埃塞俄比亚ANC访问的空间格局和相关因素:埃塞俄比亚人口健康调查数据的空间和多层次建模。

Advances in Preventive Medicine Pub Date : 2020-08-19 eCollection Date: 2020-01-01 DOI:10.1155/2020/4676591
Zemenu Tadesse Tessema, Temesgen Yihunie Akalu
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引用次数: 9

摘要

背景:尽管埃塞俄比亚产前保健(ANC)有所增加,但仍有许多妇女缺乏推荐的ANC联系人。因此,本研究旨在利用2016年埃塞俄比亚人口与健康调查(EDHS)数据确定未进行ANC访问的空间模式和相关因素。方法:基于2016年1月18日至6月27日的EDHS数据,采用两阶段分层整群抽样技术。共有7462名女性参与了这项研究。采用ArcGIS 10.7软件对空间分布进行可视化。使用Kilduff SaTScan 9.6版软件应用伯努利模型来识别埃塞俄比亚没有ANC访问的重要纯空间集群。使用多变量多水平逻辑回归模型来确定个人和社区水平的不进行产前保健的决定因素。模型比较采用似然检验,拟合优度采用偏差检验。结果:主要集群的空间窗口位于索马里、奥罗米亚、阿法尔、迪勒达瓦和哈拉里地区,对数似然比(LLR)为133.02,p < 0.001显著水平。在本研究中,伊斯兰教信仰(调整比值比(AOR) = 0.7, 95%可信区间(CI)(0.52,0.96))、母亲受教育程度较低(AOR = 0.59, 95% CI(0.49,0.71))、与医疗机构的距离是一个大问题(AOR = 0.76, CI(0.65,0.89))、第二出生顺序(AOR = 1.35, CI(1.03, 1.76))、较富裕的财富指数(AOR = 0.65, CI(0.51,0.82))、农村居住(AOR = 2.38, CI(1.54,3.66))、较高的社区媒体接触(AOR = 0.68,在埃塞俄比亚,CI(0.52,0.89)是不进行产前保健的决定因素。结论:埃塞俄比亚ANC的空间分布是非随机的。在阿姆哈拉东北部、西本尚古曼兹、索马里、阿法尔、北部和SNNPR东北部,没有ANC的比例较高。另一方面,在提格雷、亚的斯亚贝巴和迪勒达瓦,没有ANC的比例很低。在埃塞俄比亚,没有产前保健受到个人和社区两方面因素的影响。联邦卫生部必须立即予以关注,以改善非孕制,特别是在农村居民、未受过教育的妇女、贫困家庭以及奥罗米亚、甘贝拉和索马里等地区。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Spatial Pattern and Associated Factors of ANC Visits in Ethiopia: Spatial and Multilevel Modeling of Ethiopian Demographic Health Survey Data.

Spatial Pattern and Associated Factors of ANC Visits in Ethiopia: Spatial and Multilevel Modeling of Ethiopian Demographic Health Survey Data.

Spatial Pattern and Associated Factors of ANC Visits in Ethiopia: Spatial and Multilevel Modeling of Ethiopian Demographic Health Survey Data.

Spatial Pattern and Associated Factors of ANC Visits in Ethiopia: Spatial and Multilevel Modeling of Ethiopian Demographic Health Survey Data.

Background: Although there is an increase in having antenatal care (ANC), still many women lack recommended ANC contacts in Ethiopia. Therefore, this study was aimed at determining spatial patterns and associated factors of not having ANC visits using the Ethiopian Demographic and Health Survey (EDHS) 2016 data.

Methods: A two-stage stratified cluster sampling technique was employed based on EDHS data from January 18 to June 27, 2016. A total of 7,462 women were included in the study. ArcGIS version 10.7 software was used to visualize the spatial distribution. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant purely spatial clusters for not having ANC visits in Ethiopia. A multivariable multilevel logistic regression model was used to identify individual- and community-level determinants of not having antenatal care. Model comparison was checked using the likelihood test and goodness of fit was assessed by the deviance test.

Results: The primary clusters' spatial window was located in Somalia, Oromia, Afar, Dire Dawa, and Harari regions with the log-likelihood ratio (LLR) of 133.02, at p < 0.001 level of significance. In this study, Islam religion (adjusted odds ratio (AOR) = 0.7 with 95% confidence interval (CI) (0.52,0.96)), mother education being primary (AOR = 0.59, 95% CI (0.49,0.71)), distance from health facility being a big problem (AOR = 0.76, CI (0.65,0.89)), second birth order (AOR = 1.35, CI (1.03, 1.76)), richer wealth index (AOR = 0.65, CI (0.51,0.82)), rural residence (AOR = 2.38, CI (1.54,3.66)), and high community media exposure (AOR = 0.68, CI (0.52,0.89)) were determinants of not having antenatal care in Ethiopia.

Conclusion: The spatial distribution of ANC in Ethiopia is non-random. A higher proportion of not having ANC is found in northeast Amhara, west Benishangul Gumuz, Somali, Afar, north, and northeast SNNPR. On the other hand, a low proportion of not having ANC was found in Tigray, Addis Ababa, and Dire Dawa. In Ethiopia, not having antenatal care is affected by both individual- and community-level factors. Prompt attention by the Federal Ministry of Health is compulsory to improve ANC especially in rural residents, uneducated women, poor households, and regions like Oromia, Gambella, and Somalia.

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