Spatial pattern of perinatal mortality and its determinants in Ethiopia: Data from Ethiopian Demographic and Health Survey 2016

Background The perinatal mortality rate in Ethiopia is among the highest in Sub Saharan Africa. The aim of this study was to identify the spatial patterns and determinants of perinatal mortality in the country using a national representative 2016 Ethiopia Demographic and Health Survey (EDHS) data. Methods The analysis was completed utilizing data from 2016 Ethiopian Demographic and Health Survey. This data captured the information of 5 years preceding the survey period. A total of 7230 women who at delivered at seven or more months gestational age nested within 622 enumeration areas (EAs) were used. Statistical analysis was performed by using STATA version 14.1, by considering the hierarchical nature of the data. Multilevel logistic regression models were fitted to identify community and individual-level factors associated with perinatal mortality. ArcGIS version 10.1 was used for spatial analysis. Moran’s, I statistics fitted to identify global autocorrelation and local autocorrelation was identified using SatSCan version 9.6. Results The spatial distribution of perinatal mortality in Ethiopia revealed a clustering pattern. The global Moran’s I value was 0.047 with p-value <0.001. Perinatal mortality was positively associated with the maternal age, being from rural residence, history of terminating a pregnancy, and place of delivery, while negatively associated with partners’ educational level, higher wealth index, longer birth interval, female being head of household and the number of antenatal care (ANC) follow up. Conclusions In Ethiopia, the perinatal mortality is high and had spatial variations across the country. Strengthening partner’s education, family planning for longer birth interval, ANC, and delivery services are essential to reduce perinatal mortality and achieve sustainable development goals in Ethiopia. Disparities in perinatal mortality rates should be addressed alongside efforts to address inequities in maternal and neonatal healthcare services all over the country.

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Geographical variations and associated factors of defaulting from immunization among children aged 12 to 23 months in Ethiopia: using spatial and multilevel analysis of 2016 Ethiopian Demographic and Health Survey

Environmental Health and Preventive Medicine ◽

10.1186/s12199-021-00984-8 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Mukemil Awol ◽

Zewdie Aderaw Alemu ◽

Nurilign Abebe Moges ◽

Kemal Jemal

Keyword(s):

Multilevel Analysis ◽

Health Survey ◽

Associated Factors ◽

Demographic And Health Survey ◽

Community Level ◽

Scan Statistics ◽

Moran’S I ◽

Moran's I ◽

Depth Analysis ◽

Global Moran’S I

Abstract Background In Ethiopia, despite the considerable improvement in immunization coverage, the burden of defaulting from immunization among children is still high with marked variation among regions. However, the geographical variation and contextual factors of defaulting from immunization were poorly understood. Hence, this study aimed to identify the spatial pattern and associated factors of defaulting from immunization. Methods An in-depth analysis of the 2016 Ethiopian Demographic and Health Survey (EDHS 2016) data was used. A total of 1638 children nested in 552 enumeration areas (EAs) were included in the analysis. Global Moran’s I statistic and Bernoulli purely spatial scan statistics were employed to identify geographical patterns and detect spatial clusters of defaulting immunization, respectively. Multilevel logistic regression models were fitted to identify factors associated with defaulting immunization. A p value < 0.05 was used to identify significantly associated factors with defaulting of child immunization. Results A spatial heterogeneity of defaulting from immunization was observed (Global Moran’s I = 0.386379, p value < 0.001), and four significant SaTScan clusters of areas with high defaulting from immunization were detected. The most likely primary SaTScan cluster was seen in the Somali region, and secondary clusters were detected in (Afar, South Nation Nationality of people (SNNP), Oromiya, Amhara, and Gambella) regions. In the final model of the multilevel analysis, individual and community level factors accounted for 56.4% of the variance in the odds of defaulting immunization. Children from mothers who had no formal education (AOR = 4.23; 95% CI: 117, 15.78), and children living in Afar, Oromiya, Somali, SNNP, Gambella, and Harari regions had higher odds of having defaulted immunization from community level. Conclusions A clustered pattern of areas with high default of immunization was observed in Ethiopia. Both the individual and community-level characteristics were statistically significant factors of defaulting immunization. Therefore, the Federal Ethiopian Ministry of Health should prioritize the areas with defaulting of immunization and consider the identified factors for immunization interventions.

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HIV and cardiovascular disease in sub-Saharan Africa: Demographic and Health Survey data for 4 countries

BMC Public Health ◽

10.1186/s12889-021-11218-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Leonard E. Egede ◽

Rebekah J. Walker ◽

Patricia Monroe ◽

Joni S. Williams ◽

Jennifer A. Campbell ◽

...

Keyword(s):

South Africa ◽

Cardiovascular Disease ◽

Health Survey ◽

Survey Design ◽

Logistic Models ◽

Population Data ◽

Demographic And Health Survey ◽

Sub Saharan Africa ◽

Sub Saharan ◽

The Relationship

Abstract Background Investigate the relationship between two common cardiovascular diseases and HIV in adults living in sub-Saharan Africa using population data provided through the Demographic and Health Survey. Methods Data for four sub-Saharan countries were used. All adults asked questions regarding diagnosis of HIV, diabetes, and hypertension were included in the sample totaling 5356 in Lesotho, 3294 in Namibia, 9917 in Senegal, and 1051 in South Africa. Logistic models were run for each country separately, with self-reported diabetes as the first outcome and self-reported hypertension as the second outcome and HIV status as the primary independent variable. Models were adjusted for age, gender, rural/urban residence and BMI. Complex survey design allowed weighting to the population. Results Prevalence of self-reported diabetes ranged from 3.8% in Namibia to 0.5% in Senegal. Prevalence of self-reported hypertension ranged from 22.9% in Namibia to 0.6% in Senegal. In unadjusted models, individuals with HIV in Lesotho were 2 times more likely to have self-reported diabetes (OR = 2.01, 95% CI 1.08–3.73), however the relationship lost significance after adjustment. Individuals with HIV were less likely to have self-reported diabetes after adjustment in Namibia (OR = 0.29, 95% CI 0.12–0.72) and less likely to have self-reported hypertension after adjustment in Lesotho (OR = 0.63, 95% CI 0.47–0.83). Relationships were not significant for Senegal or South Africa. Discussion HIV did not serve as a risk factor for self-reported cardiovascular disease in sub-Saharan Africa during the years included in this study. However, given the growing prevalence of diabetes and hypertension in the region, and the high prevalence of undiagnosed cardiovascular disease, it will be important to continue to track and monitor cardiovascular disease at the population level and in individuals with and without HIV. Conclusions The odds of self-reported diabetes in individuals with HIV was high in Lesotho and low in Namibia, while the odds of self-reported hypertension in individuals with HIV was low across all 4 countries included in this study. Programs are needed to target individuals that need to manage multiple diseases at once and should consider increasing access to cardiovascular disease management programs for older adults, individuals with high BMI, women, and those living in urban settings.

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Households access to improved drinking water sources and toilet facilities in Ethiopia: a multilevel analysis based on 2016 Ethiopian Demographic and Health Survey

BMJ Open ◽

10.1136/bmjopen-2020-042071 ◽

2021 ◽

Vol 11 (3) ◽

pp. e042071

Author(s):

Zewudu Andualem ◽

Henok Dagne ◽

Zelalem Nigussie Azene ◽

Asefa Adimasu Taddese ◽

Baye Dagnew ◽

...

Keyword(s):

Drinking Water ◽

Health Survey ◽

Rural Households ◽

Wealth Index ◽

Water Sources ◽

Demographic And Health Survey ◽

P Value ◽

Cluster Sampling ◽

Drinking Water Source ◽

Drinking Water Sources

ObjectiveThis study aimed to assess households access to improved drinking water sources and sanitation facilities and their associated factors in Ethiopia.DesignCross-sectional study.SettingEthiopia.ParticipantsHousehold heads.Primary outcomesAccess to improved drinking water sources and toilet facilities.MethodsWe conducted an in-depth secondary data analysis of 2016 Ethiopian Demographic and Health Survey. Data from a total of 16 650 households and 645 clusters were included in the analysis. The households were selected using a stratified two-stage cluster sampling technique. Multilevel binary logistic regression analyses were performed to identify factors associated with access to an improved drinking water source and toilet facilities. Adjusted OR with a 95% CI was reported with p value <0.05 was used to declare a significant association between the covariates and the outcome variables.ResultsThe proportions of households’ access to improved sources of drinking water and toilet facilities were 69.94% (95% CI: 69.23% to 70.63%) and 25.36% (95% CI: 24.69% to 26.03%), respectively. Households headed by women and households with a better wealth index were positively associated with access to improved drinking water sources. Whereas rural households, ≥30 min round trip to obtain drinking water and region were factors negatively associated with households access to improved drinking water sources. A higher probability of having access to improved toilet facilities: households with heads who had attained higher education, households having better access to improved sources of drinking water and households with better wealth index. While the following households were less likely to have access to improved toilet facilities: households with heads were widowed, households with four to six members, rural households and region.ConclusionThe study found that the proportions of households’ access to improved drinking water sources and toilet facilities in Ethiopia were relatively low, which demands the need to tailor strategies to increase the coverage of access to improved drinking water sources and toilet facilities.

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HIV knowledge and associated factors among young Ethiopians: application of multilevel order logistic regression using the 2016 EDHS

BMC Infectious Diseases ◽

10.1186/s12879-020-05436-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Teshome Kabeta Dadi ◽

Merga Belina Feyasa ◽

Mamo Nigatu Gebre

Keyword(s):

Logistic Regression ◽

Survey Data ◽

Health Survey ◽

Statistical Significance ◽

Insurance Coverage ◽

Mobile Telephone ◽

Demographic And Health Survey ◽

Sub Saharan Africa ◽

Hiv Knowledge ◽

Health Survey Data

Abstract Background Human Immunodeficiency virus continues to be a major global health problem infecting 75 million and killing 32 million people since the beginning of the epidemic. It badly hit Sub Saharan Africa than any country in the world and youths are sharing the greatest burden. The study aims to assess the level of HIV-knowledge and its determinants among Ethiopian youths using the 2016 Ethiopia Demographic and Health Survey data. Methods A nationally representative 2016 Ethiopian Demographic and Health Survey data were used. A total of 10,903 youths comprising 6401 females and 4502 males were included in the study. Descriptive statistics and multilevel order logistic regression were used and confidence interval was used to declare statistical significance in the final model. Results The mean age and SD of youths included in this study was 19.10 (±2.82). Among Ethiopian youths, 20.92% (95% CI: 18.91, 23.09%) had low knowledge of HIV whereas, 48.76% (95% CI: 47.12, 50.41%) and 30.31% (95% CI: 28.51, 32.18%) of them had moderate and comprehensive HIV knowledge respectively. Being male, access to TV and radio, ever tested for HIV/AIDS, owning a mobile telephone, and attending primary school and above compared to non-attendants were associated with having higher HIV knowledge. But, dwelling in rural Ethiopia, being in the Protestant and Muslim religious groups as compared to those of Orthodox followers and being in married groups were associated with having lower HIV knowledge. Approximately, 12% of the variation in knowledge of HIV was due to regions. Conclusion Only one-third of Ethiopian youths have deep insight into the disease, whereas, nearly one-fifth of them have lower HIV-knowledge. There is a significant disparity in HIV-related knowledge among Ethiopian youths living in different regions. Rural residents, less educated, female, and married youths have less knowledge of HIV as compared to their counterparts. Youths who do not have a mobile phone, who lack health insurance coverage, and who have limited access to media have less knowledge about HIV. Therefore, the due focus should be given to the aforementioned factors to minimize the disparities between regions and to enhance Ethiopian youths’ HIV-knowledge.

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KNOWLEDGE OF HEPATITIS PREVENTION AMONG REPRODUCTIVE AGE GROUP WOMEN FROM PAKISTAN DEMOGRAPHIC HEALTH SURVEY DATA 2012-13

Pakistan Journal of Public Health ◽

10.32413/pjph.v9i3.358 ◽

2020 ◽

Vol 9 (3) ◽

pp. 135-138

Author(s):

Faiz Rasul Awan ◽

Muhammad Safdar Baig ◽

Atiq ur Rehman Khan

Keyword(s):

International Development ◽

Survey Data ◽

Health Survey ◽

Demographic And Health Survey ◽

Reproductive Age ◽

P Value ◽

Cluster Sampling ◽

Age Group ◽

Significant Difference ◽

Reproductive Age Group

Background: Pakistan and Egypt bear more than 80% of the burden of disease as more than 12 million people are suffering from hepatitis B or C infection and there is addition of about 150000 new cases each year.Methods: We have used secondary data PDHS - Pakistan Demographic and Health Survey, DHS has become the gold standard of survey data in developing countries, a project by ORC Macro with financial support from the USAID for the International Development carried out as multistage, cluster sampling for its data collection on multiple questions, most pertinent from our study point view the maternal and child health related to knowledge attitude and practices of hepatitis and its prevention. Results:The final multivariate model six variables came out to be statistically significant with their adjusted odd's ration p-value and 95% confidence interval i.e., use of new disposable syringe every time for therapeutic injection purpose, the respondent being rich as wealth index, reading newspapers and magazines, watching television as source of information, area of residence being urban and with higher educational level came out to be most important variable which are making statistically significant difference for prevention of hepatitis among females of reproductive age group as our study population from Pakistan Demographic and Health Survey 2012-13. Conclusion: It is quite evident from the results of our study that use of new disposal syringes, being rich , being educated, having access to information resources like watching television, listening radio, reading newspaper & magazine and being as an urban dwellers are significant factor among women of reproductive age groups for prevention of hepatitis.

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Spatial distribution and predictors of domestic violence against women: evidence from analysis of Ethiopian demographic health survey 2016

BMC Women s Health ◽

10.1186/s12905-021-01465-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elias Seid ◽

Tesfahun Melese ◽

Kassahun Alemu

Keyword(s):

Domestic Violence ◽

Spatial Distribution ◽

Regression Analysis ◽

Violence Against Women ◽

Health Survey ◽

Spatial Clustering ◽

Wife Beating ◽

Moran’S I ◽

Demographic Health Survey ◽

Moran's I

Abstract Background Violence against women particularly that is committed by an intimate partner is becoming a social and public health problem across the world. Studies show that the spatial variation in the distribution of domestic violence was commonly attributed to neighborhood-level predictors. Despite the prominent benefits of spatial techniques, research findings are limited. Therefore, the current study intends to determine the spatial distribution and predictors of domestic violence among women aged 15–49 in Ethiopia. Methods Data from the Ethiopian demographic health survey 2016 were used to determine the spatial distribution of domestic violence in Ethiopia. Spatial auto-correlation statistics (both Global and Local Moran’s I) were used to assess the spatial distribution of domestic violence cases in Ethiopia. Spatial locations of significant clusters were identified by using Kuldorff’s Sat Scan version 9.4 software. Finally, binary logistic regression and a generalized linear mixed model were fitted to identify predictors of domestic violence. Result The study found that spatial clustering of domestic violence cases in Ethiopia with Moran’s I value of 0.26, Z score of 8.26, and P value < 0.01. The Sat Scan analysis identifies the primary most likely cluster in Oromia, SNNP regions, and secondary cluster in the Amhara region. The output from regression analysis identifies low economic status, partner alcohol use, witnessing family violence, marital controlling behaviors, and community acceptance of wife-beating as significant predictors of domestic violence. Conclusion There is spatial clustering of IPV cases in Ethiopia. The output from regression analysis shows that individual, relationship, and community-level predictors were strongly associated with IPV. Based upon our findings, we give the following recommendation: The government should give prior concern for controlling factors such as high alcohol consumption, improper parenting, and community norm that encourage IPV that were responsible for IPV in the identified hot spot areas.

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Spatial distribution and associated factors’ of Early Marriage among Reproductive age women in Ethiopia: A Secondary Data Analysis of Ethiopian Demographic and Health Survey 2016.

10.21203/rs.2.23055/v3 ◽

2020 ◽

Author(s):

Zemenu Tessema Tadesse

Keyword(s):

Spatial Distribution ◽

Health Survey ◽

Associated Factors ◽

Demographic And Health Survey ◽

Reproductive Age ◽

Scan Statistics ◽

Early Marriage ◽

P Value ◽

Factors Associated ◽

Reproductive Age Women

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.

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Geographical disparities and determinants of childhood diarrheal illness in Ethiopia: Further Analysis of 2016 Ethiopian Demographic and Health Survey

10.21203/rs.2.22887/v1 ◽

2020 ◽

Author(s):

Asmamaw Atnafu ◽

Malede Mequanent Sisay ◽

Getu Debalkie Demissie ◽

Zemenu Tadesse Tessema

Keyword(s):

Health Survey ◽

Mixed Model ◽

Addis Ababa ◽

Demographic And Health Survey ◽

Sub Saharan Africa ◽

Childhood Diarrhea ◽

Mixed Effect ◽

Under Five ◽

Diarrheal Illness ◽

Under Five Children

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

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Medical Perspective of Childhood Marriage in Nigeria: Body of Evidence from 2013 Nigeria Demographic and Health Survey

Current Women s Health Reviews ◽

10.2174/1573404814666181026095357 ◽

2019 ◽

Vol 15 (3) ◽

pp. 188-195

Author(s):

Audu Alayande ◽

Bahijjatu Bello-Garko ◽

Zubaida Abubakar ◽

Hafsat Kagara ◽

Islamiyat A. Nuhu

Keyword(s):

Health Survey ◽

Female Circumcision ◽

Child Survival ◽

Antenatal Clinic ◽

Skilled Birth Attendance ◽

Demographic And Health Survey ◽

Sub Saharan Africa ◽

Child Marriage ◽

Reproductive Health Services ◽

Birth Attendance

Background: Available data from South Asia and sub-Saharan Africa indicates that 12% and 34% of girls were married at age 15years and 18years respectively. This practice of child marriage may debar countries from achieving the Sustainable Development Goals. Objective: To extract and present disaggregated indices in the 2013 Nigeria Demographic and Health Survey (NDHS) on the effect of child marriage on health. Method: This desk review study extracted disaggregated maternal and child health indices on married females aged 15-19 years from the 2013 NDHS. Results: The result showed that married females aged 15-19 years were short, thin, and least likely to receive prophylactic Vitamin A dose postpartum and deworming medication at last pregnancy. Also, while awareness for Family Planning (FP) was high, its utilization was poor at only 1.2%. Their Antenatal clinic attendance, facility delivery, skilled birth attendance at delivery and post natal service utilization were lowest. Similarly, mortality of children under 5 was highest amongst these mothers. Although violence during pregnancy was highest amongst this group, nevertheless more than 20% of them agreed that the practice of female circumcision should be continued. Conclusion: These findings depict some of the negative outcomes of child marriage on maternal and child survival which require integrated multisectoral interventions to ensure that all girls have access to timely sexual reproductive health services and information.</P>

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