Evaluating infant multimorbidity in Ethiopia through the international classification of functioning, disability, and health framework: Results from the performance monitoring for action survey

Abstract

Objective

Infant multimorbidity—defined as the co-occurrence of multiple symptoms or conditions—can negatively influence early development and population well-being. This study aimed to apply the International Classification of Functioning, Disability, and Health (ICF) framework to classify infant morbidity and examine its association with social and health-related risk factors.

Study design

Cross-sectional analysis of population-based survey data.

Methods

Data were drawn from the 2019 Performance Monitoring for Action Ethiopia (PMA-ET) community survey. Using multistage stratified cluster sampling, women aged 15–49 were screened, and those pregnant or postpartum within six weeks were eligible. Mothers reported infant illnesses in the preceding two weeks, which were then classified using the ICF framework. Multivariable weighted logistic regression was conducted to assess associations with selected risk factors.

Results

Among 2514 infants, 24.7 % experienced morbidity in the cardiovascular, hematological, immunological, or respiratory domains (ICF code b4); 14.0 % in digestive, metabolic, or endocrine systems (b5); 4.5 % in skin and related structures (b8); 2.5 % in sensory functions and pain (b2); and 1.5 % in mental function (b1). Significant risk factors for b4 morbidity included poor sanitation (adjusted OR = 0.68; 95 % CI: 0.47–0.99), lack of cooking facilities (adjusted OR = 0.72; 95 % CI: 0.52–0.99), and a partner's disapproval of family planning (adjusted OR = 1.40; 95 % CI: 1.05–1.87). For b5 morbidity, lower maternal education and partner disapproval or indifference toward family planning were significant predictors.

Conclusions

Addressing household-level determinants and empowering women through education and reproductive autonomy may reduce infant morbidity and support early childhood health.