Spatial distribution and determinants of the change in pre-lacteal feeding practice over time in Ethiopia: A spatial and multivariate decomposition analysis

Background Pre-lacteal feeding persists in low and middle-income countries as deep-rooted nutritional malpractice. It imposes significant negative consequences on neonatal health, including increased risk of illness and mortality. Different studies revealed that pre-lacteal feeding practice is decreased over time. Even though different studies are done on the prevalence and determinants of pre-lacteal feeding practice, up to our knowledge, the spatial distribution and the determinants of the change in pre-lacteal feeding practice over time are not researched. Objective To assess the spatial distribution and determinants of the change in pre-lacteal feeding practice over time in Ethiopia. Methods We used the Ethiopian demographic and health surveys (EDHSs) data. For this study, a total weighted sample of 14672 (5789 from EDHS 2005, 4510 from EDHS 2011, and 4373 from EDHS 2016) reproductive-age women who gave birth within two years preceding the respective surveys and whoever breastfeed were used. The logit-based multivariate decomposition analysis was used to identify factors that contributed to the decrease in pre-lacteal feeding practice over the last 10 years (from 2005 to 2016). Using the 2016 EDHS data, we also conducted a spatial analysis by using ArcGIS version 10.3 and SaTScan version 9.6 software to explore the spatial distribution and hotspot clusters of pre-lacteal feeding practice. Result Pre-lacteal feeding practice was decreased from 29% [95% Confidence interval (CI): 27.63–29.96%] in 2005 to 8% [95% CI: 7.72–8.83%] in 2016 with annual rate of reduction of 7.2%. The overall decomposition analysis showed that about 20.31% of the overall decrease in pre-lacteal feeding practice over the last 10 years was attributable to the difference in composition of women (endowment) across the surveys, while, the remaining 79.39% of the overall decrease was explained by the difference in the effect of characteristics (coefficient) across the surveys. In the endowment component, the difference in composition of residence, perception of distance from the health facility, maternal educational level, wealth status, occupation, ANC visit, place of delivery, the timing of breastfeeding initiation, and wanted last-child/pregnancy were found to be significant contributing factors for the decrease in pre-lacteal feeding practice. After controlling for the role of compositional changes, the difference in the effect of distance from the health facility, wealth status, occupation, antenatal care (ANC) visit, and wanted last-child/pregnancy across the surveys were significantly contributed to the observed decrease in pre-lacteal feeding practice. Regarding the spatial distribution, pre-lacteal feeding practice was non-random in Ethiopia in which the primary and secondary clusters’ of pre-lacteal feeding identified in Somalia and the Afar region respectively. Conclusion Pre-lacteal feeding practice has shown a significant decline over the 10-year period. Program interventions considering women with poor maternal health service utilization such as ANC visits, women with poor socioeconomic status, women with an unintended pregnancy, and women from remote areas especially at border areas such as Somali and Afar could decrease pre-lacteal feeding practice in Ethiopia.

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Trends and determinants of breastfeeding within one hour in Ethiopia, further analysis of Ethiopian Demographic and Health Survey: multivariate decomposition analysis

Italian Journal of Pediatrics ◽

10.1186/s13052-021-01032-5 ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Tilahun Yemanu Birhan ◽

Wullo Sisay Seretew ◽

Muluneh Alene

Keyword(s):

Health Facility ◽

Decomposition Analysis ◽

Facility Delivery ◽

Early Initiation ◽

Breastfeeding Initiation ◽

Health Facility Delivery ◽

Initiation Rate ◽

Early Initiation Of Breastfeeding ◽

Over Time ◽

Initiation Of Breastfeeding

Abstract Background Despite the substantial efforts to improve timely/early initiation of breastfeeding, avoidance of colostrum, and delayed initiation of breastfeeding remains a big challenge in developing countries. Therefore, this study aimed to analyze the trends of early breastfeeding rate over time based on the Ethiopian Demographic and Health Survey (EDHS). Methods Secondary data analysis was conducted based on the Ethiopian Demographic Health Surveys (EDHSs) conducted in 2005, 2011, and 2016. A total weighted sample of 9, 111, 10,106, and 8564 in 2005, 2011, and 2016 respectively were included for analysis. Trend and Logistic based decomposition analysis technique was used for analyzing the trends of early breastfeeding initiation over time and factors contributing to the change in early breastfeeding initiation rate. STATA 15 was employed for data management and analyses. All analyses presented in this paper were weighted for the sampling probabilities and non-response. Result Among children age less than 5 years the rate of early breastfeeding initiation rate overtime was increased from 70.5% in 2005 to 72.7% in 2016. The highest rate of improvement was seen in the second phase of the study (2011–2016) while it shows a decline in the first phase (2005–2011) from 70.5 to 55.1%. The decomposition analysis indicated that about half of the overall change in early breastfeeding initiation rate was due to the difference in women’s composition. Particularly, an increase in health facility delivery and vaginal delivery was a significant predictor of the increasing rate of early breastfeeding initiation over the surveys. Conclusion Early initiation of breastfeeding slightly increasing over the last 10 years in Ethiopia. Half of the overall increase in the early initiation of breastfeeding was due to the change in compositional characteristics of women over 10 years in Ethiopia. Change in the composition of women according to health facility delivery and vaginal delivery were the major source of the increase in early breastfeeding initiation over time. Public interventions including promoting health facility delivery of women for further improvements of early breastfeeding initiation should be needed.

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Spatial distribution and regional difference of carbon emissions efficiency of industrial energy in China

Scientific Reports ◽

10.1038/s41598-021-98225-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Fang Liu ◽

Lu Tang ◽

Kaicheng Liao ◽

Lijuan Ruan ◽

Pingsheng Liu

Keyword(s):

Spatial Distribution ◽

Carbon Emissions ◽

Regional Difference ◽

Emissions Reduction ◽

Data Envelopment ◽

Undesirable Outputs ◽

Carbon Emissions Reduction ◽

Industrial Energy ◽

The Difference ◽

Over Time

AbstractThe three-stage super-efficiency slack-based measure and data envelopment analysis (SBM-DEA) model with undesirable outputs is used to calculate carbon emissions efficiency of industrial energy (CEEIE) of 30 provinces in China from 2000 to 2017. Then ArcGIS software is used to illustrate the spatial distribution of CEEIE, and Dagum Gini ratio is calculated to decompose the regional difference. The results show that the spatial distribution of CEEIE changes from disorder to order and provinces characterized with high or low CEEIE cluster in space over time. The total Dagum Gini coefficient indicates that the interprovincial difference in CEEIE across China is gradually expanding, which is mainly induced by the difference between regions. Our findings attach more importance to interregional integration policies for carbon emissions reduction in China.

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Spatial Distribution and Regional Difference of Carbon Emissions Efficiency of Industrial Energy in China

10.21203/rs.3.rs-684325/v1 ◽

2021 ◽

Author(s):

Fang Liu ◽

Lu Tang ◽

Kaicheng Liao ◽

Lijuan Ruan ◽

Pingsheng Liu

Keyword(s):

Spatial Distribution ◽

Carbon Emissions ◽

Regional Integration ◽

Regional Difference ◽

Emissions Reduction ◽

Data Envelopment ◽

Carbon Emissions Reduction ◽

Industrial Energy ◽

The Difference ◽

Over Time

Abstract The three-stage super-efficiency slack-based measure and data envelopment analysis (SBM-DEA) model with undesirable outputs is used to calculate carbon emissions efficiency of industrial energy (CEEIE) of 30 provinces in China from 2000 to 2017. Then ArcGIS software is used to illustrate the spatial distribution of CEEIE, and Dagum Gini ratio is calculated to decompose the regional difference. The results show that the spatial distribution of CEEIE changes from disorder to order and provinces characterized with high or low CEEIE cluster in space over time. The total Dagum Gini coefficient indicates that the provincial difference in CEEIE across China is gradually expanding, which is mainly induced by the difference between regions. Our findings attach more importance to regional integration policies for carbon emissions reduction in China.

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Decomposition of Factors Associated With Housing Material Inequality in Under-Five Deaths in Low and Middle-Income Countries

10.21203/rs.3.rs-152523/v1 ◽

2021 ◽

Author(s):

Oyewale Mayowa Morakinyo ◽

Adeniyi Francis Fagbamigbe ◽

Ayo Stephen Adebowale

Keyword(s):

Decomposition Analysis ◽

Household Wealth ◽

Outcome Variable ◽

Demographic And Health Surveys ◽

Wealth Status ◽

Middle Income ◽

Under Five ◽

Neighbourhood Level ◽

Housing Materials ◽

The Individual

Abstract Background: Low-and Medium-Income Countries (LMIC) continue to record high burden of under-five deaths (U5D). There is a gap in knowledge of the factors contributing to housing materials inequalities in U5D. This study examined the contributions of the individual- and neighbourhood-level factors to housing materials inequalities in influencing U5D in LMIC.Methods: We pooled data from the most recent Demographic and Health Surveys for 56 LMIC conducted between 2010 and 2018. In all, we analysed the data of 798,796 children living in 59,791 neighbourhoods. The outcome variable was U5D among live births within 0 to 59 months of birth. The main determinate variable was housing material types, categorised as unimproved housing materials (UHM) and improved housing materials (IHM) while the individual-level and neighbourhood-level factors are the independent variables. Data were analysed using Fairlie decomposition analysis at α=0.05. Results: The overall U5D rate was 53 per 1000 children, 61 among children from houses built with UHM, and 41 among children from houses built with IHM (p<0.001). This rate was higher among children from houses that were built with UHM in all countries except in Malawi, Zambia, Lesotho, Gambia, Liberia, Sierra Leone, Indonesia, Maldives, Jordan, and Albania. None of these countries had significant pro-IHM inequality. The factors explaining housing inequalities in U5D include household wealth status, residence location, source of drinking water, media access, paternal employment, birth interval, and toilet type.Conclusions: There are variations in individual- and neighbourhood-level factors driving housing materials inequalities as it influences U5D in LMIC. Interventions focusing on reducing the burden of U5D in households built with UHM are urgently needed.

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A success story of reduction in childhood stunting and underweight in India: analysis of pooled data from three rounds of Indian Demographic and Health Surveys (1998–2016)

Journal of Biosocial Science ◽

10.1017/s002193202000070x ◽

2020 ◽

pp. 1-18

Author(s):

Swati Srivastava ◽

Ashish Kumar Upadhyay

Keyword(s):

Antenatal Care ◽

Birth Order ◽

Health Surveys ◽

Maternal Education ◽

Decomposition Analysis ◽

Demographic And Health Surveys ◽

Wealth Status ◽

Indian Children ◽

Clean Fuel ◽

Childhood Stunting

Abstract This study used a series of individual-level datasets from National Family Health Surveys conducted in 1998–99, 2005–06 and 2015–16 to assess the factors behind the reduction in childhood stunting and underweight in India between the years 1998–99 and 2015–16. A multivariable decomposition regression analysis was performed. Results showed that the prevalence of childhood stunting declined from 49.4% in 1998–99 to 34.9% in 2015–16. Over the same period, the prevalence of childhood underweight declined from 41.9% in 1998–99 to 33.1% in 2015–16. The reduction in the prevalence of stunting was found to be contributed largely by a reduction in the combined prevalence of stunting and underweight (60%), followed by stunted only (21%) and the combined prevalence of stunting, underweight and wasting (19%). Likewise, the reduction in the prevalence of underweight was contributed by a reduction in the combined prevalence of stunting and underweight and the combined prevalence of stunting, underweight and wasting. Results of the decomposition analysis showed that over the period 1998–99 to 2015–16, improvement in wealth status and maternal education led to 13% and 12% declines, respectively, in childhood stunting and to 31% and 19% declines, respectively, in childhood underweight. Furthermore, reductions in childhood stunting and underweight were due to an increased average number of antenatal care visits, lower average birth order, decreased share of children with below-average birth size, increased use of clean fuel for cooking and a reduction in the practice of open defecation. These findings suggest that further reduction in the prevalence of childhood stunting and underweight could be attained through more equitable household economic growth, investment in girl’s education, greater access to improved toilet facilities, more widespread use of clean fuel for cooking, reduction in average birth order, increased antenatal care visits and greater consumption of IFA tablets by pregnant women. Policymakers need to prioritize these measures to further reduce malnutrition among Indian children.

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Trends and Spatial Variation of Female Genital Mutilation among Reproductive Age Women in Ethiopia based on 2000, 2005, and 2016 Ethiopian Demographic and Health Surveys: Spatial-temporal and Multivariate Decomposition Analysis

10.21203/rs.2.16478/v1 ◽

2019 ◽

Author(s):

Getayeneh Antehunegn Tesema ◽

Achamyeleh Birhanu Teshale ◽

Chilot Desta Agegnehu ◽

Adugnaw Zeleke Alem ◽

Alemneh Mekuriaw Liyew ◽

...

Keyword(s):

Public Health ◽

Scale Up ◽

Decomposition Analysis ◽

Media Exposure ◽

Reproductive Age ◽

Scan Statistics ◽

Health Concern ◽

Demographic And Health Surveys ◽

The Difference ◽

The Government

Abstract Introduction: Even if FGM has been declined dramatically in the world, the rate of decline is far below the rate needed to achieve SDG in Ethiopia. FGM remains as a serious public health concern in Ethiopia and the prevalence has varied across and within countries. Therefore, this study aimed to assess the trends and geographic variation of FGM practice in Ethiopia based on EDHSs. Methods: The study used the data from the three DHSs conducted in Ethiopia. Trend and Logistic based decomposition analysis technique was used for analyzing the change in FGM practice overtime and factors contributing to the change in FGM practice. STATA 14 was used for data management and analysis. The Bernoulli model was fitted using spatial scan statistics version 9.6 to identify hotspot areas and ArcGIS version 10.6 to explore the spatial distribution FGM. Results : The prevalence of FGM practice was decreased from 79.9% in 2000 to 70.4% in 2016. The decomposition analysis indicated that about 95% of the overall decrease in FGM practice was due to the difference in the change in the behavior of FGM practice among urban residents, orthodox and Muslim followers, self-employed, education, and media exposure were significant factors contributed to the change in FGM over the study period. The SaTScan analysis identified 141 most likely clusters (LLR=711.9, p<0.001) in 2000, 175 (LLR=576.4, p<0.001) in 2005, and 220 (LLR= 243.6, p<0.001) in 2016 which was located in Somali, Somali, Harari, and border areas of Somali consistently over the three surveys. Conclusions: These results showed that FGM practice has been declined in Ethiopia. The decrease in FGM practice could be attributable to the difference in the change in effects of residence, media exposure; religion, region, and educational status. The spatial analysis provides further insight into differences in FGM practice within the country and highlights primary and secondary clusters. This could enable efficient and timely spatial targeting of hotspot areas of FGM practice to achieve the goals of eliminating FGM practice in Ethiopia by 2025 and the government should scale up the public health programs to improve the rate of reduction.

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Decomposition analysis of modern contraceptive use among currently married women in Ethiopia: EDHS 2000-2016

10.21203/rs.2.20723/v1 ◽

2020 ◽

Author(s):

Endalekachew Worku Mengesha ◽

Desalegne Amare Zelellw ◽

Haile Mekonnen Fenta

Keyword(s):

Contraceptive Use ◽

Descriptive Analysis ◽

Unwanted Pregnancy ◽

Decomposition Analysis ◽

Married Women ◽

Demographic And Health Surveys ◽

Modern Contraceptive ◽

History Of ◽

Modern Contraceptive Use ◽

The Difference

Abstract Background Contraceptive use is an essential care to reduce maternal and child mortality by preventing unwanted pregnancy and abortion. Despite different studies are conducted related to family planning services, difference in characteristics of changes and the effects of population behavior were not well addressed. Therefore, the aim of this study was to assess the trend of modern contraceptive use, and investigate the difference in characteristics of changes and the effects of population behavior in the use of modern contraceptives.Methods The data source were from a four consecutive Ethiopia demographic and health surveys of women with complete interview file from 2000 -2016. The total sampled married women considered for this study were 9,380 (2000), 8,644(2005), 10,204(2011) and 9,824 (2016). Descriptive analysis was applied to describe socio demographic variables, fertility desire and media exposure. Multivariate decomposition analysis was carried out to investigate the changes in characteristics and effect of population behavior in modern contraceptive use.Results The trend of modern contraceptive use was steadily increased from 6% in 2000 to 35% in 2016. The overall decomposition change in modern contraceptive use among married women was 8.3% (2000 to 2016); due to difference in characteristics. Variables contribute for the change are religion, residence, women’s and partners’ education, women’s and partners’ occupation, head of house hold, history of abortion and media of exposure.Conclusion The trend of modern contraceptive use was steadily increased in all surveys. The change in contraceptive use was due to change in characteristics and population health behavior.

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Decomposition of factors associated with housing material inequality in under-five deaths in low and middle-income countries

Archives of Public Health ◽

10.1186/s13690-021-00768-0 ◽

2022 ◽

Vol 80 (1) ◽

Author(s):

Oyewale Mayowa Morakinyo ◽

Adeniyi Francis Fagbamigbe ◽

Ayo Stephen Adebowale

Keyword(s):

Decomposition Analysis ◽

Household Wealth ◽

Outcome Variable ◽

Demographic And Health Surveys ◽

Wealth Status ◽

Middle Income ◽

Under Five ◽

Neighbourhood Level ◽

Housing Materials ◽

The Individual

Abstract Background Low-and Medium-Income Countries (LMIC) continue to record a high burden of under-five deaths (U5D). There is a gap in knowledge of the factors contributing to housing materials inequalities in U5D. This study examined the contributions of the individual- and neighbourhood-level factors to housing materials inequalities in influencing U5D in LMIC. Methods We pooled data from the most recent Demographic and Health Surveys for 56 LMIC conducted between 2010 and 2018. In all, we analysed the data of 798,796 children living in 59,791 neighbourhoods. The outcome variable was U5D among live births within 0 to 59 months of birth. The main determinate variable was housing material types, categorised as unimproved housing materials (UHM) and improved housing materials (IHM) while the individual-level and neighbourhood-level factors are the independent variables. Data were analysed using the Fairlie decomposition analysis at α = 0.05. Results The overall U5D rate was 53 per 1000 children, 61 among children from houses built with UHM, and 41 among children from houses built with IHM (p < 0.001). This rate was higher among children from houses that were built with UHM in all countries except Malawi, Zambia, Lesotho, Gambia, Liberia, Sierra Leone, Indonesia, Maldives, Jordan, and Albania. None of these countries had significant pro-IHM inequality. The factors explaining housing inequalities in U5D include household wealth status, residence location, source of drinking water, media access, paternal employment, birth interval, and toilet type. Conclusions There are variations in individual- and neighbourhood-level factors driving housing materials inequalities as it influences U5D in LMIC. Interventions focusing on reducing the burden of U5D in households built with UHM are urgently needed.

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Trends of delayed first antenatal care visit among pregnant women in Ethiopia based on the EDHS 2000-2016 data: Multivariate decomposition analysis

10.21203/rs.3.rs-109954/v1 ◽

2020 ◽

Author(s):

Asaye Gebeyehu ◽

Achenef Muche ◽

Mehari Merid

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Family Size ◽

Statistical Significance ◽

Decomposition Analysis ◽

Demographic And Health Surveys ◽

Cross Sectional ◽

Antenatal Care Visit ◽

Care Visit ◽

Over Time

Abstract Background: Timing of first antenatal care visiting is crucial for women and fetus health. However, most of the women had delayed antenatal care visits and lacked early detection of existing complications. Hence, this study aimed to assess the trends and magnitude of delayed first antenatal care visits among pregnant women in Ethiopia.Method: This study used cross-sectional data analysis on Ethiopian Demographic and Health Surveys. A total weighted sample of 2146 in 2000, 2051 in 2005, 3368 in 2011, and 4740 in 2016 women who received at least one antenatal care visit in the past five years before each survey were included. Stata 14.1 software was used for data management and further analysis. Trends and multivariate logistic decomposition analyses were employed to examine the change in delayed first antenatal care visits with sampling weighting for the survey data. The 95% confidence interval was used for considering statistical significance.Results: The proportion of delayed first antenatal care visit was declined from 76.8 (95%CI: 75.1−78.6) in 2000 to 67.3 (95%CI: 65.9−68.6) in 2016. The decomposition analysis showed that 39% of the overall change in delayed first antenatal care visit over time was due to differences in characteristics whereas about 61% was due to the effect of characteristics. The significant contributing factors for the decline of delayed first antenatal care visit were the place of residence, husband’s education, women occupation, told about pregnancy complications, caesarean delivery, and family size. Conclusion: The proportion of delayed first antenatal care visits has been declined over time in Ethiopia, but still it remains high. More of the overall change in delayed first antenatal care visit was attributed to a change in health behavior among pregnant women. Public health interventions or programs such as health education and behavioral change communication targeting the rural residents, lower economic status, and family size would be suggested to decline delayed first antenatal care visit.

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The life table paradox: has Brazil already overcome it?

Revista Brasileira de Estudos de População ◽

10.20947/s0102-3098a0179 ◽

2021 ◽

Vol 38 ◽

pp. 1-23

Author(s):

Filipe Costa de Souza

Keyword(s):

Infant Mortality ◽

Life Expectancy ◽

Life Table ◽

National Level ◽

Decomposition Analysis ◽

Life Tables ◽

Total Change ◽

Life Expectancy At Birth ◽

The Difference ◽

Over Time

Ideally, life expectancy should be a decreasing function of age. When this fact is not observed, this situation is known as the life table paradox. This paper investigated the timing (and health metrics at the time) in which Brazil and its Federation Units (FU) overcame (or are expected to overcome) this paradox. The data were gathered from the Brazilian Institute of Geography and Statistics and contained 3,416 sex-specific abridged life tables, from 2000 to 2060. At national level, females and males overcame the paradox in 2016 and 2018, respectively. However, when the FU were examined separately, much heterogeneity was observed. Through the decomposition analysis of the change over time in the difference between life expectancy at birth and at age one, we found that Brazil and most of its FU are expected to have both changes declining over time and the total change is expected to be decreasing and greater than zero. Nevertheless, for some Northeastern states the total change is expected to pass from a positive to a negative value; and for two Northern states the total change is expected to be neither decreasing nor increasing. In a public planning perspective, we understand that achieving balancing in the life tables is a goal to be pursued, especially because having an imbalanced table means that life expectancy at birth is still strongly influenced by high levels of infant mortality. Therefore, this knowledge could help planners to properly define strategies to accelerate the balancing process and revert unequal scenarios.

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