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 Individual- and Community-Level Risk Factors Associated with Childhood Diarrhea in Ethiopia: A Multilevel Analysis of 2016 Ethiopia Demographic and Health Survey

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Setegn Muche Fenta ◽  
Teshager Zerihun Nigussie
Keyword(s):  
Risk Factors ◽  
Drinking Water ◽  
Health Survey ◽  
Community Level ◽  
World Health ◽  
Childhood Diarrhea ◽  
Individual Level ◽  
Factors Associated ◽  
Health Organization ◽  
The Individual

Background. Diarrhea is the second cause of child deaths globally. According to World Health Organization reports, in each year, it kills more than 525,000 children under 5 years. More than half of these deaths occur in five countries including Ethiopia. This study is aimed at identifying both individual- and community-level risk factors of childhood diarrhea in Ethiopia. Methods. Ethiopian demography and health survey of 2016 data were used for the analysis. A total of 10,641 children aged 0–59 months were included in the analysis. A multilevel mixed-effects logistic regression model was used to identify both individual- and community-level risk factors associated with childhood diarrhea. Result. The incidence of childhood diarrhea was 12% (95% CI: 11.39, 12.63). The random-effects model revealed that 67% of the variability of childhood diarrhea was explained by individual- and community-level factors. From the individual-level factors, children aged 36–59 months ( AOR = 3.166 ; 95% CI: 2.569, 3.900), twin child ( AOR = 1.871 ; 95% CI: 1.390, 2.527), birth order 5 and above ( AOR = 2.210 , 95% CI: 1.721, 2.839), not received any vaccination ( AOR = 1.197 ; 95% CI: 1.190, 1.527), smaller size of child at birth ( AOR = 1.303 ; 95% CI: 1.130, 1.504), and never breastfed children ( AOR = 2.91 ; 95% CI: 2.380, 3.567) associated with the higher incidence of childhood diarrhea. From the community-level factors, living in a rural area ( AOR = 1.505 ; 95% CI: 1.233, 1.836)), unprotected source of drinking water ( AOR = 1.289 ; 95% CI: 1.060, 1.567), and availability of unimproved latrine facilities (OR: 1.289; 95% CI: 1.239, 1.759) associated with the higher incidence of childhood diarrhea. Besides, children who live in Afar, Amhara, Benishangul-Gumuz, Gambella, SNNPR, and Dire Dawa regions had higher incidence of childhood diarrhea. Conclusion. The incidence of childhood diarrhea was different from cluster to cluster in Ethiopia. Therefore, integrated child health intervention programs including provisions of toilet facility, access to a clean source of drinking water, educate parents about the importance of breastfeeding, and vaccination have to be strongly implemented in order to reduce the high incidence of childhood diarrhea among children in Ethiopia.

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 and community level factors associated with anemia among children 6—59 months of age in Ethiopia: A further analysis of 2016 Ethiopia demographic and health survey

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241720
Author(s):  
Menaseb Gebrehaweria Gebremeskel ◽  
Afework Mulugeta ◽  
Abate Bekele ◽  
Lire Lemma ◽  
Muzey Gebremichael ◽  
...  
Keyword(s):  
Health Survey ◽  
Logistic Regression Model ◽  
Demographic And Health Survey ◽  
Community Level ◽  
Multilevel Logistic Regression ◽  
Factors Associated ◽  
Dire Dawa ◽  
Poverty Status ◽  
The Individual ◽  
Multilevel Logistic Regression Model

Background Anemia is a global public health problem; but its burden is disproportionately borne among children in the African Regions. The 2016 Ethiopia Demographic and Health Survey report showed that the prevalence of anemia among children 6–59 months of age was 57%; far exceeding the national target of 25% set for 2015. Although studies have been conducted in Ethiopia, multilevel analysis has rarely been used to identify factors associated with anemia among children. Therefore, this study aimed to identify individual and community-level factors associated with anemia among children 6–59 months of age by fitting a multilevel logistic regression model. Methods The data was obtained from the 2016 Ethiopia Demographic and Health Survey, conducted from January to June 2016, and downloaded from the website http://www.DHSprogram.com. The sample was taken using two-stage stratified sampling. In stage one, 645 Enumeration Areas and in stage two 28 households per Enumeration Area were selected. A sample of 7790 children 6–59 months of age was included. Data were analyzed using STATA version 14. A multilevel logistic regression model was fitted and an adjusted odds ratio with a 95% confidence interval was obtained. Result From the individual-level factors, anemia was associated most strongly with child age, wealth index, maternal anemia and child stunting followed by child underweight, child fever and birth order whereas from the community-level, the strongest odds of anemia occurred among children from Somali, Harari, Dire Dawa and Afar region followed by Oromia and Addis Ababa. Low community-poverty is a protective factor for anemia. The odds of anemia were 0.81 (95% CI: 0.66, 0.99) times lower for children who were living in communities of lower poverty status than children who were living in communities of higher poverty status. Children from Somali and Dire Dawa had 3.38 (95% CI: 3.25, 5.07) and 2.22 (95% CI: 1.42, 3.48) times higher odds of anemia, respectively than children from the Tigray region. Conclusions This study shows that anemia among children 6–59 months of age is affected both by the individual and community level factors. It is better to strengthen the strategies of early detection and management of stunted and underweight children. At the same time, interventions should be strengthened to address maternal anemia, child fever and poverty, specifically targeting regions identified to have a high risk of anemia.

scholarly journals Title: Determinants of Minimum Acceptable Diet among 6–23 Months Age Children in Ethiopia: A Multilevel Analysis of The Ethiopian Demographic Health Survey

2018 ◽  
Author(s):  
Aberash abay ◽  
Dejen Yemane ◽  
Abate Bekele ◽  
Beyene Meressa
Keyword(s):  
Logistic Regression ◽  
Health Survey ◽  
Community Context ◽  
Community Level ◽  
P Value ◽  
Multilevel Logistic Regression ◽  
Cross Sectional ◽  
Nutritional Interventions ◽  
Individual Level ◽  
The Individual

AbstractBackgroundThough infant and young children should be fed according to a minimum acceptable diet to ensure appropriate growth and development, only 7% of Ethiopian 6-23 months age children meet the minimum acceptable dietary standards, which is lower than the national target of 11% set for 2016. Therefore, this study aims to assess the individual and community level determinants of minimum acceptable diet among 6–23 months age children in Ethiopia.MethodsThis study analyzed retrospectively a cross-sectional data on a weighted sample of 2919 children aged 6-23 months nested within 617 clusters after extracting from Ethiopian Demographic and Health Survey 2016 via the link www.measuredhs.com. By employing bi-variate multilevel logistic regression model, variables which were significant at the p-value < 25 were included in multivariable multilevel logistic regression analysis. Finally, variables with p-value < 0.05 were considered as significant predictors of minimum acceptable diet.ResultsOnly 6.1% of 6-23 months age children feed minimum acceptable diet in Ethiopia. Children 18-23 months age (AOR=3.7, 95%CI 1.9, 7.2), father’s with secondary or higher education (AOR=2.1, 95%CI 1.2, 3.6), Employed mothers (AOR=1.7, 95%CI 1.2, 2.5), mothers have access to drinking water (AOR=1.9, 95%CI 1.2, 2.9), mothers with media exposure (AOR=2.1 95%CI 1.1, 2.7) were positive individual level predictors. Urban mothers (AOR=4.8, 95%CI 1.7, 13.2)) and agrarian dominant region (AOR=5.6, 95%CI 2.2, 14.5) were community level factors that significantly associated with minimum acceptable diet of 6–23 months age children.ConclusionBoth individual and community level factors were significantly associated with minimum acceptable diet of 6-23 months age children in Ethiopia, suggesting that nutritional interventions designed to improve child health should not only be implemented at the individual level but tailored to community context as well.

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 Individual and community level associates of contraceptive use in Ethiopia: a multilevel mixed effects analysis

2019 ◽  
Vol 77 (1) ◽  
Author(s):  
Masrie Getnet Abate ◽  
Amare Abera Tareke
Keyword(s):  
Fixed Effects ◽  
Contraceptive Use ◽  
Household Wealth ◽  
Mixed Effects ◽  
Community Level ◽  
Reproductive Age ◽  
Safe Motherhood ◽  
Sampled Data ◽  
Individual Level ◽  
Factors Associated

Abstract Background Family planning is one of the four pillars of safe motherhood initiative to reduce maternal death in developing countries. Despite progress in contraceptive use, unmet needs are wide open and fertility remains high. Ethiopia have a higher fertility rate which contributes to maternal and child health destitution, putting pressure on the already weak health system. This study examined individual and community-level factors associated with contraceptive use in Ethiopia. Methods Data from Ethiopian Demographic and Health Survey 2016 were used to identify individual and community level associated factors among reproductive-age women. Non-pregnant, fecund and sexually active women aged 15–49 were included. Six hundred forty-two communities and 6854 women were involved from this two-stage cluster sampled data. The analysis was done using two-level mixed-effects logistic regression to determine fixed effects of individual and community-level factors and random intercept of between characteristics. Results From the total eligible women for contraceptive use 2393 (34.9%) of them were users. Injectables were the commonest of all contraceptive methods. Various individual-level variables were associated with contraceptive use. Household wealth index, women’s age, number of living children, husband’s occupation, ever experience of a terminated pregnancy, current working status of the women, number of births in the last 3 years, and hearing of FP messages through different media were significantly associated individual-level variables after adjusting other factors. Community characteristics like region, place of residence, religion, and community-level wealth were the factors associated with contraceptive use. Conclusion Both individual and community-level characteristics were significant predictors of use of contraceptives in Ethiopian women. Besides the individual-level factors, interventions should also consider community-level associates.

scholarly journals Understanding Food Waste, Food Insecurity, and the Gap between the Two: A Nationwide Cross-Sectional Study in Saudi Arabia

Foods ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 681
Author(s):  
Nora A. Althumiri ◽  
Mada H. Basyouni ◽  
Ali F. Duhaim ◽  
Norah AlMousa ◽  
Mohammed F. AlJuwaysim ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Food Insecurity ◽  
Food Waste ◽  
Cross Sectional ◽  
Household Level ◽  
Individual Level ◽  
Factors Associated ◽  
Household Factors ◽  
Cooked Food ◽  
The Individual

Background: Food waste and food insecurity may co-exist in various balances in developing and developed countries. This study aimed to explore the levels of food waste and food insecurity, the factors associated with them, and their relationships at the household and individual levels in Saudi Arabia. Methods: This study was a nationwide cross-sectional survey conducted via computer-assisted phone interviews in January 2021. Quota sampling was utilized to generate balanced distributions of participants by gender across all the administrative regions of Saudi Arabia. Data collection included household demographics, food waste and disposal, the Food Insecurity Experience Scale (FIES), and the Household Food Insecurity Access Scale (HFIAS). Results: Out of the 2807 potential participants contacted, 2454 (87.4%) completed the interview. The mean age was 31.4 (SD = 11.7; range = 18–99) and 50.1% were female. The weighted prevalence of uncooked food waste in the last four weeks was 63.6% and the cooked food waste was 74.4%. However, the food insecurity weighted prevalence at the individual level (FIES) was 6.8%. In terms of food insecurity at the household level (HFIAS), 13.3% were in the “severely food insecure” category. Moreover, this study found that “moderately food insecure” households were associated with an increased likelihood to waste uncooked food (relative risk (RR) = 1.25), and the “mildly food insecure” (RR = 1.21) and “moderately food insecure” (RR = 1.17) households were associated with an increased likelihood to waste cooked food. However, “food secure” households were associated with a decreased likelihood to waste cooked food (RR = 0.56). Finally, this study identified four household factors associated with food waste and three household factors that were associated with “severe food insecurity.” Conclusions: This first national coverage study to explore food waste and food insecurity at the individual level and household level, identified household factors associated with food waste and food insecurity and identified new associations between food waste and food insecurity in Saudi Arabia. The associations found between food waste and food insecurity are potential areas of intervention to reduce both food waste and food insecurity at the same time, toward achieving the Sustainable Development Goal (SDG) targets related to food waste and food security.

Prevalence and determinant factors of exclusive breastfeeding practices among mothers in Marrakesh province, Morocco: A cross- sectional survey

2021 ◽  
pp. 1-11
Author(s):  
Soufiane El Moussaoui ◽  
Kamal Kaoutar ◽  
Ahmed Chetoui ◽  
Abdeslam El Kardoudi ◽  
Fatiha Chigr ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Multivariate Logistic Regression ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Breastfeeding Practices ◽  
Survey Report ◽  
Duration Of Breastfeeding ◽  
Breastfeeding Practice

BACKGROUND: Exclusive breastfeeding is the best form of nutrition for infants during the first 6 months of life. Nevertheless, the practice of breastfeeding is currently declining throughout the world. OBJECTIVE: The objective of this study was to assess the prevalence of exclusive breastfeeding (EBF) practice and its associated factors among mothers living in Marrakesh province, Morocco. METHODS: The data were collected using an interviewer administered questionnaire. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with exclusive breastfeeding practice. RESULTS: Prevalence of exclusive breastfeeding was 50.2%. Mothers with age more than 30 years, residing in rural area, receiving counseling related breastfeeding during antenatal follow up and having knowledge about duration of breastfeeding were more likely to practice exclusive breastfeeding than their counterparts. CONCLUSION: Although the prevalence of breastfeeding in Marrakesh was higher than the last national survey report but it is still insufficient. These findings have to stress authorities and deciders to sensitize mothers and future mothers to increase exclusive breastfeeding practice notably through the involvement of health professionals.

scholarly journals Individual and community-level risk factors of women’s acceptance of intimate partner violence in Ethiopia: multilevel analysis of 2011 Ethiopian Demographic Health Survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emiru Merdassa Atomssa ◽  
Araya Abrha Medhanyie ◽  
Girmatsion Fisseha
Keyword(s):  
Risk Factors ◽  
Intimate Partner Violence ◽  
Health Survey ◽  
Women's Education ◽  
Partner Violence ◽  
Significant Risk ◽  
Intimate Partner ◽  
Community Level ◽  
State Region ◽  
The Individual

Abstract Background The prevalence of Intimate partner violence (IPV) is higher in societies with higher acceptance of norms that support IPV. In Ethiopia, the proportion of women’s acceptance of IPV was 69%, posing a central challenge in preventing IPV. The main objective of this study was to assess the individual and community-level factors associated with women’s acceptance of IPV. Methods Two-level mixed-effects logistic regression was applied to the 2011 Ethiopia Demographic and Health Survey data. A total of 16,366 women nested in the 596 clusters were included in the analysis. Results The acceptability of the IPV was estimated to be 69%. Among the individual-level factors: women’s education with secondary and above (AOR = 0.38; 95% CI 0.29–0.52), partner’s education secondary and above (AOR = 0.71; 95% CI 0.54–0.82), women aged 35–49 years (AOR = 0.67; 95% CI 0.54–0.82), fully empowered in household level decision making (AOR = 0.67; 95% CI0.54–0.81), literate (AOR = 0.76; 95% CI 0.62–0.92), and perceived existence of law that prevents IPV (AOR = 0.56; 95% CI 0.50–0.63) were significantly associated with women’s acceptance of IPV. Similarly, rural residence (AOR = 1.93; 95% CI 1.53–2.43) and living in the State region (AOR = 2.37; 95% CI 1.81–3.10) were significantly associated with the women’s acceptance of IPV among the community-level factors. Conclusion Both individual and community-level factors were significant risk factors for the acceptability of intimate partner violence. Women's education, women's age, women’s empowerment, partner education level, perceived existence of the law, and literacy were among individual factors. State region and residence were among community-level risk factors significantly associated women’s acceptance of IPV.

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