Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective

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 (

Spatial distribution and associated factors of antenatal care utilization in Ethiopia in 2019: Spatial and multilevel analysis

“…Almost every studies conducted country level samples support the existence of such disparities and that is the sign for the need of region specific interventions (8,9,22,23). For instance, the current analysis showed 48%, 73%, and 62.32% of respondents were not learned, living in rural residences, and illiterates respectively and this is also supported by a plenty of evidences in literature (11,(23)(24)(25)(26). The reason might be all efforts made to get women learned, economically empowered, making easy access to service in rural residences, and reducing illiteracy were not good enough as study after study reported similar findings.…”

“…The positively correlation of institutional delivery, might be due to the increased contact between health professionals and women service takers and that is why health provider should promote service utilization every time they get access to women. Other studies portraits the same finding in many parts of the country (11,28). Women utilizing ANC was decreased among pregnant the than that of not/unsure of pregnancy.…”

“…Married, widowed, and divorced women had all conveyed history of ANC in their last pregnancies. Other evidences also showed that having any type of marital status was related to ANC(17) (11). Of course, this worthy nothing as no one would expect more ANC from non-formally married women.…”

Determinants and spatial distribution of institutional delivery in Ethiopia: evidence from Ethiopian Mini Demographic and Health Surveys 2019

“…Contextual analysis indicated that except Oromia, all agrarian regions and city administrations showed good institutional deliveries; however, pastoralists regions (Somali and Afar) showed high home deliveries; henceforth, the home delivery was also higher in rural areas. Other studies also supported this finding(17) (5). During this analysis, we recognized many limitations.…”

“…Because of the various factors, the country wasn't able to achieve as planned. Many studies indicated that there was a high proportion of home delivery in the country (3,4,5,6,7,8,9,10). There were various factors cited affecting women to prefer home over institutions for delivery.…”