Predictive accuracy of perceived baby birth size for birth weight: a cross-sectional study from the 2016 Ethiopian Demographic and Health Survey

Nigatu, Dabere; Haile, Demewoz; Gebremichael, Bereket; Tiruneh, Yordanos M.

doi:10.1136/bmjopen-2019-031986

“…Consistent with studies from Tanzania [ 83 ], Burundi [ 84 ], Nigeria [ 46 ], India [ 45 ] and Nepal [ 72 ], our study showed that children perceived by their mothers to be smaller than average size at birth had higher odds of stunting. In the absence of measured birth weight data, mother-reported perceived birth size data have been used as a proxy indicator to approximate birthweight [ 45 , 46 , 72 , 83 , 85 ]. The relationship between smaller birth size and stunting could be due to lower sized children at birth having an increased vulnerability to infection (such as diarrhea, ARI, and malaria) [ 86 , 87 , 88 ] with resultant complications that include respiratory distress, jaundice, anemia, fatigue and loss of appetite [ 89 , 90 ].…”

Section: Discussionmentioning

confidence: 99%

Mapping Geographical Differences and Examining the Determinants of Childhood Stunting in Ethiopia: A Bayesian Geostatistical Analysis

Ahmed

¹

,

Agho

²

,

Page

³

et al. 2021

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Understanding the specific geographical distribution of stunting is essential for planning and implementing targeted public health interventions in high-burdened countries. This study investigated geographical variations in the prevalence of stunting sub-nationally, and the determinants of stunting among children under 5 years of age in Ethiopia. We used the 2016 Ethiopia Demographic and Health Survey (EDHS) dataset for children aged 0–59 months with valid anthropometric measurements and geographic coordinates (n = 9089). We modelled the prevalence of stunting and its determinants using Bayesian geospatially explicit regression models. The prevalence of stunting among children under five years was 36.3% (95% credible interval (CrI); 22.6%, 51.4%) in Ethiopia, with wide variations sub-nationally and by age group. The prevalence of childhood stunting ranged from 56.6% (37.4–74.6%) in the Mekelle Special zone of the Tigray region to 25.5% (10.5–48.9%) in the Sheka zone of the Southern Nations, Nationalities and Peoples region. Factors associated with a reduced likelihood of stunting in Ethiopia included non-receipt of breastmilk, mother’s BMI (overweight/obese), employment status (employed), and higher household wealth, while the enablers were residence in the “arid” geographic areas, small birth size of the child, and mother’s BMI (underweight). The prevalence and determinants of stunting varied across Ethiopia. Efforts to reduce the burden of childhood stunting should consider geographical heterogeneity and modifiable risk factors.

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“…The lack of association might be because of inaccurate classification of the baby size at birth. The problem of misclassification was addressed in a previous study reporting that maternal assessment of the baby size is an inaccurate proxy indicator of low birth weight in Ethiopia [ 38 ]. This implies the importance of noncriteria-based (i.e., irrespective of birth size) application of SSC at the community level.…”

Section: Discussionmentioning

confidence: 99%

“…However, the results of this study may not be free of recall bias because skin-to-skin care practice was assessed for the index live births taking place in the last five years preceding the survey. Birth weight, a potential predictor variable for SSC practice, was not considered because of a large missing (85%) in the 2016 EDHS data [ 24 , 38 ]. We have considered the baby's birth size which is a proxy indicator of birth weight where there is a lack of data on birth weight [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Maternal Health Service Uptake Is Associated with a Higher Skin-to-Skin Care Practice in Ethiopia: Result from a National Survey

Nigatu

¹

,

Abeje

²

,

Mekonnen

³

et al. 2020

BioMed Research International

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Background. Though skin-to-skin care (SSC) is becoming an important newborn care package at both facility and community levels in Ethiopia, there is a lack of evidence to monitor the progress at each level. Therefore, this study is aimed at quantifying the proportion of SSC at both national and regional levels and identifying factors that affect SSC uptake in Ethiopia. Method. We used the 2016 Ethiopia Demographic and Health Survey data. The survey employed a multistage cluster sampling method. We included 7,488 live births in the analysis. The factors influencing SSC practice were identified using a multivariable logistic regression model. We reported adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results. In Ethiopia, 24.3% of mothers practiced SSC for their newborns (95% CI = 23.3 , 25.2). The highest proportion was in Addis Ababa (63%), and the lowest was in the Somali region (14.5%). Attending 1-4 antenatal care ( AOR = 1.51 , 95 % CI = 1.08 , 2.12 , giving birth at health facility ( AOR = 4.51 , 95 % CI = 2.16 , 9.44 , and having female births ( AOR = 1.24 , 95 % CI = 1.01 , 1.54 ) were associated with more odds of practicing SSC. However, giving birth by the cesarean section had resulted in lower odds of practicing SSC ( AOR = 0.37 , 95 % CI = 0.22 , 0.63 ). Regions with reduced odds of SSC practice include Amhara ( AOR = 0.57 , 95 % CI = 0.40 , 0.82 ), Somali ( AOR = 0.51 , 95 % CI = 0.31 , 0.83 ), and Southern Nations, Nationalities, and People ( AOR = 0.64 , 95 % CI = 0.43 , 0.94 ). Conclusions. The SSC practice was low in Ethiopia with a high level of variation between regions. In Ethiopia, maternal health service uptake affects the SSC of the newborns. Well-tailored community-level interventions are needed to increase skin-to-skin care practice among home delivery mothers.

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“…Observer errors have been reported in birth-weight research (36). Weights ending in multiples of 100 or 500 grams tend to be preferred, resulting in a heaping of birth weight measurements (15,19,20). This affects LBW estimates, particularly in LMICs (22).…”

Section: Discussionmentioning

confidence: 99%

“…Birth weight data may also be inaccurately recorded for various reasons. A common preference for the terminal digit 0 or 5 has been described (19,20) and heaping of birth weight data, which involves rounding birth weights to the closest 100-or 500-gram interval. For example, infants weighing 2,490 grams are recorded as 2,500 grams.…”

Section: Introductionmentioning

confidence: 99%

Improving Birth Weight Measurement and Recording Practices in Kenya and Tanzania: a Prospective Intervention Study With Historical Controls

K’Oloo

¹

,

Godfrey

²

,

Koivu

³

et al. 2021

Preprint

0

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Background Low birth weight (LBW) is a significant public health concern given its association with early-life mortality and other adverse health consequences that can impact the entire life-cycle. In many countries, accurate estimates of LBW prevalence are lacking due to inaccuracies in collection and gaps in available data. Our study aimed to determine LBW prevalence among facility-born infants in selected areas of Kenya and Tanzania, and to assess whether the introduction of an intervention to improve the accuracy of birth-weight measurement would result in a meaningfully different estimate of LBW prevalence than current practice. Methods We carried out a historically-controlled intervention study in 22 health facilities in Kenya and three health facilities in Tanzania. The intervention included: provision of high-quality digital scales, training of nursing staff on accurate birth weight measurement, recording and scale calibration practices, and quality maintenance support that consisted of enhanced supervision and feedback (prospective arm). The historically-controlled data were birth weights from the same facilities recorded in maternity registers for the same calendar months from the previous year measured using routine practices and manual scales. Results Between October 2019 and February 2020, we prospectively collected birth weights from 8,441 newborns in Kenya and 4,294 in Tanzania. Historical data were available from 9,318 newborns in Kenya and 12,007 in Tanzania. In the prospective sample, the prevalence of LBW was 12.6% (95% confidence intervals [CI]: 10.9%-14.4%) in Kenya and 18.2% (12.2%-24.2%) in Tanzania. In the historical sample, the corresponding prevalence estimates were 7.8% (6.5%-9.2%) and 10.0% (8.6%-11.4%). Compared to the retrospective sample, the LBW prevalence in the prospective sample was 4.8%-points (3.2%-6.4%) higher in Kenya and 8.2%-points (2.3%-14.0%) higher in Tanzania, corresponding to a risk ratio of 1.61 (1.38–1.88) in Kenya and 1.81 (1.30–2.52) in Tanzania. Conclusion Routine birth weight records under-estimate the risk of LBW among facility born infants in Kenya and Tanzania. The quality of birth-weight data can be improved by a simple intervention consisting of provision of digital scales and supportive training.

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Predictive accuracy of perceived baby birth size for birth weight: a cross-sectional study from the 2016 Ethiopian Demographic and Health Survey

Cited by 9 publications

References 17 publications

Mapping Geographical Differences and Examining the Determinants of Childhood Stunting in Ethiopia: A Bayesian Geostatistical Analysis

Mapping Geographical Differences and Examining the Determinants of Childhood Stunting in Ethiopia: A Bayesian Geostatistical Analysis

Maternal Health Service Uptake Is Associated with a Higher Skin-to-Skin Care Practice in Ethiopia: Result from a National Survey

Improving Birth Weight Measurement and Recording Practices in Kenya and Tanzania: a Prospective Intervention Study With Historical Controls

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