Spatial pattern of perinatal mortality and its determinants in Ethiopia: Data from Ethiopian Demographic and Health Survey 2016

Abstract

Background The perinatal mortality rate in Ethiopia is among the highest in Sub Saharan Africa. The aim of this study was to identify the spatial patterns and determinants of perinatal mortality in the country using a national representative 2016 Ethiopia Demographic and Health Survey (EDHS) data. Methods The analysis was completed utilizing data from 2016 Ethiopian Demographic and Health Survey. This data captured the information of 5 years preceding the survey period. A total of 7230 women who at delivered at seven or more months gestational age nested within 622 enumeration areas (EAs) were used. Statistical analysis was performed by using STATA version 14.1, by considering the hierarchical nature of the data. Multilevel logistic regression models were fitted to identify community and individual-level factors associated with perinatal mortality. ArcGIS version 10.1 was used for spatial analysis. Moran’s, I statistics fitted to identify global autocorrelation and local autocorrelation was identified using SatSCan version 9.6. Results The spatial distribution of perinatal mortality in Ethiopia revealed a clustering pattern. The global Moran’s I value was 0.047 with p-value <0.001. Perinatal mortality was positively associated with the maternal age, being from rural residence, history of terminating a pregnancy, and place of delivery, while negatively associated with partners’ educational level, higher wealth index, longer birth interval, female being head of household and the number of antenatal care (ANC) follow up. Conclusions In Ethiopia, the perinatal mortality is high and had spatial variations across the country. Strengthening partner’s education, family planning for longer birth interval, ANC, and delivery services are essential to reduce perinatal mortality and achieve sustainable development goals in Ethiopia. Disparities in perinatal mortality rates should be addressed alongside efforts to address inequities in maternal and neonatal healthcare services all over the country.

Women’s Decision-Making Power on Modern Family Planning Use and Its Associated Factors in Northwest Ethiopia

“…Even though joint decision-making with spouses about family planning has significant importance [ 16 ], women are underrepresented in decision-making power on child spacing worldwide [ 17 ]. In Ethiopia, among the top causes of perinatal mortality is pregnancy termination [ 18 ]. The most common reason women mentioned for nonuse of family planning was husband objections [ 15 ].…”

How applicable is geospatial analysis in maternal and neonatal health in sub-Saharan Africa? A systematic review

“…On the other hand, a study in seven East African and seven West African countries found higher neonatal mortality in Ethiopia, Kenya, and Tanzania compared to the rest of the countries [ 23 ]. Studies in Malawi [ 24 ], Nigeria [ 25 ], and Ethiopia [ 26 , 27 ] also found inequalities in perinatal deaths within the countries. For instance, relatively lower perinatal deaths in Ethiopia were found in Addis Ababa, some parts of Tigray, Gambella, Benishangul-Gumuz, and Southern Nations Nationalities and Peoples Region, whereas significantly higher perinatal deaths were recorded in the Somali region, South Amhara, North Oromia, and Southern Afar [ 26 , 27 ].…”

“…Studies in Malawi [ 24 ], Nigeria [ 25 ], and Ethiopia [ 26 , 27 ] also found inequalities in perinatal deaths within the countries. For instance, relatively lower perinatal deaths in Ethiopia were found in Addis Ababa, some parts of Tigray, Gambella, Benishangul-Gumuz, and Southern Nations Nationalities and Peoples Region, whereas significantly higher perinatal deaths were recorded in the Somali region, South Amhara, North Oromia, and Southern Afar [ 26 , 27 ]. For example, in one study, women within a specific hotspot area in the Somali region of Ethiopia had a 22.5 times higher risk of experiencing stillbirth than women outside the hotspot area [ 27 ].…”

“…Seven studies [13,[22][23][24][25][26][27] reported the geographical distribution of stillbirth, perinatal, and neonatal mortality at regional, national, and subnational levels. A large study in all 49 SSA countries indicated no spatial clustering of neonatal mortality between countries [22].…”

Prevalence and Associated Factors of Under-Five Mortality in Ethiopia: Further Analysis of Ethiopian Mini Demographic and Health Surveys 2019

“…Primipara, prematurity, low birth weight, perinatal asphyxia, respiratory distress syndrome, congenital anomalies, neonatal sepsis, and duration of hospital stay increased the deaths (7,8). Maternal age, rural residence, ever terminated pregnancy, and place of delivery were increased perinatal deaths, while husband education, higher wealth index, longer birth interval, female household leader, and the number of antenatal care (ANC) inversely related (12). The under-five mortality showed clustering in the country in Benishangul-Gumuz, Afar, Gambella, and the South Nation Nationality and People (SNNP) Regions until the year 2016 (13).…”