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

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...

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Autores principales: Muluneh, Atalay Goshu, Animut, Yaregal, Ayele, Tadesse Awoke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014695/
https://www.ncbi.nlm.nih.gov/pubmed/32046677
http://dx.doi.org/10.1186/s12884-020-2793-6
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author Muluneh, Atalay Goshu
Animut, Yaregal
Ayele, Tadesse Awoke
author_facet Muluneh, Atalay Goshu
Animut, Yaregal
Ayele, Tadesse Awoke
author_sort Muluneh, Atalay Goshu
collection PubMed
description 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 (AOR = 1.41, 95%CI: 1.17–1.71), no information about birth preparedness plan (AOR = 2.21, 95%CI: 1.83–2.69), pregnancies wanted later (AOR = 1.55, 95%CI: 1.20, 2.06), not having health insurance (AOR = 2.16, 95% CI: 1.29, 3.62), Muslim (AOR = 1.57, 95% CI: 1.13, 2.19) and protestant (AOR = 1.72, 95%CI: 1.16, 2.42) religions were positively associated with home delivery; While being rich (AOR = 0.42, 95%CI: 0.32–0.54), middle wealth index (AOR = O.66, 95%CI: 0.51, 0.86), primary education (AOR = 0.45, 95%CI: 0.36–0.55), secondary education (AOR = 0.11, 95%CI: 0.07–0.16), above secondary education (AOR = 0.06, 95%CI: 0.03–0.11) were negatively associated. CONCLUSIONS: Home delivery after ANC follow ups was spatially clustered. Socio-demographic, health service and pregnancy related factors determined the prevalence of home delivery after antenatal care visits. Strengthening women’s education, ANC visit, giving more information about birth preparedness plan, and improving family wealth are vital to reduce home delivery after antenatal care visits.
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spelling pubmed-70146952020-02-18 Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective Muluneh, Atalay Goshu Animut, Yaregal Ayele, Tadesse Awoke BMC Pregnancy Childbirth Research Article 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 (AOR = 1.41, 95%CI: 1.17–1.71), no information about birth preparedness plan (AOR = 2.21, 95%CI: 1.83–2.69), pregnancies wanted later (AOR = 1.55, 95%CI: 1.20, 2.06), not having health insurance (AOR = 2.16, 95% CI: 1.29, 3.62), Muslim (AOR = 1.57, 95% CI: 1.13, 2.19) and protestant (AOR = 1.72, 95%CI: 1.16, 2.42) religions were positively associated with home delivery; While being rich (AOR = 0.42, 95%CI: 0.32–0.54), middle wealth index (AOR = O.66, 95%CI: 0.51, 0.86), primary education (AOR = 0.45, 95%CI: 0.36–0.55), secondary education (AOR = 0.11, 95%CI: 0.07–0.16), above secondary education (AOR = 0.06, 95%CI: 0.03–0.11) were negatively associated. CONCLUSIONS: Home delivery after ANC follow ups was spatially clustered. Socio-demographic, health service and pregnancy related factors determined the prevalence of home delivery after antenatal care visits. Strengthening women’s education, ANC visit, giving more information about birth preparedness plan, and improving family wealth are vital to reduce home delivery after antenatal care visits. BioMed Central 2020-02-11 /pmc/articles/PMC7014695/ /pubmed/32046677 http://dx.doi.org/10.1186/s12884-020-2793-6 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Muluneh, Atalay Goshu
Animut, Yaregal
Ayele, Tadesse Awoke
Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective
title Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective
title_full Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective
title_fullStr Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective
title_full_unstemmed Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective
title_short Spatial clustering and determinants of home birth after at least one antenatal care visit in Ethiopia: Ethiopian demographic and health survey 2016 perspective
title_sort spatial clustering and determinants of home birth after at least one antenatal care visit in ethiopia: ethiopian demographic and health survey 2016 perspective
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014695/
https://www.ncbi.nlm.nih.gov/pubmed/32046677
http://dx.doi.org/10.1186/s12884-020-2793-6
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