scholarly journals Utilization of insecticide-treated bed nets and care-seeking for fever and its associated socio-demographic and geographical factors among under-five children in different regions: evidence from the Myanmar Demographic and Health Survey, 2015–2016

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Kyi Thar Min ◽  
Thae Maung Maung ◽  
Myo Minn Oo ◽  
Tin Oo ◽  
Zaw Lin ◽  
...  

Abstract Background Malaria is one of the top-five contributors to under-5 deaths in Myanmar. Use of insecticide-treated nets (ITN) and receiving early appropriate care in case of fever are the core interventions to prevent malaria and its complications and thereby deaths. This study aimed to assess among the under-five children, (a) utilization of ITNs and its associated factors, (b) care-seeking behaviour among their caregivers and its associated factors and uptake of malaria testing among those with fever in the last 2 weeks. Methods This was a cross sectional study using secondary analysis of Myanmar Demographic and Health Survey (MDHS) conducted in 2015–2016. Multivariable logistic regression was used to explore the factors associated with non-utilization of ITNs and not seeking care for fever. Effect sizes have been presented using odds ratios with 95% confidence intervals. Data analysis was done using svyset command in STATA to account for the multi-stage sampling design of the survey. Results Of 4597 alive under-five children, 80.5% did not sleep under an ITN last night. The factors significantly associated with non-utilization of ITNs were residing in malaria elimination regions (aOR = 2.0, 1.3–3.2), urban residence (aOR = 1.8, 1.2–2.9), staying in delta region (aOR = 8.7, 4.7–12.2), hilly region (aOR = 3.0, 2.0–4.6, and having highest wealth quintile (aOR = 1.8, 1.1–3.0). Around 16% had fever in the last 2 weeks, of whom 66.7% sought care for fever and 3% got tested for malaria. Nearly half (50.9%) of the caregivers sought care from a government health facility, followed by private hospital/doctor (27.8%), shop (8.0%), village health worker (4.4%) and pharmacy (3.1%). The factors associated with not seeking care for fever were residing in specific geographical locations (hilly, delta and central plains compared to coastal region) and having lowest wealth quintile (aOR = 2.3, 1.1–5.7). Conclusions This study highlighted that ownership and utilization of ITNs was very poor among under-5children. Care-seeking behaviour of the caregivers of under-5 children in case of fever was dismal with two-thirds not seeking care. The programme should seriously consider addressing these barriers if Myanmar is to achieve zero malaria deaths by 2030.

2021 ◽  
Author(s):  
Mathewos Alemu Gebremichael ◽  
Melkamu Merid Mengesha ◽  
Samuel Hailegebrea’l ◽  
Hanan Abdulkadir ◽  
Biruk Bogale Wolde

Abstract Background: Childhood overweight and obesity are emerging public health challenges of the 21st century. There was a 24% increase in the number of overweight children under the age of five years in low-income countries. Despite the significant risk of childhood overweight/obesity for non-communicable diseases, premature death, disability, and reproductive disorders in their adult life, little attention has been given. Therefore, we aimed to assess the prevalence of overweight/obesity and associated factors among under-five children. Methods: This study was conducted using data from a nationally representative sample of the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). The Mini EDHS was a community-based cross-sectional study that covered all the administrative regions of Ethiopia. The data collection was conducted between March 21, 2019, to June 28, 2019. Both descriptive and analytic findings were produced using STATA version 14. For associated factors, a multilevel binary logistic regression model was fitted to account for the hierarchical nature of the data. Adjusted odds ratio (aOR) with 95% confidence interval (CI) was reported to show the strength of association and statistical significance. Results: A total 5,164 under-five children were included in this study. The overall prevalence of overweight/obesity was 2.14 % (95% CI; 1.74-2.53) (more than two standard deviations (+2SD) above the median of the reference population) based on the body mass index (BMI) Z-score. The odds of overweight/obesity was higher among children aged less than 6 months (aOR= 5.19; 95%CI: 2.98-9.04), 6-24 months (aOR = 1.97; 95%CI: 1.18-3.29), delivered by caesarean section (aOR = 1.75; 95% CI: 1.84-3.65), living in Addis Ababa city (aOR = 2.16; 95%CI: 1.59-7.81), Oromia region (aOR = 1.93; 95CI: 1.71-5.24), having mothers with the age 40-49 years (aOR = 3.91; 95%CI: 1.90-16.92), uses traditional contraceptive methods (aOR = 2.63; 95%CI: 1.66-10.47), and households headed by male (aOR = 1.71; 95%CI: 1.84-3.48). Conclusion: This study showed that childhood overweight/obesity is the problem in Ethiopia. There was an interplay of several factors that affect childhood obesity including child factors, maternal socio-demography, and healthcare utilization, and geography of residence. Therefore, strategies to reduce childhood overweight and obesity should consider a multitude of contributing factors.


2020 ◽  
Author(s):  
Melkamu Molla Ferede

Abstract Background: Diarrhoea is one of the major contributors to deaths among under-five children in Ethiopia. Studies conducted in different countries showed that rural children are highly affected by diarrhoea than urban children. Thus, the purpose of this study was to identify the socio-demographic, environmental and behavioural associated factors of the occurrence of diarrhoea among under-five children in rural Ethiopia. Methods: Data for the study was drawn from the 2016 Ethiopia Demographic and Health Survey. A total of 8,041 under-five children were included in the study. Data was analysed using SPSS version 23. Binary logistic regression was used for the analysis of the data to assess the association of occurrence of diarrhoea with socio-demographic, environmental and behavioural associated factors among under-five children. Results: Children aged 6-11 months (AOR: 3.5; 95% CI: 2.58-4.87), 12-23 months (AOR: 3.1; 95% CI: 2.33-4.04) and 24-35 months (AOR: 1.7; 95% CI: 1.26-2.34) were significantly associated with diarrhoea. Diarrhoea was also significantly associated with male children (AOR: 1.3; 95% CI: 1.05-1.58), children in Afar region (AOR: 1.92; 95% CI: 1.01-3.64), Somali region (AOR: .42; 95% CI: (.217-.80), Gambela region (AOR: 2.12; 95% CI: 1.18, 3.81), households who shared toilet facilities with other households (AOR: 1.4; 95% CI: 1.09-1.77), fourth birth order (AOR: .1.81; 95% CI: 1.17-2.79), fifth and above birth order (AOR: 1.85; 95% CI: 1.22, 2.81) and the interaction of older mothers with three or more under-five children (AOR: 4.7; 95% CI: 1.64-13.45). Conclusion: The age of a child, sex of a child, region, birth order, toilet facilities shared with other households and the interaction effect of number of under-five children with mother’s current age are identified as associated factors for diarrhoea occurrence among under-five children in rural Ethiopia. The findings carry implications for the need for planning and implementing appropriate prevention strategies that target rural under-five children.


2021 ◽  
Author(s):  
Delelegn Emwodew ◽  
Binyam Tariku ◽  
Getanew Aschalew ◽  
Elias Seid ◽  
Samuel Hailegebreal ◽  
...  

Abstract Background: Childhood stunting is a major challenge to the growth and development of nations by affecting millions of children across the world. Although Ethiopia has made steady progress in reducing stunting, the prevalence of stunting is still one of the highest in the world. This study aims to investigate the spatial variation and factors associated with childhood stunting in Ethiopia.Methods: This study is a secondary data analysis of the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). A total of 4,971 children aged 0–59 months were included in the analysis. The Getis-Ord statistics tool has been used to identify areas with high and low hotspots of stunting. A multilevel logistic regression model was used to identify factors associated with stunting.Results: The prevalence of stunting was found to be 36.86% in Ethiopian under-five children. Statistically significant hotspots of stunting were found in northern parts of Ethiopia. Both individual and community-level factors determined the odds childhood stunting among under-five children. Children in the age group between 24–35 months were more likely to be stunted than children whose age was less than one year [AOR = 3.74; 95 % CI: (3.04–4.59)]. Children with mothers who had completed higher education had lower odds of being stunted compared to children whose mothers had no formal education [AOR = 0.55; 95%CI: (0.38–0.82)]. Children from the poorest wealth quintile had higher odds of being stunted compared to children from the richest wealth quintiles [AOR = 2; 95 % CI: (1.46–2.73)]. Children living in Tigray (AOR =3.64; 95 % CI: 2.17–6.11), Afar (AOR 2.02; 95 % CI 1.19-3.39), Amhara (AOR =2.29; 95 % CI: 1.37–3.86), Benishangul Gumz (AOR=1.87; 95% CI: 1.10-3.17) and Harari (AOR=1.95; 95% CI: 1.17-3.25) regions were more likely to be stunted compared to children living in Addis Ababa.Conclusion: This study showed that both individual and community-level factors were significant predictors of childhood stunting. Improving maternal education, improving the economic status of households, improving age-specific child feeding practice, and providing additional resources to regions with high hotspots of childhood stunting are recommended.


Author(s):  
Abdul-Aziz Seidu ◽  
Ebenezer Agbaglo ◽  
Louis Kobina Dadzie ◽  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
...  

Abstract Background This study sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in Papua New Guinea. Methods The study was conducted among 14 653 women aged 15–49 y using data from the 2016–2018 Papua New Guinea Demographic and Health Survey. The outcome variable was barriers to accessing healthcare. Descriptive and multilevel logistic regression analyses were conducted. Statistical significance was declared at P < 0.05. Results Women aged 15–19 y were more likely to experience at least one barrier compared with those aged 40–49 y (adjusted OR [AOR]=1.48; 95% CI 1.18 to 1.86). Women with secondary/higher education (AOR=0.68; 95% CI 0.57 to 0.81), women in the richest wealth quintile (AOR=0.36; 95% CI 0.28 to 0.46) and those in the least disadvantaged socioeconomic status (AOR=0.46; 95% CI 0.33 to 0.64) had lower odds of having challenges with at least one barrier to healthcare. However, living in rural areas increased the odds of facing at least one barrier to healthcare (AOR=1.87; 95% CI 1.27 to 2.77). Conclusions This study has demonstrated that both individual and contextual factors are associated with barriers to healthcare accessibility among women in Papua New Guinea. To enhance the achievement of the Sustainable Development Goals 3.1, 3.7 and 3.8, it is critical to deem these factors necessary and reinforce prevailing policies to tackle barriers to accessing healthcare among women in Papua New Guinea.


2021 ◽  
Author(s):  
Juwel Rana ◽  
Md Nuruzzaman Khan ◽  
Rakibul M Islam ◽  
Razia Aliani ◽  
Youssef Oulhote

Abstract Background: Household air pollution (HAP) from solid fuel use (SFU) for cooking has been considered a public health threat, particularly for women and children in low and middle-income countries (LMICs), with limited evidence. This study was undertaken to investigate the effects of HAP on neonatal, infant, and under-five child mortality in Myanmar. Methods: This cross-sectional study employed data from the Myanmar Demographic and Health Survey (MDHS), the first nationally representative survey conducted in 2016. Data were collected from MDHS based on stratified two-stage cluster sampling design applied in urban and rural areas. The sample consists of 3249 under-five children in the household with a 98% response rate. Exposure measures were HAP (coal and biomass) and level of exposure to HAP (no exposure, moderate and high exposure). The main outcomes were neonatal, infant, and under-five child mortality reported by mothers presented in rates and risk ratios with 95% confidence intervals, accounting for survey weight and cluster variation. Results: The prevalence of SFU was 79.0%. The neonatal, infant and under-five child mortality rates were 26, 45, and 49 per 1,000 live births, respectively. The risks of infant (aRR 2.02; 95% CI: 1.01-4.05) and under-five mortality (aRR 2.16; 95% CI: 1.07-4.36) mortality were higher among children from households with SFU compared to children from households using clean fuel. When applying an augmented measure of exposure to HAP by incorporating SFU and the kitchen's location, the likelihoods of infant and under-five mortality were even higher among moderate and highly exposed children than unexposed children with similar trends. Neonatal mortality was not associated with either HAP exposure or levels of exposure to HAP.Conclusion: Infants and under-five children are at higher risk of mortality from exposure to HAP. Increasing access to cookstoves and clean fuels is imperative to reduce the risk of infant and under-five child mortality in LMICs, including Myanmar.


2020 ◽  
Author(s):  
Zemenu Tessema Tadesse

Abstract Background Besides, the presence of national law, the country has to set up its own mid-term and long term goals to bring about a significant reduction in child marriages in Ethiopia. To achieve this, determining the spatial pattern of early marriage and factors associated is important for government, other concerned bodies, program implementers and policy developers to end up early childhood marriage. Thus, the aim of this study was to assess the spatial patterns and associated factors of Early marriage among reproductive-age women in Ethiopia. Methods This study analyzed retrospectively a cross-sectional data on a weighted sample of 11,646 women aged 15-49 years after requesting from Ethiopian Demographic and Health Survey 2016 via the link www.measuredhs.com . ArcGIS version 10.7 software was used to visualize spatial distribution for Early marriage. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant purely spatial clusters for Early marriage in Ethiopia multiple logistic regression analysis was used to identify factors associated with early marriage. Finally, variables with a p-value<0.05 were considered as statistically significant. Results In this analysis, about 62.8% (95%CI: 61.9, 63.74%) of the study participants were married before they reached 18 years. The overall median age at first marriage was 17.1 with IQR 5 years. The high clustering of early marriage was located in Amhara, Afar, and Gambella Regions. In spatial Scan statistics 87 clusters (RR = 1.28, P-value < 0.001) significant primary clusters were identified. The associated factors of early marriage were lesser among women’s attending primary (AOR=0.60; 95%CI: 0.51, 0.71), secondary (AOR=0.19; 95%CI: 0.13, 0.26) and tertiary education (AOR=0.11; 95%CI: 0.07, 0.18). Similarly, women found in Addis Ababa were at a lesser risk of early marriage compared to other regions of the country. Conclusion Marriage below age 18 was high in Ethiopia. High-risk area of early marriage was located in Amhara, Afar, and Gambella and special attention should be given for identified risk areas. Therefore, providing educational opportunities to young girls was important in addition to inhibiting the marriage of girls under 18 years.


2020 ◽  
Author(s):  
Asmamaw Atnafu ◽  
Malede Mequanent Sisay ◽  
Getu Debalkie Demissie ◽  
Zemenu Tadesse Tessema

Abstract Background: Childhood diarrheal illness is the second leading cause of child mortality in Sub Saharan Africa, including Ethiopia. Studies hypothesized that there are regional variations. Thus, the study aimed to examine the spatial variations and to identify the determinants of childhood diarrhea in Ethiopia. Methods: Data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was analyzed. This nationwide survey involved 10,337 children below 5 years old. The survey was carried out using a two-stage stratified sampling design. Moran’s I and LISA were used to detect the spatial clustering of diarrhea cases and to test for clustering in the data. Descriptive statistics followed by a mixed-effect logistic regression was used to identify the factors associated with the prevalence of diarrhea. Results: Overall, 11.87% of children were experienced childhood diarrheal illness. The study reveals high-risk areas were Southern and central Ethiopia, while eastern and west were indicated as low-risk regions. Younger children were more likely to suffer from childhood diarrhea than their older counterparts: age 6 to 12, 12 to 23, and 24 to 35 months were (AOR = 2.66, (95% CI 2.01, 3.52)), (AOR = 2.45, (95% CI 1.89, 3.17)), and (AOR = 1.53, (95% CI 1.17, 2.01)), respectively. Children living in Tigray (AOR= 1.69 (95% CI, 1.01, 2.83)), Amhara (AOR = 1.80, (95% CI, 1.06, 3.06), SNNPR (AOR = 2.04, 95% CI 1.22, 3.42), and Gambela (AOR = 2.05, (95% CI 1.22, 3.42)), faced greater risk than Addis Ababa city. The odds of getting diarrhea is decreased by 24% among households having ≥3 under-five children as compared to households having only one under-five child (AOR = 0.76 (95% CI: 0.61, 0.94)). The odds of children getting diarrheal illness among working mothers increase by 19% as compared to not working (AOR = 1.19 (95% CI 1.03, 1.38)). Conclusions: childhood diarrheal illness is highly prevalent among under-five children, particularly in SNNP, Gambella, Oromia, and Benishangul Gumuz regions. Capacity building programs with best experience sharing and better household environment may prove effective in reducing the incidence of childhood diarrhea in Ethiopia. Keywords: Spatial statistics, Ethiopia, under-five children, Diarrhea, Generalized Mixed Model


Author(s):  
Pramesh Ghimire ◽  
Kingsley Agho ◽  
Osita Ezeh ◽  
Andre Renzaho ◽  
Michael Dibley ◽  
...  

Child mortality in Nepal has reduced, but the rate is still above the Sustainable Development Goal target of 20 deaths per 1000 live births. This study aimed to identify common factors associated with under-five mortality in Nepal. Survival information of 16,802 most recent singleton live births from the Nepal Demographic and Health Survey for the period (2001–2016) were utilized. Survey-based Cox proportional hazard models were used to examine factors associated with under-five mortality. Multivariable analyses revealed the most common factors associated with mortality across all age subgroups included: mothers who reported previous death of a child [adjusted hazard ratio (aHR) 17.33, 95% confidence interval (CI) 11.44, 26.26 for neonatal; aHR 13.05, 95% CI 7.19, 23.67 for post-neonatal; aHR 15.90, 95% CI 11.38, 22.22 for infant; aHR 16.98, 95% CI 6.19, 46.58 for child; and aHR 15.97, 95% CI 11.64, 21.92 for under-five mortality]; nonuse of tetanus toxoids (TT) vaccinations during pregnancy (aHR 2.28, 95% CI 1.68, 3.09 for neonatal; aHR 1.86, 95% CI 1.24, 2.79 for post-neonatal; aHR 2.44, 95% CI 1.89, 3.15 for infant; aHR 2.93, 95% CI 1.51, 5.69 for child; and aHR 2.39, 95% CI 1.89, 3.01 for under-five mortality); and nonuse of contraceptives among mothers (aHR 1.69, 95% CI 1.21, 2.37 for neonatal; aHR 2.69, 95% CI 1.67, 4.32 for post-neonatal; aHR 2.01, 95% CI 1.53, 2.64 for infant; aHR 2.47, 95% CI 1.30, 4.71 for child; and aHR 2.03, 95% CI 1.57, 2.62 for under-five mortality). Family planning intervention as well as promotion of universal coverage of at least two doses of TT vaccine are essential to help achieve child survival Sustainable Development Goal (SDG) targets of <20 under-five deaths and <12 neonatal deaths per 1000 births by the year 2030.


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