Spatial variation and associated factors of home delivery among reproductive age group women in Ethiopia, evidence from Performance Monitoring for Action Ethiopia Survey 2019, spatial and multilevel logistic regression analysis
IntroductionHome birth is described as a delivery that takes place at home without the presence of a skilled birth attendant. In 2017, nearly 295,000 mothers died from various pregnancy and childbirth-related problems, accounting for approximately 810 maternal deaths per day. Therefore, this study a...
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Global Women's Health |
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| author | Ermias Bekele Enyew Kokeb Ayele Lakew Asmare Fekade Demeke Bayou Mastewal Arefaynie Yawkal Tsega Abel Endawkie Shimelis Derso Kebede Abiyu Abadi Tareke Kaleab Mesfine Abera Natnael Kebede Mahider Shimelis Feyisa Mengistu Mera Mihiretu |
| author_facet | Ermias Bekele Enyew Kokeb Ayele Lakew Asmare Fekade Demeke Bayou Mastewal Arefaynie Yawkal Tsega Abel Endawkie Shimelis Derso Kebede Abiyu Abadi Tareke Kaleab Mesfine Abera Natnael Kebede Mahider Shimelis Feyisa Mengistu Mera Mihiretu |
| author_sort | Ermias Bekele Enyew |
| collection | DOAJ |
| description | IntroductionHome birth is described as a delivery that takes place at home without the presence of a skilled birth attendant. In 2017, nearly 295,000 mothers died from various pregnancy and childbirth-related problems, accounting for approximately 810 maternal deaths per day. Therefore, this study aims to investigate the spatial distributions of home birth and associated factors in Ethiopia using the Performance Monitoring for Action Survey (PMAS) 2019) to get information that helps to take geographic-based interventions and can assist health planners and policymakers in developing particular measures to reduce home deliveries.MethodIn PMA-ET 2019, a community-based cross-sectional study was conducted in collaboration with Addis Ababa University, Johns Hopkins University, and the Federal Ministry of Health from September 2019 to December 2019, in Ethiopia. A multi-stage cluster sampling procedure was employed to draw from the stratified 2019 PMAS sample. A weighted total of 5,796 women were included in this study. ArcGIS version 10.7 software was used to visualize the spatial analysis. In addition, STATA version 14 of the statistical software was used for multilevel analysis The Bernoulli model was applied using Kulldorff's SaTScan version 9.6 software to identify significant purely spatial clusters for home delivery in Ethiopia. Intra-class Correlation Coefficient (ICC), Likelihood Ratio (LR) test, Median Odds Ratio (MOR), and deviance (−2LLR) values were used for model comparison and fitness. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) and p-value <0.05 in the multilevel logistic model were used to declare significant factors associated with home delivery.ResultThe spatial distribution of home delivery was non-random in Ethiopia. Statistically significant high hotspots of home delivery were found in Somali, Afar, Sidama, most of South Nation Nationality and People Region (SNNP), most parts of Amhara, south west Ethiopia, and Oromia region. In the multilevel logistic regression model; Women from the lowest wealth quintile were 1.68 times [AOR = 1.68; 95% CI: 1.31, 2.15] higher odds of giving birth at home as compared to their counterparts. Regarding maternal educational status, mothers who had no education, primary education, and secondary education had 9.91 times [AOR = 9.91, 95% CI: 5.44, 18.04], 6.62 times [AOR = 6.62, 95% CI: 3.65, 12.00] and 2.99 times [AOR = 2.99, 95% CI: 1.59, 5.63] higher odds of giving birth at home compared to mothers who attained higher education, respectively. In addition, community-level factors were significantly associated with home delivery, women who had high community-level poverty were 1.76 times [AOR = 1.76; 95% CI: 1.14, 2.72] higher odds of home delivery compared to women who had low community-level poverty.ConclusionHome delivery was statistically found to be a significantly high hot spot in Somalia, Afar, Sidama, most of the South Nation Nationality and People area (SNNP), most of Amhara, southwest Ethiopia, and the Oromia region of Ethiopia. Significant factors associated with home delivery in Ethiopia were women with lower levels of education, poor wealth, living in rural areas, high levels of community poverty, divorced or separated widowed marital status, and older maternal ages. Therefore, health institutions, health professionals, National and regional policymakers health planners community leaders and all concerned should give priority to the identified hot spot clusters to design an effective intervention program to reduce home delivery. |
| format | Article |
| id | doaj-art-bb6625c962414cc587f3639b09cad8fa |
| institution | OA Journals |
| issn | 2673-5059 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Global Women's Health |
| spelling | doaj-art-bb6625c962414cc587f3639b09cad8fa2025-08-20T02:35:53ZengFrontiers Media S.A.Frontiers in Global Women's Health2673-50592024-12-01510.3389/fgwh.2024.14747621474762Spatial variation and associated factors of home delivery among reproductive age group women in Ethiopia, evidence from Performance Monitoring for Action Ethiopia Survey 2019, spatial and multilevel logistic regression analysisErmias Bekele Enyew0Kokeb Ayele1Lakew Asmare2Fekade Demeke Bayou3Mastewal Arefaynie4Yawkal Tsega5Abel Endawkie6Shimelis Derso Kebede7Abiyu Abadi Tareke8Kaleab Mesfine Abera9Natnael Kebede10Mahider Shimelis Feyisa11Mengistu Mera Mihiretu12Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaDepartment of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaDepartment of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaDepartment of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaDepartment of Reproductive and Family Health, School of Public Health, Wollo University, Dessie, EthiopiaDepartment of Health System and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaDepartment of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaDepartment of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaAmref Health Africa in Ethiopia, West Gondar Zonal Health Department, Gondar, EthiopiaDepartment of Health System and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaDepartment of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaDepartment of Medical Laboratory, College of Health Science, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Health System and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaIntroductionHome birth is described as a delivery that takes place at home without the presence of a skilled birth attendant. In 2017, nearly 295,000 mothers died from various pregnancy and childbirth-related problems, accounting for approximately 810 maternal deaths per day. Therefore, this study aims to investigate the spatial distributions of home birth and associated factors in Ethiopia using the Performance Monitoring for Action Survey (PMAS) 2019) to get information that helps to take geographic-based interventions and can assist health planners and policymakers in developing particular measures to reduce home deliveries.MethodIn PMA-ET 2019, a community-based cross-sectional study was conducted in collaboration with Addis Ababa University, Johns Hopkins University, and the Federal Ministry of Health from September 2019 to December 2019, in Ethiopia. A multi-stage cluster sampling procedure was employed to draw from the stratified 2019 PMAS sample. A weighted total of 5,796 women were included in this study. ArcGIS version 10.7 software was used to visualize the spatial analysis. In addition, STATA version 14 of the statistical software was used for multilevel analysis The Bernoulli model was applied using Kulldorff's SaTScan version 9.6 software to identify significant purely spatial clusters for home delivery in Ethiopia. Intra-class Correlation Coefficient (ICC), Likelihood Ratio (LR) test, Median Odds Ratio (MOR), and deviance (−2LLR) values were used for model comparison and fitness. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) and p-value <0.05 in the multilevel logistic model were used to declare significant factors associated with home delivery.ResultThe spatial distribution of home delivery was non-random in Ethiopia. Statistically significant high hotspots of home delivery were found in Somali, Afar, Sidama, most of South Nation Nationality and People Region (SNNP), most parts of Amhara, south west Ethiopia, and Oromia region. In the multilevel logistic regression model; Women from the lowest wealth quintile were 1.68 times [AOR = 1.68; 95% CI: 1.31, 2.15] higher odds of giving birth at home as compared to their counterparts. Regarding maternal educational status, mothers who had no education, primary education, and secondary education had 9.91 times [AOR = 9.91, 95% CI: 5.44, 18.04], 6.62 times [AOR = 6.62, 95% CI: 3.65, 12.00] and 2.99 times [AOR = 2.99, 95% CI: 1.59, 5.63] higher odds of giving birth at home compared to mothers who attained higher education, respectively. In addition, community-level factors were significantly associated with home delivery, women who had high community-level poverty were 1.76 times [AOR = 1.76; 95% CI: 1.14, 2.72] higher odds of home delivery compared to women who had low community-level poverty.ConclusionHome delivery was statistically found to be a significantly high hot spot in Somalia, Afar, Sidama, most of the South Nation Nationality and People area (SNNP), most of Amhara, southwest Ethiopia, and the Oromia region of Ethiopia. Significant factors associated with home delivery in Ethiopia were women with lower levels of education, poor wealth, living in rural areas, high levels of community poverty, divorced or separated widowed marital status, and older maternal ages. Therefore, health institutions, health professionals, National and regional policymakers health planners community leaders and all concerned should give priority to the identified hot spot clusters to design an effective intervention program to reduce home delivery.https://www.frontiersin.org/articles/10.3389/fgwh.2024.1474762/fullhome deliveryspatial variationreproductive age womenPerformance Monitoring for ActionPMASEthiopia |
| spellingShingle | Ermias Bekele Enyew Kokeb Ayele Lakew Asmare Fekade Demeke Bayou Mastewal Arefaynie Yawkal Tsega Abel Endawkie Shimelis Derso Kebede Abiyu Abadi Tareke Kaleab Mesfine Abera Natnael Kebede Mahider Shimelis Feyisa Mengistu Mera Mihiretu Spatial variation and associated factors of home delivery among reproductive age group women in Ethiopia, evidence from Performance Monitoring for Action Ethiopia Survey 2019, spatial and multilevel logistic regression analysis Frontiers in Global Women's Health home delivery spatial variation reproductive age women Performance Monitoring for Action PMAS Ethiopia |
| title | Spatial variation and associated factors of home delivery among reproductive age group women in Ethiopia, evidence from Performance Monitoring for Action Ethiopia Survey 2019, spatial and multilevel logistic regression analysis |
| title_full | Spatial variation and associated factors of home delivery among reproductive age group women in Ethiopia, evidence from Performance Monitoring for Action Ethiopia Survey 2019, spatial and multilevel logistic regression analysis |
| title_fullStr | Spatial variation and associated factors of home delivery among reproductive age group women in Ethiopia, evidence from Performance Monitoring for Action Ethiopia Survey 2019, spatial and multilevel logistic regression analysis |
| title_full_unstemmed | Spatial variation and associated factors of home delivery among reproductive age group women in Ethiopia, evidence from Performance Monitoring for Action Ethiopia Survey 2019, spatial and multilevel logistic regression analysis |
| title_short | Spatial variation and associated factors of home delivery among reproductive age group women in Ethiopia, evidence from Performance Monitoring for Action Ethiopia Survey 2019, spatial and multilevel logistic regression analysis |
| title_sort | spatial variation and associated factors of home delivery among reproductive age group women in ethiopia evidence from performance monitoring for action ethiopia survey 2019 spatial and multilevel logistic regression analysis |
| topic | home delivery spatial variation reproductive age women Performance Monitoring for Action PMAS Ethiopia |
| url | https://www.frontiersin.org/articles/10.3389/fgwh.2024.1474762/full |
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