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Spatial variation and factors associated with home delivery after ANC visit in Ethiopia; spatial and multilevel analysis.
PLoS One. 2022; 17(8):e0272849.Plos

Abstract

INTRODUCTION

Institutional delivery is crucial to reduce maternal and neonatal mortality as well as serious morbidities. However, in Ethiopia, home delivery (attended by an unskilled birth attendant) after antenatal care (ANC) visit is highly in practice. Therefore, this study aimed to assess the spatial variation and determinants of home delivery after antenatal care visits in Ethiopia.

METHOD

A secondary data analysis was conducted using the 2019 mini Ethiopian demographic and health survey. A total of 2,923 women who had ANC visits were included. Spatial analysis was done by using GIS 10.7 and SaTscan 9.6. The risk areas for home delivery from GIS and spatial scan statistics results were reported. A multi-level logistic regression model was fitted using Stata14 to identify individual and community-level factors associated with home delivery after ANC visit. Finally, AOR with 95% CI and random effects were reported.

RESULT

Home delivery after ANC visit was spatially clustered in Ethiopia(Moran's index = 0.52, p-value <0.01). The primary clusters were detected in Oromia and SNNP region (LLR = 37.48, p < 0.001 and RR = 2.30) and secondary clusters were located in Benishangul Gumuz, Amhara, Tigray and Afar (LLR = 29.45, p<0.001 and RR = 1.54). Being rural resident (AOR = 2.52; 95%CI 1.09-5.78), having no formal education (AOR = 3.19;95% CI 1.11-9.16), being in the poor (AOR = 2.20;95%CI 1.51-3.22) and middle wealth index (AOR = 2.07;95% CI 1.44-2.98), having one ANC visit (AOR = 2.64; 95% CI 1.41-4.94), and living in the agrarian region (AOR = 3.63; 95%CI 1.03-12.77) had increased the odds of home delivery after ANC visit.

CONCLUSION AND RECOMMENDATION

Home delivery after ANC visit was spatially clustered in Ethiopia. Factors like maternal education, wealth index, number of ANC visits, residency and region were significantly associated with home delivery after ANC visit. Therefore, it is better to increase the number of ANC contact by giving health education, especially for women with low levels of education and better to improve the wealth status of women. A special strategy is also vital to reduce home delivery after ANC visit in those high-risk regions.

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Authors+Show Affiliations

Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

Department of Human Anatomy, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia. Department of Human Physiology, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

MeSH

EthiopiaFemaleHome ChildbirthHumansInfant, NewbornMultilevel AnalysisPregnancyPrenatal CareRural PopulationSpatial Analysis

Pub Type(s)

Journal Article

Language

eng

PubMed ID

36007083

Citation

Ayalew, Hiwotie Getaneh, et al. "Spatial Variation and Factors Associated With Home Delivery After ANC Visit in Ethiopia; Spatial and Multilevel Analysis." PloS One, vol. 17, no. 8, 2022, pp. e0272849.

Ayalew HG, Liyew AM, Tessema ZT, et al. Spatial variation and factors associated with home delivery after ANC visit in Ethiopia; spatial and multilevel analysis. PLoS One. 2022;17(8):e0272849.

Ayalew, H. G., Liyew, A. M., Tessema, Z. T., Worku, M. G., Tesema, G. A., Alamneh, T. S., Teshale, A. B., Yeshaw, Y., & Alem, A. Z. (2022). Spatial variation and factors associated with home delivery after ANC visit in Ethiopia; spatial and multilevel analysis. PloS One, 17(8), e0272849. https://doi.org/10.1371/journal.pone.0272849

Ayalew HG, et al. Spatial Variation and Factors Associated With Home Delivery After ANC Visit in Ethiopia; Spatial and Multilevel Analysis. PLoS One. 2022;17(8):e0272849. PubMed PMID: 36007083.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Spatial variation and factors associated with home delivery after ANC visit in Ethiopia; spatial and multilevel analysis. AU - Ayalew,Hiwotie Getaneh, AU - Liyew,Alemneh Mekuriaw, AU - Tessema,Zemenu Tadesse, AU - Worku,Misganaw Gebrie, AU - Tesema,Getayeneh Antehunegn, AU - Alamneh,Tesfa Sewunet, AU - Teshale,Achamyeleh Birhanu, AU - Yeshaw,Yigizie, AU - Alem,Adugnaw Zeleke, Y1 - 2022/08/25/ PY - 2021/10/18/received PY - 2022/07/27/accepted PY - 2022/8/25/entrez PY - 2022/8/26/pubmed PY - 2022/8/30/medline SP - e0272849 EP - e0272849 JF - PloS one JO - PLoS One VL - 17 IS - 8 N2 - INTRODUCTION: Institutional delivery is crucial to reduce maternal and neonatal mortality as well as serious morbidities. However, in Ethiopia, home delivery (attended by an unskilled birth attendant) after antenatal care (ANC) visit is highly in practice. Therefore, this study aimed to assess the spatial variation and determinants of home delivery after antenatal care visits in Ethiopia. METHOD: A secondary data analysis was conducted using the 2019 mini Ethiopian demographic and health survey. A total of 2,923 women who had ANC visits were included. Spatial analysis was done by using GIS 10.7 and SaTscan 9.6. The risk areas for home delivery from GIS and spatial scan statistics results were reported. A multi-level logistic regression model was fitted using Stata14 to identify individual and community-level factors associated with home delivery after ANC visit. Finally, AOR with 95% CI and random effects were reported. RESULT: Home delivery after ANC visit was spatially clustered in Ethiopia(Moran's index = 0.52, p-value <0.01). The primary clusters were detected in Oromia and SNNP region (LLR = 37.48, p < 0.001 and RR = 2.30) and secondary clusters were located in Benishangul Gumuz, Amhara, Tigray and Afar (LLR = 29.45, p<0.001 and RR = 1.54). Being rural resident (AOR = 2.52; 95%CI 1.09-5.78), having no formal education (AOR = 3.19;95% CI 1.11-9.16), being in the poor (AOR = 2.20;95%CI 1.51-3.22) and middle wealth index (AOR = 2.07;95% CI 1.44-2.98), having one ANC visit (AOR = 2.64; 95% CI 1.41-4.94), and living in the agrarian region (AOR = 3.63; 95%CI 1.03-12.77) had increased the odds of home delivery after ANC visit. CONCLUSION AND RECOMMENDATION: Home delivery after ANC visit was spatially clustered in Ethiopia. Factors like maternal education, wealth index, number of ANC visits, residency and region were significantly associated with home delivery after ANC visit. Therefore, it is better to increase the number of ANC contact by giving health education, especially for women with low levels of education and better to improve the wealth status of women. A special strategy is also vital to reduce home delivery after ANC visit in those high-risk regions. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/36007083/Spatial_variation_and_factors_associated_with_home_delivery_after_ANC_visit_in_Ethiopia DB - PRIME DP - Unbound Medicine ER -