Department of Reproductive Health and Population Studies, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
PLoS One. 2022 May 6;17(5):e0267802. doi: 10.1371/journal.pone.0267802. eCollection 2022.
High-risk fertility behavior is a major public health concern in low and middle-income countries including Ethiopia. Some studies show that the relationship between high-risk fertility behavior and child mortality has analyzed each fertility behavior individually. Yet, there are limited studies that have analyzed outcomes associated with the joint impact of high-risk fertility behaviors. Therefore, the objective of this study was to examine the individual and combined influence of high-risk fertility behavior on under-five mortalities in Ethiopia.
Data from the 2016 Ethiopian Demographic and Health Survey were used analyzed. A total of 10,773 mothers who gave live births were included in the final analysis. Both descriptive and bivariate and multivariate logistic regression analyses were performed using STATA V.14.
Overall, 62.1%, 24.0%, and 2.3% of women experienced at least one, two, and three high-risk fertility behaviors, respectively. In the multivariable analysis, under-five mortality was significantly associated with a combination of two or more maternal high-risk fertility behaviors. The odds of under-five mortality among children of women who were engaged in a combination of two high-risk fertility behaviors (AOR = 2.17, 95%CI: 1.52-3.08) and three high-risk fertility behaviors (AOR = 3.69, 95%CI:1.80, 7.55) was higher compared to children of women who have not engaged any high-risk fertility behaviors.
This study revealed that a single high-risk fertility behavior was not associated with under-five mortality, yet the presence of two or more maternal high-risk fertility behaviors was an important factor that increased the likelihood of under-five child death. Thus, special emphasis should be given to children of women who engage in a combination of high-risk fertility behaviors. Furthermore, more emphasis should be placed on increasing access to family planning services and raising awareness about high-risk reproductive behaviors among Ethiopian women.
高风险生育行为是包括埃塞俄比亚在内的中低收入国家的一个主要公共卫生问题。一些研究表明，高风险生育行为与儿童死亡率之间的关系已经分别分析了每种生育行为。然而，很少有研究分析与高风险生育行为的联合影响相关的结果。因此，本研究的目的是研究高风险生育行为对埃塞俄比亚五岁以下儿童死亡率的单独和联合影响。
使用 2016 年埃塞俄比亚人口与健康调查的数据进行分析。共有 10773 名生育活产的母亲被纳入最终分析。使用 STATA V.14 进行描述性、双变量和多变量逻辑回归分析。
总体而言，62.1%、24.0%和 2.3%的妇女分别经历了至少一种、两种和三种高风险生育行为。在多变量分析中，五岁以下儿童死亡与母亲的两种或多种高风险生育行为的组合显著相关。与没有参与任何高风险生育行为的妇女的子女相比，参与两种高风险生育行为（AOR=2.17，95%CI：1.52-3.08）和三种高风险生育行为（AOR=3.69，95%CI：1.80-7.55）的妇女的子女的五岁以下儿童死亡的几率更高。
本研究表明，单一高风险生育行为与五岁以下儿童死亡无关，但存在两种或多种母亲高风险生育行为是增加五岁以下儿童死亡可能性的一个重要因素。因此，应特别关注参与多种高风险生育行为的妇女的子女。此外，应更加重视增加获得计划生育服务的机会，并提高埃塞俄比亚妇女对高风险生殖行为的认识。
