Spatial pattern and determinants of institutional delivery in Ethiopia: Spatial and multilevel analysis using 2019 Ethiopian demographic and health survey.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2023
2023
Historique:
received:
14
12
2021
accepted:
01
12
2022
entrez:
16
2
2023
pubmed:
17
2
2023
medline:
22
2
2023
Statut:
epublish
Résumé
In Ethiopia, despite the progress that has been made to improve maternal and child health, the proportion of births occurring at health institutions is still very low (26%), Which significantly contribute to a large number of maternal death 412 deaths/100,000 live births. Therefore, this study intended to determine spatial pattern and factors affecting institutional delivery among women who had live birth in Ethiopia within five years preceding survey. Data from 2019 Ethiopian demographic and health survey were used. Taking into account the nested structure of the data, multilevel logistic regression analysis has been employed to a nationally representative sample of 5753 women nested with in 305 communities/clusters. A significant heterogeneity was observed between clusters for institutional delivery which explains about 57% of the total variation. Individual-level variables: primary education (OR = 1.8: 95% CI: 1.44-2.26), secondary education (OR = 3.65: 95% CI: 2.19-6.1), diploma and higher (OR = 2.74: 95% CI: 1.02-7.34), women who had both Radio and Television were 4.6 times (OR = 4.6; 95% CI: 2.52, 8.45), four and above Antenatal visit (AOR = 2.72, 95% CI:2.2, 3.34), rich wealth index (OR = 2.22; 95% CI: 1.62-2.99), birth interval for 18 to 33 months (OR = 1.8; 95% CI: 1.19, 2.92), and women who space birth for 33 and above months (OR = 2.02; 95% CI: 1.3, 3.12) were associated with institutional delivery. Community level variables, community high proportion of antenatal visit (OR = 4.68; 95% CI: 4.13-5.30), and Region were associated with institutional delivery. A clustered pattern of areas with low institutional delivery was observed in Ethiopia. Both individual and community level factors found significantly associated with institutional delivery theses showed the need for community women education through health extension programs and community health workers. And the effort to promote institutional delivery should pay special attention to antenatal care, less educated women and interventions considering awareness, access, and availability of the services are vital for regions. A preprint has previously been published.
Sections du résumé
BACKGROUND
In Ethiopia, despite the progress that has been made to improve maternal and child health, the proportion of births occurring at health institutions is still very low (26%), Which significantly contribute to a large number of maternal death 412 deaths/100,000 live births. Therefore, this study intended to determine spatial pattern and factors affecting institutional delivery among women who had live birth in Ethiopia within five years preceding survey.
METHOD
Data from 2019 Ethiopian demographic and health survey were used. Taking into account the nested structure of the data, multilevel logistic regression analysis has been employed to a nationally representative sample of 5753 women nested with in 305 communities/clusters.
RESULT
A significant heterogeneity was observed between clusters for institutional delivery which explains about 57% of the total variation. Individual-level variables: primary education (OR = 1.8: 95% CI: 1.44-2.26), secondary education (OR = 3.65: 95% CI: 2.19-6.1), diploma and higher (OR = 2.74: 95% CI: 1.02-7.34), women who had both Radio and Television were 4.6 times (OR = 4.6; 95% CI: 2.52, 8.45), four and above Antenatal visit (AOR = 2.72, 95% CI:2.2, 3.34), rich wealth index (OR = 2.22; 95% CI: 1.62-2.99), birth interval for 18 to 33 months (OR = 1.8; 95% CI: 1.19, 2.92), and women who space birth for 33 and above months (OR = 2.02; 95% CI: 1.3, 3.12) were associated with institutional delivery. Community level variables, community high proportion of antenatal visit (OR = 4.68; 95% CI: 4.13-5.30), and Region were associated with institutional delivery.
CONCLUSION
A clustered pattern of areas with low institutional delivery was observed in Ethiopia. Both individual and community level factors found significantly associated with institutional delivery theses showed the need for community women education through health extension programs and community health workers. And the effort to promote institutional delivery should pay special attention to antenatal care, less educated women and interventions considering awareness, access, and availability of the services are vital for regions. A preprint has previously been published.
Identifiants
pubmed: 36795685
doi: 10.1371/journal.pone.0279167
pii: PONE-D-21-39458
pmc: PMC9934410
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0279167Informations de copyright
Copyright: © 2023 Awol et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Déclaration de conflit d'intérêts
The author declare that they have no competing interests.
Références
Lancet. 2006 Oct 7;368(9543):1284-99
pubmed: 17027735
BMC Int Health Hum Rights. 2013 Apr 15;13:20
pubmed: 23587369
BMC Pregnancy Childbirth. 2020 Aug 5;20(1):445
pubmed: 32758171
BMC Res Notes. 2018 Mar 2;11(1):162
pubmed: 29499736
BMC Res Notes. 2015 Aug 26;8:376
pubmed: 26306558
Health Place. 2012 Mar;18(2):415-23
pubmed: 22265205
PLoS One. 2018 Oct 12;13(10):e0204410
pubmed: 30312312
Reprod Health Matters. 2004 Nov;12(24):138-53
pubmed: 15626204
Lancet Glob Health. 2016 Feb;4(2):e98-e108
pubmed: 26795602
BMC Public Health. 2014 Sep 28;14:1014
pubmed: 25263746
PLoS One. 2011 Feb 28;6(2):e17155
pubmed: 21386886
Int J Health Plann Manage. 2021 May;36(3):668-688
pubmed: 33438771
Trop Med Int Health. 2015 Aug;20(8):1057-66
pubmed: 25877211
Asia Pac Fam Med. 2013 Oct 24;12(1):5
pubmed: 24156527
Reprod Health. 2013 Aug 20;10:40
pubmed: 23962135
BMC Pregnancy Childbirth. 2017 Jul 14;17(1):225
pubmed: 28705188
Lancet. 2010 Oct 9;376(9748):1261-71
pubmed: 20933263
Reprod Health. 2015 Apr 16;12:33
pubmed: 25890317
BMC Pregnancy Childbirth. 2015 Feb 13;15:27
pubmed: 25884164
Health Policy Plan. 2014 Aug;29(5):542-59
pubmed: 23783832
Asia Pac J Public Health. 2015 Mar;27(2):NP1372-88
pubmed: 23666835
BMC Res Notes. 2018 Mar 27;11(1):194
pubmed: 29580256
BMC Pregnancy Childbirth. 2013 Jan 16;13:5
pubmed: 23324550
PLoS One. 2014 Apr 21;9(4):e95439
pubmed: 24751600
Lancet. 2016 Jan 30;387(10017):462-74
pubmed: 26584737
J Health Popul Nutr. 2018 Oct 22;37(1):22
pubmed: 30348219
Stat Med. 2008 Nov 10;27(25):5111-42
pubmed: 18712778
Stat Med. 1995 Apr 30;14(8):799-810
pubmed: 7644860