A Multilevel Analysis Factors Associated With Diarrhea Among Under-five Children in Ethiopia Using 2016 EDHS Data: Individual and Community Level Factors.
Abstract Background: Despite numerous attempts, diarrhea remains one of the leading causes of death among children under the age of five around the world. Globally, diarrhea is the second prominent cause of death in children next to pneumonia. Every year, there are 1.7 billion children who develop diarrhea and at least 525,000 die from diarrhea. In low- and middle-income countries such as Ethiopia, diarrhea still remains one of the health problems due to its high morbidity and mortality. This study was conducted identify factors associated with diarrhea at community (cluster) level and individual level.Objectives: To assess individual and community level factors of childhood (0–59months) diarrhea in Ethiopia by using the 2016 Ethiopian Demography and Health surveys (EDHS) data, 2020. Methods: A cross-sectional secondary analysis of data pooled from 2016 Ethiopian Demographic and Health Surveys (EDHS) data was used. The analysis was done using Stata version 14.2. A multilevel logistic regression model was used to identify independent predictors of childhood diarrhea. Odds ratio with 95% CI was used in identifying the association between dependent and independent predictors Result: The prevalence of diarrhea in Ethiopia based on EDHS 2016 was 11.78%.The odds of diarrhea among children reside in rural area were 1.84 times more likely to develop diarrhea (AOR=1.82; 95% CI: 1.52-2.16) as compared to urban dwellers. Those children aged between 13 and 24 months were 2.2 times more likely to have diarrhea than (AOR=2.2, 2.15-2.98) their older counter parts (48-59 months). The measure of variation was also assessed by using ICC, MOR, and DIC with the result of 10.08, 1.56 and 316.18 respectively.Conclusion: Our findings identified that childhood diarrhea was affected by not only individual level factors but also community-level factors. At the individual level (age of the women, number of under five children in the households, age of the child, number of family members, maternal education, and the number of under-5 children) and the community-level, place of residence were significant factors associated with childhood diarrhea in Ethiopia.