Geographical variations of early age sexual initiation among reproductive-age women in Ethiopia: evidence from EDHS 2016

Abstract Abstract Background : The early age of sexual initiation will contribute a lot for various risks such as mistimed pregnancy followed by insecure termination, developing fistula and contracting sexually transmitted infections which are currently the major public health concerns, particularly for low-income countries. Therefore, the purpose of this study was to detect spatial clusters and identify factors associated with an early age sexual initiation of women in the reproductive age group. Methods : We used a population-based nationwide representative Ethiopian demographic and health survey 2016 data for this analysis. A total of 12,033 respondents of reproductive age (15–49 years) who had at least one event of sexual initiation was retrieved and included for the analysis. Spatial cluster detection and autocorrelation analysis were also done to explore the patterns of early age sexual initiation. Results : The median age at first sexual intercourse among respondents was 16 (±3.3) years and more than half (66.2%), had their first intercourse before the age of 18 years. The spatial variations of the age of sexual initiation was nonrandom and clustered with a Moran's I = 0.413 (P-value < 0.001). In addition, five significant spatial clusters were also identified. Moreover, the probability of starting sex at an earlier age was associated with the respondent’s residence, marital status, educational attainment and wealth index. Conclusion : This study found a higher proportion of an early age sexual initiation of women. Socio-demographic variables were also significantly associated with early sexual initiation. The SaTScan analysis identified five statistical significant spatial clusters which indicate that there were geographical variations. Therefore, targeted and integrated interventions focusing on the identified high spot clustered areas are recommended to reduce early age sexual initiation. Keywords : Early sexual initiation, geographical variations, Ethiopia

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Geographical variations of early age sexual initiation among reproductive-age women in Ethiopia: Evidence from EDHS 2016

10.21203/rs.2.18827/v2 ◽

2020 ◽

Author(s):

Araya Mesfin Nigatu ◽

Abraham Yeneneh Birhanu ◽

Berhanu Fikadie Endehabtu

Keyword(s):

Low Income ◽

Wealth Index ◽

Sexual Initiation ◽

Reproductive Age ◽

Low Income Countries ◽

P Value ◽

Early Age ◽

Spatial Clusters ◽

Geographical Variations ◽

Early Sexual Initiation

Abstract Background : The early age of sexual initiation will contribute a lot for various risks such as mistimed pregnancy followed by insecure termination, developing fistula and contracting sexually transmitted infections which are currently the major public health concerns, particularly for low-income countries. Therefore, the purpose of this study was to detect spatial clusters and identify factors associated with an early age sexual initiation of women in the reproductive age group. Methods : We used a population-based nationwide representative Ethiopian demographic and health survey 2016 data for this analysis. A total of 12,033 respondents of reproductive age (15–49 years) who had at least one event of sexual initiation was retrieved and included for the analysis. Spatial cluster detection and autocorrelation analysis were also done to explore the patterns of early age sexual initiation. Results : The median age at first sexual intercourse among respondents was 16 (±3.3) years and more than half (66.2%), had their first intercourse before the age of 18 years. The spatial variations of the age of sexual initiation was nonrandom and clustered with a Moran's I = 0.413 (P-value < 0.001). In addition, five significant spatial clusters were also identified. Moreover, the probability of starting sex at an earlier age was associated with the respondent’s residence, marital status, educational attainment and wealth index. Conclusion : This study found a higher proportion of an early age sexual initiation of women. Socio-demographic variables were also significantly associated with early sexual initiation. The SaTScan analysis identified five statistical significant spatial clusters which indicate that there were geographical variations. Therefore, targeted and integrated interventions focusing on the identified high spot clustered areas are recommended to reduce early age sexual initiation. Keywords : Early sexual initiation, geographical variations, Ethiopia

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Time to first birth and its predictors among reproductive-age women in Ethiopia: inverse Weibull gamma shared frailty model

BMC Women s Health ◽

10.1186/s12905-021-01254-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Reta Dewau ◽

Fantahun Ayenew Mekonnen ◽

Wullo Sisay Seretew

Keyword(s):

Frailty Model ◽

Education Level ◽

Reproductive Age ◽

Early Age ◽

Age Difference ◽

Age At First Birth ◽

First Birth ◽

Reproductive Age Women ◽

Shared Frailty Model ◽

Shared Frailty

Abstract Background High maternal and child death with high fertility rate have been reported in Ethiopia. Extreme age at first birth is linked with both maternal and child morbidity and mortality. However, literatures showed there were limited studies on the timing of the first birth and its predictors in the area so far. Therefore, determining the time to first birth and its predictors will help to design strategies to improve maternal and child survival. Methods A community-based cross-sectional study was conducted among reproductive-age women in Ethiopia using the Ethiopian demographic health survey, 2016 data. Stratified two-stage cluster sampling technique was used for sampling. The Kaplan–Meier method was used to estimate time to first birth. Inverse Weibull gamma shared frailty model applied to model the data at 95% confidence interval (CI), adjusted hazard ratio (AHR) and median hazard ratio (MHR) were reported as effect size. Proportional hazard assumption checked using Schoenfeld residual test. Information Criteria were applied to select a parsimonious model. Stratified analysis performed for the interaction terms and statistical significance was declared at p value < 0.05. Results The overall median age at first birth was found to be 20 years (IQR, 16–24 years). The independent predictors of time to first birth were: married 15–17 years (AHR = 2.33, 95% CI 2.08–2.63), secondary education level (AHR = 0.84, 95% CI 0.78–0.96), higher education level (AHR = 0.75, 95% CI 0.65–0.85), intercourse before 15 years in the married stratum (AHR = 23.81, 95% CI 22.22–25.64), intercourse 15–17 years in married stratum (AHR = 5.56, 95% CI 5.26–5.88), spousal age difference (AHR = 1.11, 95% CI 1.05–1.16),and use of contraceptives (AHR = 0.91, 95% CI 0.86–0.97). The median increase in the hazard of early childbirth in a cluster with higher early childbirth is 16% (MHR = 1.16, 95% CI 1.13–1.20) than low risk clusters adjusting for other factors. Conclusion In this study, first birth was found to be at an early age. Early age at first marriage, at first sexual intercourse and their interaction, high spousal age difference, being Muslim were found to increase early motherhood. Conversely, living in the most urban region, secondary and higher women education were identified to delay the first birth. Investing on women education and protecting them from early marriage is required to optimize time to first birth. The contextual differences in time to first birth are an important finding which requires more study and interventions.

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Determinant of Early Age Sexual Initiation: Associated Factors Among Rural Women in Ethiopia: Evidence From EDHS 2016.

10.21203/rs.3.rs-578274/v1 ◽

2021 ◽

Author(s):

Solomon Sisay Mulugeta ◽

Shewayiref Geremew Gebremichael

Keyword(s):

Sexual Intercourse ◽

Rural Women ◽

Multivariable Analysis ◽

Sexual Initiation ◽

Reproductive Age ◽

Early Age ◽

Age At First Birth ◽

Aids Awareness ◽

Geopolitical Region ◽

Significant Factors

Abstract Background: The aim of this study was to examine the determinant factors on early age sexual intercourse among rural women in Ethiopia.Methods: This study contains further analysis of the Ethiopian Demographic and Health Survey (EDHS) 2016 dataset. A total of 8001 participants of under reproductive age (15–49 years) women, who had at least one set of sexual intercourse, were involved in the analysis. The binary logistic multivariable analysis result was obtained by STATA-14 software. Results: Among the rural women in Ethiopia, more than half (59.6%) of women was experienced sexual intercourse at early age. The higher proportion of experiencing early age sexual initiation among rural women was found in Amhara (18.63%) region. Age of women [(OR= 0.374;95%CI:0.301-0.465) of 20-24 years, (OR= 0.44;95%CI:0.36-0.54) of 25-49 years], geopolitical region [Amhara (OR=1.514; 95%CI:1.25–1.83), Oromia (OR=0.74; 95%CI:0.64-0.905), Somali(OR=0.47; 95% CI: 0.364-0.658), SNNPR (OR= 0.5; 95% CI: 1.13–1.81), and Dire Dawa (OR=0.68; 95% CI: 0.49-0.941)]; women age at first birth (OR=0.3; 95% CI: 0.11-0.5) of greater than 18 years old; HIV/AIDS awareness (OR=0.4; 95% CI: 0.183-1.604, had awareness); chat chewing(OR=1.23; 95% CI:1.03-1.47); willingness at first sex (OR=2.51; 95% CI: 1.22-3.8, by force); marital status [married women (OR=2.52; 95% CI:1.69-3.75); divorced/separated women(OR=2.39; 95% CI: 1.58-3.63)]; and educational attainment [secondary school and above completed (OR= 0.231; 95% CI: 0.183-0.291) and primary level of education (OR= 0.67; 95% CI: 0.06-0.76)] were examined as statistically significant factors.Conclusion: The commencement of early age sexual initiation among reproductive-age women was high. This study suggests that continued programmatic and policy initiatives should be directed to improve adolescent’s overall situation as a means of improving their sexual health.

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Time to first birth and its Predictors among reproductive-age women in Ethiopia: inverse Weibull gamma shared frailty model

10.21203/rs.3.rs-24244/v1 ◽

2020 ◽

Author(s):

Reta Dewau Yimer ◽

Fantahun Ayenew Mekonnen ◽

Wullo Sisay Seretew

Keyword(s):

Frailty Model ◽

Reproductive Age ◽

Early Age ◽

Age Difference ◽

Age At First Birth ◽

First Birth ◽

Interaction Terms ◽

Reproductive Age Women ◽

Shared Frailty Model ◽

Shared Frailty

Abstract Background: High maternal and child death with high fertility rate have been reported in Ethiopia. Extreme age at first birth is linked with both maternal and child morbidity and mortality. However, literatures showed there are limited studies on timing of first birth and its predictors in the area so far. Therefore, determining time to first birth and its predictors will help to design strategies to improve maternal and child survival. Methods: A survey-based study was conducted among reproductive-age women in Ethiopia using Ethiopian demographic health survey (EDHS), 2016 data. Stratified two-stage cluster sampling technique was used for sampling. The Kaplan-Meier (KM) method was used to estimate time to first birth. Inverse Weibull gamma shared frailty model applied to model the data at 95% confidence interval (CI), adjusted hazard ratio (AHR) and median hazard ratio (MHR) were reported as effect size. Proportional hazard assumption checked using Schoenfeld residual test. Information Criteria was applied to select parsimonious model. Stratified analysis performed for interaction terms and statistical significance declared at p value<0.05. Results: The overall median age at first birth found to be 20 years (IQR, 16-24years). The independent predictors of time to first birth were: marriage 15-17 years (AHR=2.33,95% CI:2.08-2.63),secondary education level (AHR=0.84,95% CI:0.78-0.96), higher education level (AHR=0.75, 95% CI:0.65-0.85), intercourse before 15 years in the married stratum (AHR=23.81, 95% CI:22.22-25.64), intercourse 15-17 years in married stratum (AHR=5.56, 95% CI:5.26-5.88),spousal age difference (AHR=1.11, 95% CI :1.05-1.16),and use of contraceptives (AHR=0.91, 95% CI [0.86-0.97]). The median increase in the hazard of early childbirth at a cluster with higher early childbirth is 16% (MHR=1.16, 95% CI [1.13-1.20]) than low risk clusters.Conclusion: In this study, first birth found to be at an early age. Early age at first marriage, at first sexual intercourse and their interaction terms, high spousal age difference, being Muslim were found to increase early motherhood. Conversely, living in most urban region, secondary and higher women education were identified to delay first birth. Investing on women education and protecting them from early marriage are required to optimize time to first birth. The contextual differences in time to first birth are a novel finding which requires more study and interventions.

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Time to first birth and its Predictors among reproductive-age women in Ethiopia: inverse Weibull gamma shared frailty model

10.21203/rs.3.rs-24244/v2 ◽

2020 ◽

Author(s):

Reta Dewau ◽

Fantahun Ayenew Mekonnen ◽

Wullo Sisay Seretew

Keyword(s):

Frailty Model ◽

Education Level ◽

Reproductive Age ◽

Early Age ◽

Age Difference ◽

Age At First Birth ◽

First Birth ◽

Reproductive Age Women ◽

Shared Frailty Model ◽

Shared Frailty

Abstract Background: High maternal and child death with high fertility rate have been reported in Ethiopia. Extreme age at first birth is linked with both maternal and child morbidity and mortality. However, literatures showed there were limited studies on the timing of the first birth and its predictors in the area so far. Therefore, determining the time to first birth and its predictors will help to design strategies to improve maternal and child survival. Methods: A community-based cross-sectional study was conducted among reproductive-age women in Ethiopia using the Ethiopian demographic health survey (EDHS), 2016 data. Stratified two-stage cluster sampling technique was used for sampling. The Kaplan-Meier (KM) method was used to estimate time to first birth. Inverse Weibull gamma shared frailty model applied to model the data at 95% confidence interval (CI), adjusted hazard ratio (AHR) and median hazard ratio (MHR) were reported as effect size. Proportional hazard assumption checked using Schoenfeld residual test. Information Criteria were applied to select a parsimonious model. Stratified analysis performed for the interaction terms and statistical significance was declared at p value<0.05. Results: The overall median age at first birth was found to be 20 years (IQR, 16-24 years). The independent predictors of time to first birth were: married 15-17 years (AHR=2.33,95% CI:2.08-2.63),secondary education level (AHR=0.84,95% CI:0.78-0.96), higher education level (AHR=0.75, 95% CI:0.65-0.85), intercourse before 15 years in the married stratum (AHR=23.81, 95% CI:22.22-25.64), intercourse 15-17 years in married stratum (AHR=5.56, 95% CI:5.26-5.88),spousal age difference (AHR=1.11, 95% CI:1.05-1.16),and use of contraceptives (AHR=0.91, 95% CI: 0.86-0.97). The median increase in the hazard of early childbirth in a cluster with higher early childbirth is 16% (MHR=1.16, 95% CI: 1.13-1.20) than low risk clusters adjusting for other factors.Conclusion:In this study, first birth was found to be at an early age. Early age at first marriage, at first sexual intercourse and their interaction, high spousal age difference, being Muslim were found to increase early motherhood. Conversely, living in the most urban region, secondary and higher women education were identified to delay the first birth. Investing on women education and protecting them from early marriage is required to optimize time to first birth. The contextual differences in time to first birth are an important finding which requires more study and interventions.

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