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

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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Time to death and its determinants among under-five children in Sub-Saharan Africa using the recent (2010–2018) demographic and health survey data: country-based shared frailty analyses

BMC Pediatrics ◽

10.1186/s12887-021-02950-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Desalegn Tesfa ◽

Sofonyas Abebaw Tiruneh ◽

Melkalem Mamuye Azanaw ◽

Alemayehu Digssie Gebremariam ◽

Melaku Tadege Engdaw ◽

...

Keyword(s):

Health Care ◽

Health Survey ◽

Demographic And Health Survey ◽

Sub Saharan Africa ◽

Early Age ◽

Under Five ◽

Under Five Children ◽

Risk Of Death ◽

Shared Frailty ◽

Sub Saharan

Abstract Background Substantial global progress has been made in reducing under-five mortality since 1990, yet progress is insufficient to meet the sustainable development goal of 2030 which calls for ending preventable child deaths. There are disproportional survivals among children in the world. Therefore, the study aimed to assess the Survival status of under-five mortality and determinants in Sub-Saharan African Countries using the recent DHS data. Methods The data was retrieved from the birth record file from the standard Demographic and Health Survey dataset of Sub-Saharan Africa countries. Countries that have at least one survey between 2010 and 2018 were retrieved. Parametric shared frailty survival analysis was employed. Results A total of 27,221 (7.35%) children were died before celebrating their fifth birthday. Children at an early age were at higher risk of dying and then decrease proportionally with increased age. The risk of death among rich and middle family were lowered by 18 and 8% (AHR =0.82, 95% CI: 0.77-0.87) and (AHR = 0.92, 95% CI: 0.87-0.97) respectively, the hazard of death were 11, 19, 17, 90 and 55% (AHR = 1.06, 95% CI: 1.00-1.12), (AHR = 1.11,95%CI:1.04-1.19), (AHR = 1.17, 95% CI:1.12-1.23), (AHR = 1.90, 95%CI: 1.78-2.04) and (AHR = 1.55, 95% CI:1.47-1.63) higher than among children in rural, use unimproved water, delivered at home, born less than 18 months and between 18 and 23 months birth intervals respectively. The hazard of death was 7% among females and low birth weights (AHR = 0.93, 95%CI: 0.90 – 0.97) and (AHR = 0.93 95%CI: 0.89-0.97) respectively. There was also a significant association between multiple births and birth orders (AHR = 2.11, 95%CI: 2.51 – 2.90), (AHR = 3.01, 95%CI: 2.85-3.19) respectively. Conclusions Death rate among under-five children was higher at an early age then decreases as age advanced. Wealth status, residence, water source, place of delivery, sex of the child, plurality, birth size, preceding birth interval, and birth order were the most predictor variables. The health care program should be designed to encourage a healthy family structure. The health care providers should intervene in the community to inspire maternal health services.

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Association Between Household Air Pollution and Infant and Child Mortality in Myanmar: Evidence From The First Demographic and Health Survey

10.21203/rs.3.rs-152520/v1 ◽

2021 ◽

Author(s):

Juwel Rana ◽

Md Nuruzzaman Khan ◽

Rakibul M Islam ◽

Razia Aliani ◽

Youssef Oulhote

Keyword(s):

Air Pollution ◽

Child Mortality ◽

Health Survey ◽

Rural Areas ◽

Demographic And Health Survey ◽

Household Air Pollution ◽

Cluster Sampling ◽

High Exposure ◽

Under Five ◽

Under Five Children

Abstract Background: Household air pollution (HAP) from solid fuel use (SFU) for cooking has been considered a public health threat, particularly for women and children in low and middle-income countries (LMICs), with limited evidence. This study was undertaken to investigate the effects of HAP on neonatal, infant, and under-five child mortality in Myanmar. Methods: This cross-sectional study employed data from the Myanmar Demographic and Health Survey (MDHS), the first nationally representative survey conducted in 2016. Data were collected from MDHS based on stratified two-stage cluster sampling design applied in urban and rural areas. The sample consists of 3249 under-five children in the household with a 98% response rate. Exposure measures were HAP (coal and biomass) and level of exposure to HAP (no exposure, moderate and high exposure). The main outcomes were neonatal, infant, and under-five child mortality reported by mothers presented in rates and risk ratios with 95% confidence intervals, accounting for survey weight and cluster variation. Results: The prevalence of SFU was 79.0%. The neonatal, infant and under-five child mortality rates were 26, 45, and 49 per 1,000 live births, respectively. The risks of infant (aRR 2.02; 95% CI: 1.01-4.05) and under-five mortality (aRR 2.16; 95% CI: 1.07-4.36) mortality were higher among children from households with SFU compared to children from households using clean fuel. When applying an augmented measure of exposure to HAP by incorporating SFU and the kitchen's location, the likelihoods of infant and under-five mortality were even higher among moderate and highly exposed children than unexposed children with similar trends. Neonatal mortality was not associated with either HAP exposure or levels of exposure to HAP.Conclusion: Infants and under-five children are at higher risk of mortality from exposure to HAP. Increasing access to cookstoves and clean fuels is imperative to reduce the risk of infant and under-five child mortality in LMICs, including Myanmar.

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Determinants of early sexual initiation among female youth in Ethiopia: a multilevel analysis of 2016 Ethiopian Demographic and Health Survey

BMC Women s Health ◽

10.1186/s12905-020-01069-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Mastewal Arefaynie ◽

Melaku Yalew ◽

Yitayish Damtie ◽

Bereket Kefale

Keyword(s):

Health Survey ◽

Addis Ababa ◽

Statistical Significance ◽

Sexual Initiation ◽

Demographic And Health Survey ◽

Community Level ◽

Wealth Status ◽

Mixed Effect ◽

Female Youth ◽

Early Sexual Initiation

Abstract Background Evidences on determinants of early sexual initiation among female youth is still limited especially; community-level factors are not investigated in Ethiopia. Therefore, the aim of this study was to assess individual and community-level factors associated with early sexual initiation among female youth in Ethiopia. Methods The 2016 Ethiopian Demographic and Health Survey (EDHS) dataset were used and a total of 6143 participants (female youth) were included. Multi-level mixed-effect logistic regression was done to identify individual and community-level factors. Adjusted odds ratio along with 95% confidence interval was used to show the strength and direction of the association. Finally, the level of statistical significance was declared at P value less than 0.05. Results Individual-level factors significantly associated with early sexual initiation among female youth were; age group from 19 to 24 years [AOR = 5.8, 95% CI = (4.6, 7.3)], not attending school [AOR = 14.1, 95% CI = (8.1, 24.7)], ever chewing Chat [AOR = 2.0, 95% CI = (1.3, 3.0)]. From community-level factors: living in Addis Ababa [AOR = 0.3, 95% CI = (0.2, 0.5)], living in Gambella [AOR = 2.7, 95% CI = (1.7, 4.3)] and live in a low proportion of poor communities [AOR = 0.7, 95% CI = (0.5, 0.9)] were significantly associated with early sexual initiation among female youth in Ethiopia. Conclusions Age, low educational status, ever chewing Chat, region and live in a high proportion of poor community had a statistical association with early sexual initiation among female youth in Ethiopia. Improving educational coverage and community-level of wealth status are important intervention areas to delay the age of early sexual initiation.

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Prevalence of Overweight/Obesity and Associated Factors Among Under-Five Children in Ethiopia: Evidence From the 2019 Ethiopia Mini Demographic and Health Survey (Emdhs); A Multilevel Analysis

10.21203/rs.3.rs-724918/v1 ◽

2021 ◽

Author(s):

Mathewos Alemu Gebremichael ◽

Melkamu Merid Mengesha ◽

Samuel Hailegebrea’l ◽

Hanan Abdulkadir ◽

Biruk Bogale Wolde

Keyword(s):

Health Survey ◽

Low Income ◽

Associated Factors ◽

Childhood Overweight ◽

Overweight And Obesity ◽

The Body ◽

Demographic And Health Survey ◽

Under Five ◽

Under Five Children ◽

Childhood Overweight And Obesity

Abstract Background: Childhood overweight and obesity are emerging public health challenges of the 21st century. There was a 24% increase in the number of overweight children under the age of five years in low-income countries. Despite the significant risk of childhood overweight/obesity for non-communicable diseases, premature death, disability, and reproductive disorders in their adult life, little attention has been given. Therefore, we aimed to assess the prevalence of overweight/obesity and associated factors among under-five children. Methods: This study was conducted using data from a nationally representative sample of the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). The Mini EDHS was a community-based cross-sectional study that covered all the administrative regions of Ethiopia. The data collection was conducted between March 21, 2019, to June 28, 2019. Both descriptive and analytic findings were produced using STATA version 14. For associated factors, a multilevel binary logistic regression model was fitted to account for the hierarchical nature of the data. Adjusted odds ratio (aOR) with 95% confidence interval (CI) was reported to show the strength of association and statistical significance. Results: A total 5,164 under-five children were included in this study. The overall prevalence of overweight/obesity was 2.14 % (95% CI; 1.74-2.53) (more than two standard deviations (+2SD) above the median of the reference population) based on the body mass index (BMI) Z-score. The odds of overweight/obesity was higher among children aged less than 6 months (aOR= 5.19; 95%CI: 2.98-9.04), 6-24 months (aOR = 1.97; 95%CI: 1.18-3.29), delivered by caesarean section (aOR = 1.75; 95% CI: 1.84-3.65), living in Addis Ababa city (aOR = 2.16; 95%CI: 1.59-7.81), Oromia region (aOR = 1.93; 95CI: 1.71-5.24), having mothers with the age 40-49 years (aOR = 3.91; 95%CI: 1.90-16.92), uses traditional contraceptive methods (aOR = 2.63; 95%CI: 1.66-10.47), and households headed by male (aOR = 1.71; 95%CI: 1.84-3.48). Conclusion: This study showed that childhood overweight/obesity is the problem in Ethiopia. There was an interplay of several factors that affect childhood obesity including child factors, maternal socio-demography, and healthcare utilization, and geography of residence. Therefore, strategies to reduce childhood overweight and obesity should consider a multitude of contributing factors.

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A Decomposition Analysis of Inequality in Malnutrition among Under-Five Children in Iran: Findings from Multiple Indicator Demographic and Health Survey, 2010

Iranian Journal of Public Health ◽

10.18502/ijph.v48i4.1009 ◽

2019 ◽

Cited By ~ 1

Author(s):

Abdollah ALMASIAN KIA ◽

Sahar GOODARZI ◽

Heshmatollah ASADI ◽

Ardeshir KHOSRAVI ◽

Aziz REZAPOUR

Keyword(s):

Health Survey ◽

Maternal Education ◽

Socioeconomic Inequality ◽

Demographic And Health Survey ◽

Decomposition Approach ◽

Under Five ◽

Under Five Children ◽

Multiple Indicator ◽

The Impact ◽

Concentration Indices

Background: Nutritional status at the early stages of children’s lives is essential for growth and development not only in infancy but also in adult life. This study aimed to measure the inequality in malnutrition among under-five children in Iran and explore the impact of socioeconomic factors on this inequality using a regression-based decomposition approach. Methods: Data were extracted from Iran's Multiple-Indicator Demographic and Health Survey 2010. The concentration index of stunting, underweight, and wasting were applied in order to measure the magnitude of socioeconomic inequality in child malnutrition. Moreover, the concentration indices were decomposed to understand the contribution of socioeconomic variables in childhood malnutrition inequality. Results: The obtained concentration indices of stunting, underweight, and wasting were respectively -0.177, -0.092, and -0.031. Socioeconomic inequality in stunting and underweight was statistically significant, however this socioeconomic gradient was not observed in wasting. More than 50% of the inequality in stunting and about 63% of the inequality in underweight were influenced by socioeconomic status. Furthermore, maternal education was associated with 19% and 22% of inequality in stunting and underweight respectively. Conclusion: The average reduction of malnutrition indices at the national level hides the burden of malnutrition among children in poor families. If government and policymakers seek to solve this problem, they have to take direct and targeted actions to eliminate the existing inequalities in the socioeconomic determinants associated with malnutrition.

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Socio-demographic, environmental and behavioural factors of diarrhoea among under-five children in Rural Ethiopia: further analysis of the 2016 Ethiopian demographic and health survey

10.21203/rs.2.14959/v3 ◽

2020 ◽

Author(s):

Melkamu Molla Ferede

Keyword(s):

Birth Order ◽

Health Survey ◽

Associated Factors ◽

Binary Logistic Regression ◽

Study Data ◽

Demographic And Health Survey ◽

Under Five ◽

Under Five Children ◽

Rural Ethiopia ◽

Behavioural Factors

Abstract Background: Diarrhoea is one of the major contributors to deaths among under-five children in Ethiopia. Studies conducted in different countries showed that rural children are highly affected by diarrhoea than urban children. Thus, the purpose of this study was to identify the socio-demographic, environmental and behavioural associated factors of the occurrence of diarrhoea among under-five children in rural Ethiopia. Methods: Data for the study was drawn from the 2016 Ethiopia Demographic and Health Survey. A total of 8,041 under-five children were included in the study. Data was analysed using SPSS version 23. Binary logistic regression was used for the analysis of the data to assess the association of occurrence of diarrhoea with socio-demographic, environmental and behavioural associated factors among under-five children. Results: Children aged 6-11 months (AOR: 3.5; 95% CI: 2.58-4.87), 12-23 months (AOR: 3.1; 95% CI: 2.33-4.04) and 24-35 months (AOR: 1.7; 95% CI: 1.26-2.34) were significantly associated with diarrhoea. Diarrhoea was also significantly associated with male children (AOR: 1.3; 95% CI: 1.05-1.58), children in Afar region (AOR: 1.92; 95% CI: 1.01-3.64), Somali region (AOR: .42; 95% CI: (.217-.80), Gambela region (AOR: 2.12; 95% CI: 1.18, 3.81), households who shared toilet facilities with other households (AOR: 1.4; 95% CI: 1.09-1.77), fourth birth order (AOR: .1.81; 95% CI: 1.17-2.79), fifth and above birth order (AOR: 1.85; 95% CI: 1.22, 2.81) and the interaction of older mothers with three or more under-five children (AOR: 4.7; 95% CI: 1.64-13.45). Conclusion: The age of a child, sex of a child, region, birth order, toilet facilities shared with other households and the interaction effect of number of under-five children with mother’s current age are identified as associated factors for diarrhoea occurrence among under-five children in rural Ethiopia. The findings carry implications for the need for planning and implementing appropriate prevention strategies that target rural under-five children.

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Determinants of wife-beating acceptance among reproductive age women in Ethiopia: a multilevel analysis of 2016 Ethiopian demographic and health survey

BMC Women s Health ◽

10.1186/s12905-021-01484-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mastewal Arefaynie ◽

Gedamnesh Bitew ◽

Erkihun Tadesse Amsalu ◽

Bereket Kefale ◽

Amare Muche ◽

...

Keyword(s):

Health Survey ◽

Addis Ababa ◽

Statistical Significance ◽

Demographic And Health Survey ◽

Community Level ◽

Reproductive Age ◽

Wife Beating ◽

Mixed Effect ◽

Reproductive Age Women ◽

Television Exposure

Abstract Background There is limited national representative evidence on determinants of women’s acceptance of wife-beating especially; community level factors are not investigated in Ethiopia. Thus, this study aimed to assess individual and community-level factors associated with acceptance of wife beating among reproductive age women in Ethiopia. Methods Secondary data analysis was done on 2016 Ethiopian Demographic and Health Survey data. A total of 15,683 weighted reproductive age group women were included in the analysis. Multi-level mixed-effect logistic regression analysis was done by Stata version 14.0 to identify individual and community-level factors. An adjusted odds ratio with a 95% confidence interval was used to show the strength and direction of the association. Statistical significance was declared at p value less than 0.05 at the final model. Result Individual-level factors significantly associated with acceptance of wife-beating among women were; being Muslim follower [AOR = 1.3, 95% CI = (1.1, 1.5)], Being married [AOR = 1.3, 95% CI = (1.1, 1.6)], attending primary, secondary and higher education [AOR = 0.8, 95% CI = (0.7, 0.9)], [AOR = 0.4, 95% CI = (0.3, 0.5)], [AOR = 0.3, 95% CI (0.2, 0.4)] respectively. From community level factors, living in Somali [AOR = 0.2 95% CI = (0.1, 0.3)], Addis Ababa [AOR = 0.3, 95%CI = (0.2, 0.5)] and Dire Dawa [AOR = 0.5, 95% CI = (0.3, 0.7)] were 80%, 70% and 50% less likely accept wife-beating when compare to women who live in Tigray region, respectively. Live in high proportion of poor community [AOR = 1.2, 95% CI = (1.1, 1.3)], live in low proportion of television exposure communities [AOR = 1.4, 95% CI = (1.2, 2.2)] were significantly associated with acceptance of wife-beating among women in Ethiopia. Conclusion Educational status, religion, marital status, region, community-level wealth, and community level of television exposure had a statistical association with women’s acceptance of wife-beating. Improving educational coverage, community-level of media exposure, community-level wealth status and providing community-friendly interventions are important to reduce the acceptance of wife-beating among women in Ethiopia.

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