽  
French Culture ◽  
Cultural Crisis ◽  
Younger Generation ◽  
The Individual

This article analyses the cultural crisis of beur youth by calling attention, in Faïza Guène’s novel, Kiffe kiffe demain (2004), to how Maghrebi immigrants as well as the French state attempt to manipulate young bodies and minds. The struggle that underlies the narrative is an exploitation of Islam within France’s Moroccan immigrant community to preserve honneur at the immigrant community level, while enjoying bonheur at the individual level. As religion is used to subjugate the younger generation, Islam loses credibility in the eyes of beurs. I also seek to explore how la laïcité of French culture marginalises individuals who do not accept assimilation into a superior racist system that is based on an exclusionary notion of citizenship. Who falls victim in the end? It is the young beur, who cannot tolerate the extremism of either French Orientalist views or their parents’ Occidentalist views.

Crown structural properties, wood density, and liana load: influence on growth and mortality in subtropical forests

2021 ◽  
Vol 51 (1) ◽  
pp. 111-121
Author(s):  
Sabrina A. Rodríguez ◽  
Piedad M. Cristiano ◽  
Oscar A. Lezcano ◽  
Teresa M. Suirezs ◽  
M. Virginia E. Díaz Villa ◽  
...  
Keyword(s):  
Structural Properties ◽  
Wood Density ◽  
Community Level ◽  
Individual Level ◽  
Explanatory Variables ◽  
Canopy Tree ◽  
Canopy Position ◽  
The Individual ◽  
Demographic Patterns ◽  
Architectural Traits

Wood density (WD) and other wood mechanical and structural properties may have a strong functional relationship with demographic patterns and allometry of trees. We analyzed the influence of WD, structural properties, architectural traits, and community-level attributes on growth rates (GRs) and mortality modes of canopy tree species in a subtropical forest of Argentina. Stem WD and the WD, strength, stiffness, toughness, and hardness of branches were measured in 10 canopy species. Architectural traits and liana load were also determined. Strength and hardness of branches were linearly correlated to branch WD, and GRs were linearly correlated to stem WD across species. At the individual level, trees with greater hardness and toughness in branches died mostly uprooted, and trees with greater branch stiffness and susceptibility to colonization by lianas were mostly broken. At the community level, the suppressed trees died mostly broken. The dominant trees with high local tree density died mostly broken, whereas more isolated trees died mostly uprooted. Mortality modes were determined not only by mechanical properties, but also by community properties such as liana load, crown canopy position, and number of neighboring trees. Other biophysical traits besides WD are important explanatory variables when dry wood is used to describe functional characteristics of trees.

Review of Family Financial Decision Making: Suggestions for Future Research and Implications for Financial Education

2017 ◽  
Vol 28 (2) ◽  
pp. 253-267 ◽  
Author(s):  
Jinhee Kim ◽  
Michael S. Gutter ◽  
Taylor Spangler
Keyword(s):  
Decision Making ◽  
Decision Process ◽  
Family System ◽  
Financial Education ◽  
Future Research ◽  
Financial Decisions ◽  
Individual Level ◽  
Financial Decision Making ◽  
Financial Decision ◽  
The Individual

This article reviews the theories and literature in intrahousehold financial decisions, spousal partners and financial decision making, family system and financial decision process, children, and financial decisions. The article draws conclusions from the literature review and discusses directions for future research and educational programs. Most financial education and counseling takes place at the individual level, whereas financial decisions take place at household and intrahousehold levels. Family members, spouses/partners, children, and others play a key role in individuals’ financial decisions. The article proposes the key programmatic implications for financial professionals and educators that need to be integrated into financial education and counseling. Understanding the unique dynamics of family financial decision making would help create effective educational and counseling strategies for the whole families.

scholarly journals Unbalanced bilingual acquisition as a mechanism of grammatical change

2011 ◽  
Vol 14 (2) ◽  
pp. 159-161 ◽  
Author(s):  
STEPHEN MATTHEWS ◽  
VIRGINIA YIP
Keyword(s):  
Language Acquisition ◽  
Language Change ◽  
First Language ◽  
Community Level ◽  
First Language Acquisition ◽  
Individual Level ◽  
Grammatical Change ◽  
The Individual

Bilingual first language acquisition (BFLA) has been considered a possible mechanism of contact-induced change in several recent studies (Siegel, 2008, p. 117; Satterfield, 2005, p. 2075; Thomason, 2001, p. 148; Yip & Matthews, 2007, p.15). There is as yet little consensus on the question, with divergent views regarding both BFLA at the individual level and the implications for language change at the community level.

Sign in / Sign up

Export Citation Format

Share Document