scholarly journals Magnitudes and Determinants of Antenatal Care Utilization among Pregnant Women in East Africa: Evidence from Demographic and Health Surveys (DHS) from 2010 to 2018

2021 ◽  
Author(s):  
Temam Beshir Raru ◽  
Belay Negash ◽  
Biruk Shalmenu ◽  
Addisu Birhanu ◽  
Lemma Demissie ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
East Africa ◽  
Health Surveys ◽  
Logistic Regression Model ◽  
Media Exposure ◽  
Wealth Index ◽  
Demographic And Health Surveys ◽  
East African ◽  
African Countries

Abstract Introduction: The use of antenatal care (ANC) plays a major role in minimizing maternal and child mortality through effective and appropriate screening, preventive, or treatment intervention. Despite the fact that almost all of the pregnancy-related mortalities are largely preventable through adequate use of ANC, Sub-Saharan Africa (SSA) particularly East African Countries continues to share the largest share of global maternal, and newborn mortality. Therefore, this study aimed to estimate the overall magnitude and determinants of ANC utilization in the 11 East Africa Countries from 2010 to 2018 using recent Demographic and Health Surveys (DHS)Methods: A secondary data analysis was done based on DHS from 2010 to 2018 in the 11 East African Countries. A total weighted sample of 89,991 women who gave birth in the 5 years preceding each country’s DHS survey were included in this study. Data processing and analysis were performed using STATA 15 software. Multilevel mixed effect logistic regression model was fitted. Model comparison was done based on Akaike and Bayesian Information Criteria (AIC and BIC). Variables with a p-value≤0.05 were declared as significant determinants of ANC utilization.Results: The magnitude of ANC utilization in East African Countries was 53.03% (95% CI: 52.70, 53.35) with the highest ANC utilization in Kenya (57.64%) and the lowest ANC utilization in Comoros (48.99%). In the multivariable multilevel logistic regression model; age 20-24 (Adjusted Odds Ratio (AOR) = 1.25; 95% CI; 1.17-1.34), 25-29 AOR = 1.47; 95% CI; 1.37-1.58), 30-34 (AOR = 1.58; 95% CI; 1.47-1.71), 35-39 (AOR = 1.63; 95% CI; 1.50-1.77), 40-44 (AOR = 1.64; 95% CI; 1.49-1.81), 45-49 (AOR = 1.71; 95% CI; 1.51-1.93), primary education (AOR = 1.24; 95% CI; 1.18-1.31), richest wealth index (AOR = 1.57; 95% CI; 1.47-1.67), being in rural resident (AOR = 0.93; 95% CI; 0.88,0.98), have media exposure (AOR = 1.11; 95% CI; 1.07-1.15), and being a Zimbabwe resident (AOR = 2.87; 95% CI; 2.55-3.23) were among factors that are significantly associated with ANC utilization.Conclusion: ANC utilization was low in the East Africa countries. Age, women education, wealth index, birth order, residence, media exposure and living countries were major determinants of ANC utilization. It would be useful to increase financial support strategies that enables mothers from poor households to use health services will be advantageous. To increase women’s understanding of the significance of ANC utilization, health education targeting mothers with no education is very crucial.

scholarly journals Complete basic childhood vaccination and associated factors among children aged 12–23 months in East Africa: a multilevel analysis of recent demographic and health surveys

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Getayeneh Antehunegn Tesema ◽  
Zemenu Tadesse Tessema ◽  
Koku Sisay Tamirat ◽  
Achamyeleh Birhanu Teshale
Keyword(s):  
East Africa ◽  
Multilevel Analysis ◽  
Birth Interval ◽  
Associated Factors ◽  
Wealth Index ◽  
Childhood Vaccination ◽  
Demographic And Health Surveys ◽  
East African ◽  
African Countries ◽  
Vaccine Preventable Diseases

Abstract Background Complete childhood vaccination remains poor in Sub-Saharan Africa, despite major improvement in childhood vaccination coverage worldwide. Globally, an estimated 2.5 million children die annually from vaccine-preventable diseases. While studies are being conducted in different East African countries, there is limited evidence of complete basic childhood vaccinations and associated factors in East Africa among children aged 12–23 months. Therefore, this study aimed to investigate complete basic childhood vaccinations and associated factors among children aged 12–23 months in East Africa. Methods Based on the Demographic and Health Surveys (DHSs) of 12 East African countries (Burundi, Ethiopia, Comoros, Uganda, Rwanda, Tanzania, Mozambique, Madagascar, Zimbabwe, Kenya, Zambia, and Malawi), secondary data analysis was performed. The study included a total weighted sample of 18,811 children aged 12–23 months. The basic childhood vaccination coverage was presented using a bar graph. Multilevel binary logistic regression analysis was fitted for identifying significantly associated factors because the DHS has a hierarchical nature. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance (−2LLR) were used for checking model fitness, and for model comparison. Variable with p-value ≤0.2 in the bi-variable multilevel analysis were considered for the multivariable analysis. In the multivariable multilevel analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the significance and strength of association with full vaccination. Results Complete basic childhood vaccination in East Africa was 69.21% (95% CI, 69.20, 69.21%). In the multivariable multilevel analysis; Mothers aged 25–34 years (AOR = 1.21, 95% CI: 1.10, 1.32), mothers aged 35 years and above (AOR = 1.50, 95% CI: 1.31, 1.71), maternal primary education (AOR = 1.26, 95% CI: 1.15, 1.38), maternal secondary education and above (AOR = 1.54, 95% CI: 1.36, 1.75), husband primary education (AOR = 1.25, 95% CI: 1.13, 1.39), husband secondary education and above (AOR = 1.24, 95% CI: 1.11, 1.40), media exposure (AOR = 1.23, 95% CI: 1.13, 1.33), birth interval of 24–48 months (AOR = 1.28, 95% CI: 1.15, 1.42), birth interval greater than 48 months (AOR = 1.35, 95% CI: 1.21, 1.50), having 1–3 ANC visit (AOR = 3.24, 95% CI: 2.78, 3.77), four and above ANC visit (AOR = 3.68, 95% CI: 3.17, 4.28), PNC visit (AOR = 1.34, 95% CI: 1.23, 1.47), health facility delivery (AOR = 1.48, 95% CI: 1.35, 1.62), large size at birth 1.09 (AOR = 1.09, 95% CI: 1.01, 1.19), being 4–6 births (AOR = 0.83, 95% CI: 0.75, 0.91), being above the sixth birth (AOR = 0.60, 95% CI: 0.52, 0.70), middle wealth index (AOR = 1.16, 95% CI: 1.06, 1.28), rich wealth index (AOR = 1.20, 95% CI: 1.09, 1.33), community poverty (AOR = 1.21, 95% CI: 1.11, 1.32) and country were significantly associated with complete childhood vaccination. Conclusions In East Africa, full basic childhood vaccine coverage remains a major public health concern with substantial differences across countries. Complete basic childhood vaccination was significantly associated with maternal age, maternal education, husband education, media exposure, preceding birth interval, number of ANC visits, PNC visits, place of delivery, child-size at birth, parity, wealth index, country, and community poverty. Public health interventions should therefore target children born to uneducated mothers and fathers, poor families, and those who have not used maternal health services to enhance full childhood vaccination to reduce the incidence of child mortality from vaccine-preventable diseases.

scholarly journals Pooled prevalence and determinants of skilled birth attendant delivery in East Africa countries: a multilevel analysis of Demographic and Health Surveys

2020 ◽  
Vol 46 (1) ◽  
Author(s):  
Zemenu Tadesse Tessema ◽  
Getayeneh Antehunegn Tesema
Keyword(s):  
East Africa ◽  
Odds Ratio ◽  
Wealth Index ◽  
Skilled Birth Attendant ◽  
Skilled Birth Attendance ◽  
Demographic And Health Surveys ◽  
East African ◽  
African Countries ◽  
Birth Attendance ◽  
Pooled Prevalence

Abstract Introduction Skilled health professional assisted delivery is an effective strategy to reduce maternal and newborn mortality. Skilled assistant delivery can prevent about 16–33% of maternal and newborn mortality. Despite the commitments of the government to assure home free delivery, majority of the births in Sub-Saharan Africa are attended by traditional birth attendants. As to our search of the literature, there is limited evidence on the prevalence and determinants of skilled delivery in East African countries. Therefore, this study aimed to estimate the pooled prevalence and determinants of skilled birth attendant delivery in East Africa Countries. Methods Pooled analysis was done based on Demographic and Health Surveys conducted in the 12 East African countries from 2008 to 2017. A total weighted sample of 141,483 women who gave birth during the study period was included in the study. The pooled prevalence of skilled birth attendance was estimated using STATA version 14. Intra-class Correlation Coefficient, Median Odds Ratio, Proportional Change in Variance, and deviance were used for model fitness and comparison. The multilevel multivariable logistic regression model was fitted to identify determinants of skilled birth attendance in the region. Adjusted Odds Ratio with its 95% Confidence Interval was used to declare significant determinants of skilled birth attendants. Results The pooled prevalence of skilled birth attendant in East African countries were 67.18% (95% CI:66.98, 67.38) with highest skilled birth attendant in Rwanda (90.68%) and the lowest skilled birth attendant in Tanzania (11.91%). In the Multilevel multivariable logistic regression model; age 15–24 (Adjusted Odds Ratio (AOR) = 1.14, 95%CI:1.09, 1.18), age 25–49(AOR = 1.16, 95%CI:1.10,1.23), primary women education (AOR = 1.57, 95%CI:1.51,1.63), secondary and above women education (AOR = 2.85, 95%CI:1.73,3.01), primary husband education (AOR = 1.11, 95%CI = 1.07,1.15), secondary and above husband education (AOR = 1.46, 95%CI = 1.40,1.53), middle wealth index (AOR = 1.43, 95%CI = 1.38,1.49),rich wealth index (AOR = 2.38, 95%CI = 2.28,2.48), had ANC visit (AOR = 1.68, 95%CI = 1.62,1.73),multiple gestation (AOR = 2.06, 95%CI = 1.90,2.25), parity 2–4(AOR = 0.65, 95%CI = 0.61,0.69), parity 5 + (AOR = 0.44, 95%CI = 0.41,0.47), accessing health care not big problem (AOR = 1.32, 95%CI = 1.28,1.36), residence (AOR = 0.43, 95%CI = 0.41,0.45) and being Burundi resident (AOR = 0.77, 95%CI = 0.70,0.85) were significantly associated with skilled assisted delivery. Conclusion Skilled birth attendance at birth in the East Africa countries was low. Maternal age, women and husband education, wealth index, antenatal care visit, multiple gestations, parity, accessing health care, residence, and living countries were major determinants of skilled attendant delivery. Strategies to increase the accessibility and availability of healthcare services, and financial support that targets mothers from poor households and rural residents to use health services will be beneficial. Health education targeting mothers and their partner with no education are vital to increasing their awareness about the importance of skilled birth attendance at birth.

scholarly journals Prevalence and Determinants of Home Delivery in Eastern Africa: Further Analysis of Countries Recent Demographic and Health Survey Data

2021 ◽  
Author(s):  
Lemma Demissie Regassa ◽  
Assefa Tola ◽  
Adisu Birhanu Weldesenbet ◽  
Biruk Shalmeno Tusa
Keyword(s):  
East Africa ◽  
Survey Data ◽  
Health Survey ◽  
Media Exposure ◽  
Wealth Index ◽  
Home Delivery ◽  
Demographic And Health Survey ◽  
Eastern Africa ◽  
East African ◽  
African Countries

Abstract Background: Despite the high proportion of maternal mortality ratio in East African countries primarily attributed to home delivery, overall magnitude of home delivery and its determinants remains unclear. Therefore, the current study aimed to determine magnitude of home delivery and its determinant factors in East Africa using Demographic and Health Survey (DHS) data.Methods: We pooled the DHS survey data of the 11 East African countries, and a total weighted sample of 125,786 women were included in the study. Generalized Linear Mixed Models (GLMM) was fitted to identify factors associated with home delivery. Variables with Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI), and p-value < 0.05 in the final GLMM model were reported to declare significantly associated factors with home delivery.Result: The weighted prevalence of home delivery was 23.79% [95% CI: 23.55 – 24.02] among women in East Africa countries. Home delivery was highest among Ethiopian women (72.5%) whereas, it was lowest among women from Mozambique (2.8%). In GMM, respondent’s age group, marital status, educational status, place of residence, living country, wealth index, media exposure and total children ever born were shown significantly associated with the home delivery in the East Africa countiesConclusion: Home delivery was varied between countries of East African zone. The home delivery was significantly increased among women aged 20-34 years, higher number of ever born children, rural residence, never married or formerly married participants. To the contrast home delivery was decreased with higher educational level, media exposure, and higher wealth index. Wide range interventions to decrease home delivery should focus on addressing inequities associated with maternal education, family wealth, increased access to media, as well as narrowing the gap between the rural and the urban areas, poor and rich families, and married and unmarried mothers.

scholarly journals Zinc utilization and associated factors among under-five children with diarrhea in East Africa: A generalized linear mixed modeling

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243245
Author(s):  
Yigizie Yeshaw ◽  
Misganaw Gebrie Worku ◽  
Zemenu Tadesse Tessema ◽  
Achamyeleh Birhanu Teshale ◽  
Getayeneh Antehunegn Tesema
Keyword(s):  
East Africa ◽  
Associated Factors ◽  
Maternal Education ◽  
Media Exposure ◽  
Wealth Index ◽  
East African ◽  
African Countries ◽  
Under Five ◽  
Under Five Children ◽  
Zinc Utilization

Introduction Diarrhea is the leading cause of illness and death among under-five children in low and middle income countries. Through the provision of zinc supplements has been shown to reduce the severity and duration of diarrhea, as well as the risk of mortality, the use of zinc for the treatment of diarrhea is still very low in low-income countries. Therefore, this study was conducted to determine the prevalence and associated factors of zinc utilization among under-five children with diarrhea in East Africa. Methods A secondary data analysis of the recent Demographic and Health Surveys (DHS) of East African countries were used to determine the prevalence and associated factors of zinc utilization among under-five children with diarrhea in East Africa. A total weighted samples of 16,875 under-five children with diarrhea were included in the study. A generalized linear mixed model (using Poisson regression with robust error variance) was used. Prevalence Ratios (PR) with their 95% confidence interval (CI) were calculated for those variables included in the final model. Results The overall prevalence of zinc utilization among under-five children with diarrhea in this study was 21.54% (95% CI = 20.92–22.16). Of East African countries, Uganda had the highest prevalence of zinc utilization (40.51%) whereas Comoros had the lowest (0.44%). Maternal primary education (Adjusted Prevalence Ratio(aPR) = 1.29, 95% CI: 1.16–1.44), secondary education (aPR = 1.36, 95% CI = 1.19–1.55) and higher education (aPR = 1.91, 95% CI = 1.52–2.40), high community women education (aPR = 1.12, 95% CI = 1.02–1.24), high wealth index (aPR = 1.12, 95% CI = 1.01–1.24), high community media exposure (aPR = 1.17, 95% CI = 1.06–1.29) were associated with a higher prevalence of zinc utilization. Conclusion The prevalence of zinc utilization among under-five children was found to be low in East Africa. Maternal education, wealth index, community women education, and community media exposure were significantly associated with zinc utilization. Increased mass media exposure, maternal education and wealth index is recommended to improve zinc utilization among under-five children with diarrhea.

Utilization and Determinants of Antenatal Care Visits in East African Countries: A Multicountry Analysis of Demographic and Health Surveys

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Zemenu Tadesse Tessema ◽  
Amare Minyihun
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Logistic Regression Model ◽  
East African ◽  
African Countries ◽  
Wealth Status ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Planned Pregnancy ◽  
Contraceptive Utilization

Background. The health care a woman receives during pregnancy is important for her survival and baby, both at the time of delivery and shortly after that. In the context of high maternal morbidity and mortality in sub-Saharan Africa, fewer than 80% of pregnant women receive antenatal care visit services. Receiving antenatal care visits at least four times increases the likelihood of receiving effective maternal health interventions through the antenatal period. This study aimed to identify the utilization and determinants of attending at least four visits in 12 East African countries. Methods. The study used the demographic and health survey data from 12 East African countries from 2008 to 2018. The DHS program adopts standardized methods involving uniform questionnaires, manuals, and field procedures to gather information comparable across countries globally. A multivariable logistic regression model was fitted to identify the determinants of completing at least four antenatal care services. With their 95% CI obtained from the adjusted multilevel logistic regression model, the adjusted odds ratio was presented to show the magnitude of the relationship between the independent variable and completing antenatal care visits. Results. The pooled utilization of attending at least four antenatal care visit in the East African region was 52.44% (95% CI: 52.13, 52.74), with the highest attending at least four or more antenatal care visit visits in Zimbabwe (75.72%) and the lowest attending at least four or more antenatal care visit visits in Ethiopia (31.82%). The significant determinants of completing at least four ANC visits were age category (24–34 (AOR = 1.24, 95% CI: 1.18, 1.31) and 35–49 (AOR = 1.42, 95% CI: 1.32, 1.53)); being married women (AOR = 1.11, 95% CI: 1.1.05, 1.16); education levels of primary education (AOR = 1.20, 95% CI: 1.13, 1.27), secondary education (AOR = 1.24, 95% CI: 1.24, 1.47), and higher education (AOR = 1.91, 95% CI: 1.62, 2.14); birth order (2–4 (AOR = 0.75, 95% CI: 0.70, 0.79) and 5+ (AOR = 0.63, 95% CI: 0.58, 0.68)); planned pregnancy (AOR = 0.81, 95% CI: 0.75, 0.86); contraceptive utilization (AOR = 1.36, 95% CI: 1.29, 1.43); wealth status of middle (AOR = 1.11, 95% CI: 1.05, 1.17) and rich (AOR = 1.25, 95% CI: 1.18, 1.32); having no problem accessing health care (AOR = 1.0.95, 95% CI: 0.89, 0.97); and living countries. Conclusions. The coverage of completing the recommended antenatal care visit was low in the region. Age, marital status, mother’s and partner’s education, women’s occupation, birth order, planned pregnancy, contraceptive utilization, wealth status, healthcare accessibility, and living countries were the major determinants of completing recommended antenatal care visits. Therefore, intersectoral collaboration to promote female education and empowerment, improve geographical access to health care, and strengthen implementation of antenatal care policies with active community participation is recommended. In addition, creating a conducive environment in entrepreneurial activities for poor women is needed.

Using survey data: towards valid estimates of poverty in the South

2019 ◽  
pp. 79-90
Author(s):  
Roy Carr-Hill
Keyword(s):  
Developing Countries ◽  
Survey Data ◽  
Health Surveys ◽  
Urban Slums ◽  
Demographic And Health Surveys ◽  
Household Surveys ◽  
Death Registration ◽  
East African ◽  
African Countries ◽  
The World

It is important to be cautious about making inferences from survey data. This chapter focuses on one very important but unexamined problem, that of the undercount of the poorest in the world. This arises both by design (excluding the homeless, those in institutions and nomadic populations) and in practice (those in fragile households, urban slums, insecure areas and servants/slaves in rich households). In developing countries, it is difficult to make inter-censal estimates because essential data like birth and death registration are not systematically collected. Donors have therefore promoted the use of international standardized household surveys. A possible alternative is Citizen surveys initiated by an Indian NGO (Pratham). Comparisons are made between citizen surveys and contemporaneous Demographic and Health Surveys in three East African countries

scholarly journals Magnitudes of Anemia and Its Determinant Factors Among Lactating Mothers in East African Countries: Using the Generalized Mixed-Effect Model

2021 ◽  
Vol 8 ◽  
Author(s):  
Biruk Shalmeno Tusa ◽  
Adisu Birhanu Weldesenbet ◽  
Nebiyu Bahiru ◽  
Daniel Berhanie Enyew
Keyword(s):  
Family Planning ◽  
Antenatal Care ◽  
Wealth Index ◽  
Mixed Effect Model ◽  
East African ◽  
African Countries ◽  
Mixed Effect ◽  
Determinant Factors ◽  
Effect Model ◽  
Lactating Mothers

Background: The number of studies on the magnitude of anemia and its determinant factors among lactating mothers is limited in East African countries regardless of its multivariate consequences. Even though few studies were conducted on the magnitude of anemia and its determinants, most of them focused on the country level and different parts of countries. Therefore, the current study is aimed to determine the magnitude of anemia and determinant factors among lactating mothers in East African countries.Methods: From nine East African countries, a total weighted sample of 25,425 lactating mothers was included in the study. Determinate factors of anemia were identified using generalized linear mixed models (GLMM). Variables with a p &lt; 0.05 in the final GLMM model were stated to confirm significant association with anemia.Result: The magnitude of anemia in East African countries was found to be 36.5% [95% confidence interval (CI): 35.55%, 36.75%]. Besides, as for the generalized linear mixed-effect model, age, educational status, working status, country of residence, wealth index, antenatal care service, place of delivery, history of using family planning in a health facility, current pregnancy, and visited by fieldworker in the last 12 months were factors that have a significant association with anemia in lactating mothers.Conclusion: In East Africa, more than one-third of lactating mothers have anemia. The odds of anemia were significantly low among young mothers (15–34), who had primary education, were working, country of residence, and higher wealth index (middle and high). In addition, the likelihood of anemia was also low among lactating mothers who had antenatal care, used family planning, delivered at a health facility, were pregnant during the survey, and visited by fieldworkers. Therefore, promoting maternal care services (family planning, Antenatal Care (ANC), and delivery at health facilities) and a field visit by health extension workers are strongly recommended.

scholarly journals Factors Affecting Postnatal Care in Bangladesh: Clustered Data Analysis

2018 ◽  
Vol 66 (1) ◽  
pp. 59-65
Author(s):  
Mehejabeen Mahbub ◽  
Most Fatima Tuz Zahura
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Data Analysis ◽  
Antenatal Care ◽  
Regression Model ◽  
Birth Order ◽  
Postnatal Care ◽  
Logistic Regression Model ◽  
Wealth Index ◽  
Factors Affecting

The study aims to determine the factors affecting postnatal care in Bangladesh using the data extracted from Bangladesh Demographic and Health Survey (BDHS), 2014. For the purpose of regression analysis, mixed logistic regression model has been utilized to take into account the possible correlation among subjects within clusters. It is found that region, place of residence, mother’s education, wealth index, access to media, birth order and antenatal care visits have significant association with postnatal care. Dhaka Univ. J. Sci. 66(1): 59-65, 2018 (January)

Sign in / Sign up

Export Citation Format

Share Document