ABSTRACT
Background: Antenatal care (ANC) reduces maternal and newborn mortalities and makes it easier to find infections early and prevent them from progressing. This study aimed to identify factors affecting ANC utilization in Ethiopia via the count regression model. Methods: The data for the study was drawn from the 2019 Ethiopian Mini Demographic and Health Survey dataset. Count regression models, such as Poisson, Negative Binomial (NB), Zero-Inflated Poisson (ZIP), and Zero-Inflated Negative Binomial (ZINB) models, were used to determine the factors influencing ANC utilization. Results: A total of 3962 women were included in the study. Only about 42% of women used the WHO-recommended number of ANC of a minimum of four visits. The ZIP model was outperforming to fit the data as compared to other count regression models. Rural residence (IRR=0.8832, 95% CI: 0.8264-0.9440), being resident of the Somalia region (IRR=0.4762, 95% CI: 0.3919-0.5785), SNNPR (IRR=0.8716, 95% CI: 0.7913-0.9600), and Gambela Region (IRR=0.7830, 95% CI: 0.7063-0.8680), being Muslim (IRR=0.9384, 95% CI: 0.8876-0.9921) decrease the ANC utilization. Contrarily, Addis Ababa residence (IRR=1.1171, 95% CI: 1.0181-1.2259), primary education (IRR=1.1278, 95% CI: 1.0728-1.1855), secondary and higher education (IRR=1.2357, 95% CI: 1.1550-1.3220), middle wealth index (IRR=1.0855, 95% CI: 1.0095-1.1671) and rich wealth index (IRR=1.0941, 95% CI: 1.0152-1.1790) increase the ANC utilization. Conclusion: The ZIP model best fitted the data compared to others. The study revealed that being poor, rural resident, uneducated, Somalia region resident, SNNPR resident, Gambela region resident, and Muslim were factors associated with lower ANC utilization. Thus, health education is needed to be given for mothers with no education. In addition, building a strong awareness-creation program regarding ANC is required for rural residents so as to improve the level of ANC utilization in Ethiopia.
ABSTRACT
Early neonatal death, which occurs during the prenatal period, is defined as the death of a newborn between 0 and 7 days after birth. It is one of the major public health problems in several developing countries. This study aimed to determine the early neonatal mortality rate and identify determinants of early neonatal mortality in Somalia region of Ethiopia. Methods: The data used for this study were drawn from the 2019 Ethiopia Mini Demographic and Health Survey (2019 EMDHS) data. A multivariable logistic regression model was used to identify the determinants of early neonatal mortality. Adjusted odds ratio (AOR) with 95% CI was used to examine the association of factors with early neonatal mortality. Results: A total of 637 live births were included in this study. The early neonatal mortality rate in the study was 44 (95% CI: 31, 65) deaths per 1000 live births. Male babies (AOR: 1.628; 95% CI: 1.152-4.895), babies delivered at home (AOR: 2.288; 95% CI: 1.194-6.593), and babies born from uneducated mothers (AOR: 2.130; 95% CI: 1.744-6.100) were at increased risk of death in the first 7 days of life after birth. Contrarily, decreased risk of death of babies in the first 7 days of life after birth was associated with urban residence (AOR: 0.669; 95% CI: 0.033-0.721) and singleton (AOR: 0.345; 95% CI: 0.070-0.609). Conclusion: The early neonatal mortality rate in the region was high. The study revealed that sex of child, place of residence, birth type, mother's educational level, and place of delivery were the determinants of the death of babies in the first 7 days of life after birth. Hence, providing health education to uneducated mothers and enhancing institutional delivery is recommended to minimize the early neonatal mortality rate in the region.
ABSTRACT
The rate of mortality during the perinatal period is higher than at any other time in a person's life, making it the most vulnerable. This study aimed to examine regional heterogeneity and the determinants of perinatal mortality in Ethiopia. Methods: The data for this study was obtained from the 2019 Ethiopia Demographic and Health Survey (2019 EMDHS) data. Logistic regression modeling and multilevel logistic modeling were used for data analysis. Results: A total of 5753 live birth children were included in this study. Of the total live births, 220 (3.8%) died in the first 7 days of life. Urban residence [adjusted odds ratio (AOR)=0.621; 95% CI: 0.453-0.850], residence in Addis Ababa (AOR=0.141; 95% CI: 0.090-0.220), family size of four or less (AOR=0.761; 95% CI: 0.608-0.952), age of mother at first birth of less than 20 years (AOR=0.728; 95% CI: 0.548-0.966), and using contraceptives (AOR=0.597; 95% CI: 0.438-0.814) were associated with lower risk of perinatal mortality compared to the respective reference categories whereas residence in Afar (AOR=2.259; 95% CI: 1.235-4.132), residence in Gambela (AOR=2.352; 95% CI: 1.328-4.167), no education (AOR=1.232; 95% CI: 1.065-1.572), poor wealth index (AOR=1.670; 95% CI: 1.172-2.380), and wealth index (AOR=1.648; 95% CI: 1.174-2.314) were associated with higher risk of perinatal mortality compared to the respective reference categories. Conclusion: In this study, the overall prenatal mortality rate was 38 (95% CI: 33-44) deaths per 1000 live births, which is high in magnitude. The study identified place of residence, region, wealth index, age of the mother at first birth, educational level of the mother, family size, and use of contraceptive methods as significant determinants of perinatal mortality in Ethiopia. Thus, mothers with no education should be given health education. Women should also be given awareness regarding the use of contraceptives. In addition, further research needs to be conducted in each region separately and information made available at the disaggregate level.
