scholarly journals Spatial distribution and Determinants of Optimal ANC visit among pregnant women in Ethiopia: Further analysis of 2016 Ethiopia demographic Health Survey

2019 ◽  
Author(s):  
Zemenu Tessema Tadesse ◽  
Yaregal Animut Babel
Keyword(s):  
Spatial Distribution ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Survey ◽  
Hot Spot ◽  
Educational Status ◽  
Community Level ◽  
Cold Spot ◽  
Male Partners ◽  
Health Institutions

Abstract Background Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing. Antenatal care coverage is improving in Africa, since over two-thirds of pregnant women have at least one ANC contact. However, to realize the complete life-saving potential that ANC guarantees for mothers and babies, four visits providing essential proof based mostly interventions square measure neededObjective The aim of this study was to identify determinants for Optimal ANC visit and its spatial distribution among pregnant women in Ethiopia.Method This study was based on 2016 Ethiopia Demography and Health Survey. Individual women record (IR) file was used to extract the data and 8,025 pregnant women were included in the final analysis. The binary response variable considered in this study indicated whether women completed an optimal ANC visit or not from skilled health care provider and coded as 1/0. Sata14 and ArcGIS10.1 software’s were used for analysis. Generalized estimating equation (GEE) model was fitted to identify factors associated with an optimal ANC visit. Crude and Adjusted odds ratio with a 95% CI computed to assess the strength of association between independent and outcome variables.Results This study revealed that rural residence (AOR=0.59, 95%CI: 0.45-0.77),male partners educational status[secondary school (AOR=1.33, 95%CI: 1.05-1.67)], distance to the health institutions[not a big problem (AOR=1.21, 95%CI: 1.04-1.39)], community level literacy(AOR=1.07, 95%CI: 1.03-1.12), and community level service utilization(AOR=2.67,95%CI:2.21-3.24) were significantly associated with optimal ANC visits. Hot spot areas are observed in Addis Ababa, Tigray Region Harari and Dire Dawa, which means an optimal ANC visit well in these regions and cold spot area.Conclusion Living in peripheral regions of the country and in rural areas, lower educational status of male partners, and distance to health institutions were prohibiting factors for adequate number of visits. In this study community level literacy and community level service utilizations were also affect women’s’ ANC utilization which implies community level interventions should be considered for improving antenatal care utilization and better health outcomes. The government should be should give spatial attention regions like Afar, Amhara, Oromia Benishangul, SNNP and Somalia which had low optimal ANC visit

scholarly journals Spatial distribution and Determinants of Optimal ANC visit among pregnant women in Ethiopia: Further analysis of 2016 Ethiopia demographic Health Survey

2020 ◽  
Author(s):  
Zemenu Tessema Tadesse ◽  
Yaregal Animut
Keyword(s):  
Spatial Distribution ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Survey ◽  
Addis Ababa ◽  
Educational Status ◽  
Community Level ◽  
Maternal And Newborn Health ◽  
Male Partners ◽  
Health Institutions

Abstract Background: Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing. Antenatal care coverage is improving in Africa since over two-thirds of pregnant women have at least one ANC contact. However, to realize the complete life-saving potential that ANC guarantees for mothers and babies, at least four visits providing essential evidence-based interventions are required. . Therefore, this study was conducted to identify determinants of an optimal ANC visit and its spatial distribution in Ethiopia. Methods: This study is a secondary data analysis of the 2016 Ethiopian Demographic and Health Survey (EDHS).A total of 8,025 women who had a live birth in the five years preceding the survey were included in this study. STATA 14 software and ArcGIS10.7 software were used for analysis. The generalized estimating equation (GEE) model was fitted to identify factors associated with an optimal ANC visit. Crude and Adjusted odds ratio with a 95% CI computed to assess the strength of association between explanatory and outcome variables. Results: This study revealed that rural residence (AOR=0.59, 95%CI: 0.45-0.77),male partners educational status[secondary school (AOR=1.33, 95%CI: 1.05-1.67)], distance to the health institutions[not a big problem (AOR=1.21, 95%CI: 1.04-1.39)], community-level literacy(AOR=1.07, 95%CI: 1.03-1.12), and community level service utilization(AOR=2.67,95%CI:2.21-3.24) were significantly associated with optimal ANC visits. From the spatial analysis result, an Optimal ANC visit was observed in Addis Ababa, Tigray, Harari, and Dire Dawa regions whereas areas with no optimal ANC visit were Afar, Amhara, Oromia Benishangul, SNNP, and Somalia regions. Conclusion: Living in peripheral regions of the country and in rural areas, lower educational status of male partners and distance to health institutions were prohibiting factors for an adequate number of visits. In this study, community-level literacy and community level service utilizations were were also affect womens’ ANC utilization which implies community-level interventions should be considered for improving antenatal care utilization and better health outcomes. The government should give special attention to the regions like Afar, Amhara, Oromia, Benishangul, SNNP, and Somalia which had low optimal ANC visits. Keywords: Optimal Antenatal Care Visit, Determinant, Spatial distribution, Ethiopia

scholarly journals Spatial distribution and Determinants of Optimal ANC visit among pregnant women in Ethiopia: Further analysis of 2016 Ethiopia demographic Health Survey

2019 ◽  
Author(s):  
Zemenu Tessema Tadesse ◽  
Yaregal Animut
Keyword(s):  
Spatial Distribution ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Addis Ababa ◽  
Educational Status ◽  
Community Level ◽  
Care Providers ◽  
Male Partners ◽  
Health Institutions

Abstract Background: Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing. Antenatal care coverage is improving in Africa since over two-thirds of pregnant women have at least one ANC contact. However, to realize the complete life-saving potential that ANC guarantees for mothers and babies, four visits providing essential proof-based mostly interventions square measure needed. Therefore, this study was performed to identify determinants of an Optimal ANC visit and its spatial distribution in Ethiopia. Methods: A total of 8,025 women who had a live birth in the five years preceding the survey were included in this study. The binary response variable considered in this study indicated whether women completed an optimal ANC visit or not from skilled health care providers and coded as 1/0. STATA 14 software and ArcGIS10.7 software were used for analysis. The generalized estimating equation (GEE) model was fitted to identify factors associated with an optimal ANC visit. Crude and Adjusted odds ratio with a 95% CI computed to assess the strength of association between explanatory and outcome variables. Results:This study revealed that rural residence (AOR=0.59, 95%CI: 0.45-0.77),male partners educational status[secondary school (AOR=1.33, 95%CI: 1.05-1.67)], distance to the health institutions[not a big problem (AOR=1.21, 95%CI: 1.04-1.39)], community-level literacy(AOR=1.07, 95%CI: 1.03-1.12), and community level service utilization(AOR=2.67,95%CI:2.21-3.24) were significantly associated with optimal ANC visits. From the spatial analysis result, an Optimal ANC visit was observed in Addis Ababa, Tigray, Harari, and Dire Dawa Regions whereas risk areas for an optimal ANC visit were Afar, Amhara, Oromia Benishangul, SNNP, and Somalia regions. Conclusion: Living in peripheral regions of the country and in rural areas, lower educational status of male partners and distance to health institutions were prohibiting factors for an adequate number of visits. In this study, community-level literacy and community level service utilizations were affected by women’s’ ANC utilization which implies community-level interventions should be considered for improving antenatal care utilization and better health outcomes. The government should give spatial attention regions like Afar, Amhara, Oromia, Benishangul, SNNP, and Somalia which had low optimal ANC visits. Keywords: Optimal Antenatal Care Visit, Determinant, Spatial distribution, Ethiopia

scholarly journals Spatial Pattern and Associated Factors of ANC Visits in Ethiopia: Spatial and Multilevel Modeling of Ethiopian Demographic Health Survey Data

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Zemenu Tadesse Tessema ◽  
Temesgen Yihunie Akalu
Keyword(s):  
Spatial Distribution ◽  
Antenatal Care ◽  
Health Survey ◽  
Associated Factors ◽  
Goodness Of Fit ◽  
Model Comparison ◽  
Addis Ababa ◽  
Community Level ◽  
Cluster Sampling ◽  
Dire Dawa

Background. Although there is an increase in having antenatal care (ANC), still many women lack recommended ANC contacts in Ethiopia. Therefore, this study was aimed at determining spatial patterns and associated factors of not having ANC visits using the Ethiopian Demographic and Health Survey (EDHS) 2016 data. Methods. A two-stage stratified cluster sampling technique was employed based on EDHS data from January 18 to June 27, 2016. A total of 7,462 women were included in the study. ArcGIS version 10.7 software was used to visualize the spatial distribution. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant purely spatial clusters for not having ANC visits in Ethiopia. A multivariable multilevel logistic regression model was used to identify individual- and community-level determinants of not having antenatal care. Model comparison was checked using the likelihood test and goodness of fit was assessed by the deviance test. Results. The primary clusters’ spatial window was located in Somalia, Oromia, Afar, Dire Dawa, and Harari regions with the log-likelihood ratio (LLR) of 133.02, at p<0.001 level of significance. In this study, Islam religion (adjusted odds ratio (AOR) = 0.7 with 95% confidence interval (CI) (0.52,0.96)), mother education being primary (AOR = 0.59, 95% CI (0.49,0.71)), distance from health facility being a big problem (AOR = 0.76, CI (0.65,0.89)), second birth order (AOR = 1.35, CI (1.03, 1.76)), richer wealth index (AOR = 0.65, CI (0.51,0.82)), rural residence (AOR = 2.38, CI (1.54,3.66)), and high community media exposure (AOR = 0.68, CI (0.52,0.89)) were determinants of not having antenatal care in Ethiopia. Conclusion. The spatial distribution of ANC in Ethiopia is non-random. A higher proportion of not having ANC is found in northeast Amhara, west Benishangul Gumuz, Somali, Afar, north, and northeast SNNPR. On the other hand, a low proportion of not having ANC was found in Tigray, Addis Ababa, and Dire Dawa. In Ethiopia, not having antenatal care is affected by both individual- and community-level factors. Prompt attention by the Federal Ministry of Health is compulsory to improve ANC especially in rural residents, uneducated women, poor households, and regions like Oromia, Gambella, and Somalia.

scholarly journals Spatial distribution and determinants of household iodized salt utilization in Ethiopia: a spatial and multilevel analysis of Ethiopian demographic and Health survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yigizie Yeshaw ◽  
Adugnaw Zeleke Alem ◽  
Getayeneh Antehunegn Tesema ◽  
Achamyeleh Birhanu Teshale ◽  
Alemneh Mekuriaw Liyew ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Health Survey ◽  
Odds Ratio ◽  
Media Exposure ◽  
Education Level ◽  
Demographic And Health Survey ◽  
Iodized Salt ◽  
Community Level ◽  
Cold Spot ◽  
Community Media

Abstract Background Iodine deficiency disorder is a significant public health problem, affecting both developed and developing nations worldwide. It is associated with poor body growth and irreversible mental retardation. However, little is known about the spatial distribution and determinants of household iodized salt utilization in Ethiopia. Therefore, this study aimed to explore the spatial distribution and determinants of iodized salt utilization at national level. Methods Ethiopian Demographic and Health Survey 2016 data was used to investigate the spatial distribution and determinants of household iodized salt utilization in Ethiopia. ArcGIS 10.6 and SaTScan™ version 9.6 software were used to explore the spatial distribution and detect significant clusters, respectively. The odds ratio with its 95% confidence interval (CI) was determined for potential determinants included in the multivariable multilevel logistic regression model. Results Household iodized salt utilization was spatially clustered in Ethiopia (Moran’s Index = 0.076, p-value = 0.01). The significant hotspot areas with high iodized salt utilization were located in Benishangul, Amhara, Gambella, Tigray and Northwest Oromia regions. Significant cold spot areas (areas with low iodized salt utilization) were found in Somali, and East Afar regions. Those households with higher education level ((Adjusted Odds Ratio [AOR] =1.49, 95% CI =1.14–1.93), high community level education (AOR = 1.51, 95% CI = 1.03–2.20), middle wealth index (AOR = 1.31, 95% CI = 1.04–1.65) and high community media exposure (AOR = 1.52, 95% CI = 1.07–2.17) had higher odds of iodized salt utilization. Conclusions Household iodized salt utilization had significant spatial variation across the country. Both household and community level variables were found to be associated with household iodized salt utilization in Ethiopia. Therefore, increasing the education level, wealth status and community media exposure is recommended to improve iodized salt utilization in a country. A targeted intervention is also needed for those regions with low household iodized salt utilization.

scholarly journals Country compliance with WHO-recommended antenatal care guidelines: equity analysis of the 2015–2016 Demography and Health Survey in Myanmar

2020 ◽  
Vol 5 (12) ◽  
pp. e002169
Author(s):  
Ngatho Samuel Mugo ◽  
Kyaw Swa Mya ◽  
Camille Raynes-Greenow
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Adolescent Mothers ◽  
Health Survey ◽  
Rural Areas ◽  
Urban Areas ◽  
Multinomial Logistic Regression ◽  
Wealth Quintile ◽  
Adjusted Risk ◽  
Factors Associated

IntroductionEarly access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar.MethodsWe examined data from 2943 mothers aged 15–49 years whose most recent birth occurred in the last 5 years prior to the 2015–2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC.ResultsApproximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30–39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84).ConclusionThe 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas.

scholarly journals A multilevel analysis of overweight and obesity among non-pregnant women of reproductive age in Malawi: evidence from the 2015–16 Malawi Demographic and Health Survey

2018 ◽  
Vol 11 (6) ◽  
pp. 496-506 ◽  
Author(s):  
Peter Austin Morton Ntenda ◽  
Jane Flora Kazambwe
Keyword(s):  
Pregnant Women ◽  
Health Survey ◽  
Media Coverage ◽  
White Collar ◽  
Overweight And Obesity ◽  
Demographic And Health Survey ◽  
Community Level ◽  
Reproductive Age ◽  
The Individual ◽  
Maternal Overweight

Abstract Background Overweight and obesity are well-known risk factors for non-communicable diseases such as cardiovascular disease, diabetes, some cancers and musculoskeletal disorders. In Malawi, the proportion of women who are overweight/obese has doubled, from 10% in 1992 to 21% in 2015–16. Therefore we aimed to explore the individual- and community-level factors associated with overweight and obesity among non-pregnant women of child-bearing age. Methods Secondary analysis of the 2015–16 Malawi Demographic and Health Survey was conducted. Overweight was defined as a body mass index (BMI) of 25 to &lt;30 kg/m2, while obesity was defined as a BMI ≥30 kg/m2. Two-level multilevel multivariable logistic regression models were constructed using a logit-link function with a binomial distribution on 7326 women living in 850 different communities. Results At the individual level, the adjusted multilevel regression results showed that women 15–19 y of age as well as women from the poorest households had reduced odds of being overweight/obese. However, women with white collar jobs and women who were affiliated with the Church of Central Africa Presbyterian and the Roman Catholic church had increased odds of being overweight/obese. At the community level, women from urban areas and women who resided in communities with a low percentage of media exposure had increased odds of being overweight or obese. While women from poor communities had reduced odds of being overweight and obese, the proportion change in variance showed that 56, 77 and 78% of total variations in the odds of overweight, obese and overweight/obese across the communities were explained by both individual- and community-level factors. The median odds ratio showed that the likelihood of maternal overweight, obese and overweight/obese increased by 63, 39 and 84% when the women moved from low- to high-risk neighbourhoods. Conclusions Older women, Christian women, women with white collar jobs and women from the richest households should be targeted during policy formulation. At the community level, media coverage should be spread evenly so that health awareness messages, consequences and means of overweight and obesity prevention are getting to the targeted women. Our study revealed evidence of clustering effects of overweight and obesity at the community level, hence neighbourhood variations with respect to maternal overweight and obesity should be taken into account when designing nutritional policies.

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.

scholarly journals Prevalence and factors associated with antenatal care utilization in Ethiopia: an evidence from demographic health survey 2016

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Berhan Tsegaye ◽  
Mohammed Ayalew
Keyword(s):  
Data Analysis ◽  
Antenatal Care ◽  
Health Survey ◽  
Wealth Quintile ◽  
Educational Status ◽  
Care Utilization ◽  
Demographic Health Survey ◽  
Factors Associated ◽  
Antenatal Care Utilization ◽  
Maternal Educational Status

Abstract Background Ethiopia is one of the sub-Saharan African country with high maternal mortality ratio (MMR). According to Ethiopian demographic health survey (EDHS) 2016 report, MMR is 420 among 100,000 live births. Antenatal care utilization is a key intervention to reduce these deaths through problem detection and treatment, promotion of health seeking behavior, and preparing pregnant women for birth. Therefore, this study aimed to assess prevalence and factors associated with antenatal care service utilization in Ethiopia in 2016. Methods Secondary data analysis was done on EDHS 2016. It was a stratified, two-stage, and cluster sampling design. Analysis has been restricted to antenatal care utilization among women who delivered at least one time in the past five years. Data were weighted to correct sampling bias. Moreover, complex data analysis was done. Bi-variate and multivariable logistic regression analyses were carried out. Adjusted odds ratio with 95% confidence interval was computed and P-value less than 0.05 considered as a statistically significance level for identification of association. Results Prevalence of antenatal care utilization was 62.8% [95%CI: 60.9, 64.6] in this study. Maternal educational status of primary school (AOR = 1.8,95%CI:1.2, 2.6), maternal educational status of secondary school (AOR = 4.4,95%CI: 1.1, 17.3), women who listen radio less than 1 per week (AOR = 1.9,95%CI:1.12,3.34), women who listen radio at least 1 per week (AOR = 2.6,95%CI:1.4,4.8), women in rich wealth quintile (AOR = 1.9,95%CI: 1.1, 3.2) were factors positively associated with antenatal care utilization. However, women who had traditional belief (AOR = 0.1,95%CI:0.02,0.49), and women who had five children and above (AOR = 0.6,95%CI: 0.3, 0.9) were factors associated negatively with antenatal care utilization. Conclusions Prevalence of antenatal care utilization is still low in Ethiopia in 2016. Maternal higher maternal educational status, frequent radio listening, higher wealth quintile, traditional belief, and greater number of children were found to be associated significantly with antenatal care utilization. Consequently, socio-economic status should be enhanced, information should be accessed by women about antenatal care utilization and family planning service through mass media. Furthermore, intensive community education program should be designed for traditional believers to increase uptake of antenatal care by stakeholders.

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