Tessema Zemenu Tadesse, Tamirat Koku Sisay
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Trop Med Health. 2020 Nov 27;48(1):93. doi: 10.1186/s41182-020-00280-1.
High-risk fertility behavior is associated with numerous unfavorable child and maternal health outcomes such as chronic undernutrition, anemia, and child mortality. As far as our knowledge goes, there is not much study on determinants of high-risk fertility behavior in Ethiopia. Therefore, this study aimed to assess determinants of high-risk fertility behavior among reproductive-age women in Ethiopia.
The study was based on secondary data analysis from the 2016 Ethiopia Demography and Health Survey. A total of 11,022 women who gave birth 5 years preceding the survey were included in this study. Kid's Record (KR) dataset was used. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) was calculated for those variables included in the multilevel logistic regression model. P value ≤ 0.05 was employed to declare the statistically significant variables.
More than three-fourths (76.9%) of (95% CI 76.11 to 77.69) reproductive-age women had at least one high-risk fertility behavior. Attended primary and secondary education adjusted odds ratio (AOR) (AOR = 0.71; 95% CI 0.63, 0.80 and AOR = 0.73; 95% CI 0.60, 0.89, respectively), never used contraceptive (AOR = 1.25, 95% CI 1.12, 1.40), unwanted pregnancies (AOR = 1.40, 95% CI 1.23, 1.59), had no ANC visit (AOR = 1.19, 95% CI 1.05, 1.35), rural-dwelling (AOR = 1.26, 95% CI 1.04, 1.51), regions of Ethiopia [Somalia (AOR = 1.70; 95% CI 1.24, 2.32) and Amhara (AOR = 0.72; 95% CI 0.53, 0.96)] were determinants of high-risk fertility behavior.
Education, rural residence, unwanted pregnancies, no antenatal care follow-up, and never used contraceptives were determinants of high-risk fertility behavior. Therefore, increased maternal health services, special intervention for hotspot areas, and giving special attention to rural dweller women were highly recommended.
高风险生育行为与众多不利的儿童和孕产妇健康结局相关，如慢性营养不良、贫血和儿童死亡率。据我们所知，埃塞俄比亚对高风险生育行为的决定因素研究较少。因此，本研究旨在评估埃塞俄比亚育龄妇女高风险生育行为的决定因素。
该研究基于对2016年埃塞俄比亚人口与健康调查的二次数据分析。本研究纳入了在调查前5年分娩的11,022名妇女。使用了儿童记录（KR）数据集。对多水平逻辑回归模型中包含的变量计算了调整后的优势比（AOR）及其95%置信区间（CI）。采用P值≤0.05来判定具有统计学意义的变量。
超过四分之三（76.9%）（95%CI 76.11至77.69）的育龄妇女至少有一项高风险生育行为。接受小学和中学教育的调整后优势比（AOR）（分别为AOR = 0.71；95%CI 0.63，0.80和AOR = 0.73；95%CI 0.60，0.89）、从未使用过避孕药具（AOR = 1.25，95%CI 1.12，1.40）、意外怀孕（AOR = 1.40，95%CI 1.23，1.59）、未进行产前检查（AOR = 1.19，95%CI 1.05，1.35）、居住在农村（AOR = 1.26，95%CI 1.04，1.51）、埃塞俄比亚的地区[索马里（AOR = 1.70；95%CI 1.24，2.32）和阿姆哈拉（AOR = 0.72；95%CI 0.53，0.96）]是高风险生育行为的决定因素。
教育、农村居住、意外怀孕、未进行产前检查随访以及从未使用避孕药具是高风险生育行为的决定因素。因此，强烈建议增加孕产妇保健服务、对热点地区进行特别干预，并特别关注农村妇女。
