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Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective.
BMC Pregnancy Childbirth. 2020 Feb 11; 20(1):97.BP

Abstract

BACKGROUND

All pregnancies are at risk and have to be attended by skilled professionals. In Ethiopia however nearly half (45.7%) of the women were giving birth at home after antenatal care (ANC) visits in which skilled professionals were not available. Therefore, the aim of this study was to assess spatial clustering and the determinant factors of home delivery after antenatal care visits in Ethiopia.

METHODS

A case control study was conducted on 2110 mothers who gave birth at home after ANC (cases), and 2510 mothers who gave birth at health institutions after attending ANC (controls), based on EDHS 2016 data. As per the recommendations of the DHS program, we weighed the data before analysis. ArcGIS 10.3 was used to show spatial pattern and SaTScan™ 9.4 to identify significant clusters. Stata 14 was used for data cleaning, weighing, and the analysis of the determinant factors. Bi variable and multi variable multilevel mixed effect logistic regression was fitted. Finally, the Log-likelihood ratio (LLR) and Relative risk with p-value of spatial scan statistics and AOR with 95% CI for significant determinant factors were reported.

RESULTS

Home delivery after ANC was spatially clustered in Ethiopia (Moran's Index = 0.91, p-value< 0.01). Attending, 1-3 ANC visits (AOR = 1.41, 95%CI: 1.17-1.71), no information about birth preparedness plan (AOR = 2.21, 95%CI: 1.83-2.69), pregnancies wanted later (AOR = 1.55, 95%CI: 1.20, 2.06), not having health insurance (AOR = 2.16, 95% CI: 1.29, 3.62), Muslim (AOR = 1.57, 95% CI: 1.13, 2.19) and protestant (AOR = 1.72, 95%CI: 1.16, 2.42) religions were positively associated with home delivery; While being rich (AOR = 0.42, 95%CI: 0.32-0.54), middle wealth index (AOR = O.66, 95%CI: 0.51, 0.86), primary education (AOR = 0.45, 95%CI: 0.36-0.55), secondary education (AOR = 0.11, 95%CI: 0.07-0.16), above secondary education (AOR = 0.06, 95%CI: 0.03-0.11) were negatively associated.

CONCLUSIONS

Home delivery after ANC follow ups was spatially clustered. Socio-demographic, health service and pregnancy related factors determined the prevalence of home delivery after antenatal care visits. Strengthening women's education, ANC visit, giving more information about birth preparedness plan, and improving family wealth are vital to reduce home delivery after antenatal care visits.

Links

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Authors+Show Affiliations

Muluneh AG
Department of Public Health Officer, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. goshuatalay12@gmail.com. Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. goshuatalay12@gmail.com.
Animut Y
Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Ayele TA
Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. Gondar University Dabat research center, Gondar, Ethiopia.

MeSH

AdolescentAdultBirth OrderCase-Control StudiesCluster AnalysisCross-Sectional StudiesDemographyEducational StatusEthiopiaFemaleHome ChildbirthHumansIncomeMothersPatient Acceptance of Health CarePregnancyPrenatal CareSpatial AnalysisYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32046677

Citation

Muluneh, Atalay Goshu, et al. "Spatial Clustering and Determinants of Home Birth After at Least One Antenatal Care Visit in Ethiopia: Ethiopian Demographic and Health Survey 2016 Perspective." BMC Pregnancy and Childbirth, vol. 20, no. 1, 2020, p. 97.
Muluneh AG, Animut Y, Ayele TA. Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective. BMC Pregnancy Childbirth. 2020;20(1):97.
Muluneh, A. G., Animut, Y., & Ayele, T. A. (2020). Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective. BMC Pregnancy and Childbirth, 20(1), 97. https://doi.org/10.1186/s12884-020-2793-6
Muluneh AG, Animut Y, Ayele TA. Spatial Clustering and Determinants of Home Birth After at Least One Antenatal Care Visit in Ethiopia: Ethiopian Demographic and Health Survey 2016 Perspective. BMC Pregnancy Childbirth. 2020 Feb 11;20(1):97. PubMed PMID: 32046677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective. AU - Muluneh,Atalay Goshu, AU - Animut,Yaregal, AU - Ayele,Tadesse Awoke, Y1 - 2020/02/11/ PY - 2018/11/26/received PY - 2020/02/06/accepted PY - 2020/2/13/entrez PY - 2020/2/13/pubmed PY - 2020/11/20/medline KW - Antenatal care KW - Ethiopia KW - Home delivery KW - Spatial distribution SP - 97 EP - 97 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 20 IS - 1 N2 - BACKGROUND: All pregnancies are at risk and have to be attended by skilled professionals. In Ethiopia however nearly half (45.7%) of the women were giving birth at home after antenatal care (ANC) visits in which skilled professionals were not available. Therefore, the aim of this study was to assess spatial clustering and the determinant factors of home delivery after antenatal care visits in Ethiopia. METHODS: A case control study was conducted on 2110 mothers who gave birth at home after ANC (cases), and 2510 mothers who gave birth at health institutions after attending ANC (controls), based on EDHS 2016 data. As per the recommendations of the DHS program, we weighed the data before analysis. ArcGIS 10.3 was used to show spatial pattern and SaTScan™ 9.4 to identify significant clusters. Stata 14 was used for data cleaning, weighing, and the analysis of the determinant factors. Bi variable and multi variable multilevel mixed effect logistic regression was fitted. Finally, the Log-likelihood ratio (LLR) and Relative risk with p-value of spatial scan statistics and AOR with 95% CI for significant determinant factors were reported. RESULTS: Home delivery after ANC was spatially clustered in Ethiopia (Moran's Index = 0.91, p-value< 0.01). Attending, 1-3 ANC visits (AOR = 1.41, 95%CI: 1.17-1.71), no information about birth preparedness plan (AOR = 2.21, 95%CI: 1.83-2.69), pregnancies wanted later (AOR = 1.55, 95%CI: 1.20, 2.06), not having health insurance (AOR = 2.16, 95% CI: 1.29, 3.62), Muslim (AOR = 1.57, 95% CI: 1.13, 2.19) and protestant (AOR = 1.72, 95%CI: 1.16, 2.42) religions were positively associated with home delivery; While being rich (AOR = 0.42, 95%CI: 0.32-0.54), middle wealth index (AOR = O.66, 95%CI: 0.51, 0.86), primary education (AOR = 0.45, 95%CI: 0.36-0.55), secondary education (AOR = 0.11, 95%CI: 0.07-0.16), above secondary education (AOR = 0.06, 95%CI: 0.03-0.11) were negatively associated. CONCLUSIONS: Home delivery after ANC follow ups was spatially clustered. Socio-demographic, health service and pregnancy related factors determined the prevalence of home delivery after antenatal care visits. Strengthening women's education, ANC visit, giving more information about birth preparedness plan, and improving family wealth are vital to reduce home delivery after antenatal care visits. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/32046677/Spatial_clustering_and_determinants_of_home_birth_after_at_least_one_antenatal_care_visit_in_Ethiopia:_Ethiopian_demographic_and_health_survey_2016_perspective_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓11 ↑17]

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