scholarly journals Individual and community-level determinants of poor tetanus toxoid immunization among pregnant women in Ethiopia using data from 2016 Ethiopian demographic and health survey; multilevel analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Alemneh Mekuriaw Liyew ◽  
Hiwotie Getaneh Ayalew
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Tetanus Toxoid ◽  
Logistic Regression Model ◽  
Community Level ◽  
Multilevel Logistic Regression ◽  
Care Visit ◽  
Multilevel Logistic Regression Model ◽  
Tetanus Toxoid Immunization

Abstract Background Tetanus is a vaccine-preventable disease that can occur in all populations, with neonates and pregnant women being at the most risk. Ethiopia has the highest maternal and neonatal tetanus morbidity and mortality rates. Besides, only 49% of mothers get vaccinated with adequate tetanus toxoid in Ethiopia which is below the world health organization recommendation. To date, there is limited evidence on the individual and community level determinants of poor tetanus toxoid (TT) immunization. Therefore, this study aimed to assess individual and community-level factors associated with poor TT immunization coverage in Ethiopia. Method Secondary data analysis was conducted using the 2016 Ethiopian demographic and health survey. A total of 7043 pregnant women were included in the current study. A multilevel logistic regression model was used to identify individual and community level determinants of poor tetanus toxoid immunization. Finally, the adjusted odds ratio with a 95% confidence interval was reported. Results In the multilevel logistic regression model adjustment, having no Antenatal care visit (AOR = 5.64; 95% CI:2.48,7.30) and having one to three antenatal care visit (AOR = 1.50; 95% CI: 1.19–1.82); poor wealth index (AOR = 1.26; 95% CI: 1.03, 1.54); not being exposed to media (AOR = 1.29; 95% CI: 1.10, 1.51); maternal unemployment (AOR = 1.15; 95% CI: 1.10, 1.31); rural residence (AOR = 1.13; 95% CI: 1.08, 1.72); and high community illiteracy (AOR = 1.28; 95% CI: 1.03, 1.58) were associated with higher odds of poor tetanus toxoid immunization. Whereas, iron uptake during pregnancy (AOR = 0.59; 95% CI: 0.51, 0.68), was associated with lower odds of poor tetanus toxoid immunization. Conclusion In this study tetanus toxoid (TT) vaccine utilization was affected by both community and individual-level factors. Therefore, focusing on antenatal care services especially encouraging pregnant women to have at least four visits, consulting women to be exposed to media, improving community literacy and maternal employment will help to minimize TT underutilization.

scholarly journals Determinants of utilization of antenatal and delivery care at the community level in rural Bangladesh

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257782
Author(s):  
Jesmin Pervin ◽  
Mahima Venkateswaran ◽  
U. Tin Nu ◽  
Monjur Rahman ◽  
Brian F. O’Donnell ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Facility Delivery ◽  
Health Facilities ◽  
Community Level ◽  
Delivery Care ◽  
Multivariate Logistic Regression ◽  
Antenatal Care Visit ◽  
Care Visit

Background Timely utilization of antenatal care and delivery services supports the health of mothers and babies. Few studies exist on the utilization and determinants of timely ANC and use of different types of health facilities at the community level in Bangladesh. This study aims to assess the utilization, timeliness of, and socio-demographic determinants of antenatal and delivery care services in two sub-districts in Bangladesh. Methods This cross-sectional study used data collected through a structured questionnaire in the eRegMat cluster-randomized controlled trial, which enrolled pregnant women between October 2018-June 2020. We undertook univariate and multivariate logistic regression analysis to determine the associations of socio-demographic variables with timely first ANC, four timely ANC visits, and facility delivery. We considered the associations in the multivariate logistic regression as statistically significant if the p-value was found to be <0.05. Results are presented as adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results Data were available on 3293 pregnant women. Attendance at a timely first antenatal care visit was 59%. Uptake of four timely antenatal care visits was 4.2%. About three-fourths of the women delivered in a health facility. Women from all socio-economic groups gradually shifted from using public health facilities to private hospitals as the pregnancy advanced. Timely first antenatal care visit was associated with: women over 30 years of age (AOR: 1.52, 95% CI: 1.05–2.19); nulliparity (AOR: 1.30, 95% CI: 1.04–1.62); husbands with >10 years of education (AOR: 1.40, 95% CI: 1.09–1.81) and being in the highest wealth quintile (AOR: 1.49, 95% CI: 1.18–1.89). Facility deliveries were associated with woman’s age; parity; education; the husband’s education, and wealth index. None of the available socio-demographic factors were associated with four timely antenatal care visits. Conclusions The study observed socio-demographic inequalities associated with increased utilization of timely first antenatal care visit and facility delivery. The pregnant women, irrespective of wealth shifted from public to private facilities for their antenatal care visits and delivery. To increase the health service utilization and promote good health, maternal health care programs should pay particular attention to young, multiparous women, of low socio-economic status, or with poorly educated husbands. Clinical trial registration ISRCTN69491836; https://www.isrctn.com/. Registered on December 06, 2018. Retrospectively registered.

Household means of transportation and place of child delivery in Nigeria

2020 ◽  
Author(s):  
Lukman Bola Solanke ◽  
Omolayo Bukola Oluwatope ◽  
Yinusa Rasheed Adebayo ◽  
Olaoye James Oyeleye ◽  
Benjamin Bukky Ilesanmi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Pregnant Women ◽  
Logistic Regression Model ◽  
Institutional Delivery ◽  
Multilevel Logistic Regression ◽  
Place Of Delivery ◽  
Pooled Data ◽  
Support Programme ◽  
Mode Of Transport ◽  
Multilevel Logistic Regression Model

Abstract Background The means of transportation available to pregnant women in households may serve either as a driver or deterrent of institutional delivery. However, how household means of transportation associates with place of delivery has been less explored in Nigeria. Methods This study was based on pooled data of 2008-2013 Nigeria Demographic and Health Survey. The study analysed a weighted sample size of 6,540 women. The multilevel logistic regression model was applied using STATA 14. Results The study revealed 37% institutional delivery among women in Nigeria. Women whose household mode of transport were cars were twice more likely to have institutional delivery compared to women who had no viable household means of transportation (AOR=2.044, p<0.01; CI=1.781-2.345). Women who live in communities with high proportions of households with no means of transportation were 12.8% less likely to have institutional delivery (AOR=0.872, p=0.01; CI: 0.788-0.967). Women who live in communities with high proportions of household who owned motorcycle compared to those in communities with low proportion were 31.9% more likely to have institutional delivery (AOR=1.319, p<0.05; CI: 1.071-1.625). Women who live in communities with high proportions of households who owned cars compared to those in communities with low proportion were more than three times more likely to have institutional delivery (AOR=3.146, p<0.01; CI: 2.621-3.777).Conclusion Means of transportation significantly explains choice of place of child delivery in urban Nigeria. A public-private transport support programme to reduce transportation burden among pregnant women is imperative in the country.

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 A One Health perspective to identify environmental factors that affect Rift Valley fever transmission in Gezira state, Central Sudan

2019 ◽  
Vol 47 (1) ◽  
Author(s):  
Rania Salah Eldien Bashir ◽  
Osama Ahmed Hassan
Keyword(s):  
Remote Sensing ◽  
Logistic Regression ◽  
Environmental Factors ◽  
Soil Type ◽  
Rift Valley ◽  
Rift Valley Fever ◽  
Logistic Regression Model ◽  
Multilevel Logistic Regression ◽  
Valley Fever ◽  
Multilevel Logistic Regression Model

Abstract Background Rift Valley fever (RVF) is a zoonotic viral vector-borne disease that affects both animals and humans and leads to severe economic consequences. RVF outbreaks are triggered by a favorable environment and flooding, which enable mosquitoes to proliferate and spread the virus further. RVF is endemic to Africa and has spread to Saudi Arabia and Yemen. There is great concern that RVF may spread to previously unaffected geographic regions due to climate change. We aimed to better understand the spatiotemporal pattern of the 2007 RVF outbreak at the human–animal–environment interface and to determine environmental factors that may have effects on RVF occurrence in Gezira state, Sudan. Materials and methods We compiled epidemiological, environmental, and spatiotemporal data across time and space using remote sensing and a geographical information system (GIS). The epidemiological data included 430 RVF human cases as well as human and animal population demographic data for each locality. The cases were collected from 41 locations in Gezira state. The environmental data represent classified land cover during 2007, the year of the RVF outbreak, and the average of the Normalized Difference Vegetation Index (NDVI) for 6 months of 2007 is compared with those of 2010 and 2014, when there was no RVF outbreak. To determine the effect of the environmental factors such as NDVI, soil type, and RVF case’s location on the Blue Nile riverbank on RVF incidence in Gezira state, a multilevel logistic regression model was carried out. Results We found that the outbreak in Gezira state occurred as a result of interaction among animals, humans, and the environment. The multilevel logistic regression model (F = 43,858, df = 3, p = 0.000) explained 23% of the variance in RVF incidence due to the explanatory variables. Notably, soil type (β = 0.613, t = 11.284, p = 0.000) and NDVI (β = − 0.165, t = − 3.254, p = 0.001) were the explanatory environmental factors that had significant effects on RVF incidence in 2007 in Gezira state, Sudan. Conclusions Precise remote sensing and the GIS technique, which rely on environmental indices such as NDVI and soil type that are satellite-derived, can contribute to establishing an early warning system for RVF in Sudan. Future preparedness and strengthening the capacity of regional laboratories are necessary for early notification of outbreaks in animals and humans.

scholarly journals Determinants of Contraceptive Practice in Oman by Using Multilevel Modeling

2015 ◽  
Vol 20 (1) ◽  
pp. 83 ◽  
Author(s):  
Moza S. Al-Balushi ◽  
Mohammed S. Ahmed ◽  
M. Mazharul Islam
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Regional Variation ◽  
Regression Models ◽  
Logistic Regression Model ◽  
Contraceptive Use ◽  
Multilevel Logistic Regression ◽  
Logistic Regression Models ◽  
Living Children ◽  
Multilevel Logistic Regression Model

In this paper, multilevel logistic regression models are developed for examining the hierarchical effects of contraceptive use and its selected determinants in Oman using the 2008 Oman National Reproductive Health Survey (ONRHS). Comparison between single level and multilevel logistic regression models has been made to examine the plausibility of multilevel effects of contraceptive use. From the multilevel logistic regression model analysis, it was found that there is real multilevel variation among contraceptive users in Oman. The results indicate that a multilevel logistic regression model is the best fit over ordinary multiple logistic regression models. Generally, this study revealed that women’s age, education, number of living children and region of residence are important factors that affect contraceptive use in Oman. The effect of regional variation for age of women, education of women and number of living children further implies that there exists considerable differences in modern contraceptive use among regions, and a model with a random coefficient or slope is more appropriate to explain the regional variation than a model with fixed coefficients or without random effects. The study suggests that researchers should use multilevel models rather than traditional regression methods when their data structure is hierarchal.  

scholarly journals Individual and community-level predictors of maternal alcohol consumption during pregnancy in Gondar town, Northwest Ethiopia: a multilevel logistic regression analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alemu Earsido Addila ◽  
Telake Azale ◽  
Yigzaw Kebede Gete ◽  
Mezgebu Yitayal
Keyword(s):  
Logistic Regression ◽  
Alcohol Consumption ◽  
Pregnant Women ◽  
Northwest Ethiopia ◽  
Community Level ◽  
Multilevel Logistic Regression ◽  
Community Based ◽  
Maternal Alcohol ◽  
Maternal Alcohol Consumption ◽  
Gondar Town

Abstract Background Prenatal alcohol consumption is a serious public health concern that is considered as one of the preventable risk factors for neonatal and childhood morbidity and several adverse pregnancy outcomes. This study aimed to determine the individual- and community-level predictors of maternal alcohol consumption during pregnancy in Gondar town, Northwest Ethiopia. Methods A community-based cross-sectional study was conducted among pregnant women in Gondar town from 13 June to 24 August 2019. A cluster random sampling technique was used to select 1237 pregnant women. Data collection was carried out using the AUDIT-C pretested standard questionnaire. Bivariable and multivariable multilevel logistic regression analyses were computed to identify predictors of alcohol consumption using the odds ratio, 95% CI, and p-value < 0.05. Results The prevalence of alcohol consumption during pregnancy was found to be 30.26% (95% CI: 27.74%, 32.91%). The study revealed that pregnant women who have a low knowledge level on harmful effect of alcohol consumption (AOR = 3.2; 95% CI: 1.9, 5.4), positive attitude towards alcohol consumption (AOR = 7.5; 95% 5, 11), history of pre-pregnancy alcohol consumption (AOR = 4.8; 95% CI: 3.4, 6.9), whose partner consume alcohol (AOR = 3.9; 95% CI: 2.5, 6), a perception that alcohol consumption is culturally or socially acceptable (AOR = 3.6; 95% CI: 2.4, 5.3), who were encouraged by their partners to consume alcohol (AOR = 4; 95% CI: 1.9, 8) were significantly associated with pregnancy alcohol consumption. Concerning the community-level characteristics, who had not ever heard/media exposure about the risk of alcohol drinking during pregnancy (AOR = 3; 95% CI: 1.7, 5.5), and who were from low community women’s education attainment (AOR = 4; 95% CI: 2.2, 7.7) were statistically significant predictors of alcohol consumption during pregnancy. Conclusions The study revealed that alcohol consumption during pregnancy is prevalent in Gondar town. Both individual- and community-level predictors were found to be associated with alcohol consumption during pregnancy. Policymakers may take into account these predictors for individual and community-based interventions to which our results appear to point.

scholarly journals Use of mobile phone for improvement in maternal health: a randomized control trial

2017 ◽  
Vol 6 (12) ◽  
pp. 5458 ◽  
Author(s):  
Vidyadhar B. Bangal ◽  
Sai K. Borawake ◽  
Satyajit P. Gavhane ◽  
Kunal H. Aher
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Mobile Phone ◽  
Pregnant Women ◽  
Tetanus Toxoid ◽  
Postnatal Care ◽  
Intervention Group ◽  
Randomized Control ◽  
Antenatal Visits ◽  
Tetanus Toxoid Immunization

Background: The rapid escalation of cellular network coverage and expansion of mobile phone usage has opened up a new way of deploying health services. The mobile app with message facilities help in imparting health education regarding nutrition, iron and folic acid prophylaxis, tetanus toxoid immunization, danger symptoms and signs during pregnancy etc. Present study aimed to improve maternal health and pregnancy outcome by optimum utilization of antenatal, natal and postnatal care services, with the use of mobile phone as a medium of communication between health care provider and community in rural area.Methods: The prospective randomized control study, with two hundred pregnant women each, coming for antenatal visit and having personal mobile phone facility, were randomly allocated to control and intervention group. Control group women received routine antenatal care and advice as per hospital protocol. In addition to routine care and advice, intervention group received mobile phone calls, as reminders about next visit and text messages (SMS) on important aspects of antenatal care at regular intervals. The primary outcome indicators of the study were percentage of pregnant women coming for at least four antenatal visits, percentage of institutional delivery and postnatal check-ups.Results: Women in the intervention group had significantly higher number of antenatal visits, consumption of iron tablets, tetanus toxoid immunization, institutional deliveries and postnatal check-ups as compared to the control group.Conclusions: In the present study, the mobile phone intervention, significantly increased the percentage of women receiving the recommended four antenatal visits and showed a trend towards more women receiving preventive health services. Study gathered good evidence that m-Health tools present an opportunity to influence behaviour change and ensure that women access prevention services, including antenatal, natal and postnatal care. Mobile technology, specifically SMS can be successfully used to extend health information services to pregnant women.

scholarly journals Perinatal mortality and its association with antenatal care visit, maternal tetanus toxoid immunization and partograph utilization in Ethiopia: a meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Melaku Desta ◽  
Tadesse Yirga Akalu ◽  
Yoseph Merkeb Alamneh ◽  
Asmare Talie ◽  
Addisu Alehegn Alemu ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Perinatal Mortality ◽  
Tetanus Toxoid ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Previous History ◽  
Major Public Health Problem ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Tetanus Toxoid Immunization

AbstractDespite remarkable progress in the reduction of under-five mortality; perinatal mortality is the major public health problem in Africa. In Ethiopia, the study findings on perinatal mortality and its predictors were inconsistent. Therefore, this systematic review and meta-analysis estimated the pooled perinatal mortality, and its association with antenatal care visit, maternal tetanus toxoid immunization, and partograph monitoring. International databases like PubMed, SCOPUS, Google Scholar and Science Direct were systematically searched. I squared statistics was used to determine the levels of heterogeneity across studies and the pooled estimate was computed using a random-effect model. The meta-analysis showed that a pooled prevalence of perinatal mortality in Ethiopia was 6.00% (95% CI 5.00%, 7.00%). The highest proportion of perinatal mortality was a stillbirth, 5.00% (95% CI 4.00%, 7.00%). Women who had antenatal care visit [OR = 0.20 (95% CI 0.12, 0.34)], maternal tetanus toxoid immunization [OR = 0.43 (95% CI 0.24, 0.77)] and partograph monitoring [POR = 0.22 (95% CI 0.06, 0.76)] reduced the risk of perinatal mortality. Whereas, previous history of perinatal mortality [POR = 7.95 (95% CI 5.59, 11.30)] and abortion history (POR = 2.02 (95% CI 1.18, 3.46)) significantly increased the risk of perinatal mortality. Therefore, antenatal care visit, maternal tetanus toxoid vaccination uptake, and partograph utilization should be an area of improvements to reduce perinatal mortality.

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