Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2023 Feb 28;18(2):e0282012. doi: 10.1371/journal.pone.0282012. eCollection 2023.
Neonatal mortality is pervasive in developing countries like Ethiopia. Though the risk of neonatal mortality is preventable through consolidating simple, low-cost, and less time-consuming essential care, there is a scarcity of evidence about the spatial distribution of newborn care in Ethiopia.
The current study aimed to demonstrate spatial distribution and determinants of newborn care within 2 days of the postpartum period in Ethiopia.
A cross-sectional study was employed based on Ethiopian demographic and health survey 2016 data and 2796 post-partum period women were included. Arc GIS version 10.7 and SaTScan version 9.6 software were used. Mixed effect analysis was done by STATA version 14 software. Bivariate analysis was done and variables with a p value<0.2 were taken as a candidate for multilevel multivariable logistic regression. Intra Class Correlation Coefficient (ICC), Proportion Change in Variance (PCV), and Median Odds Ratio (MOR) were used for model comparison and an Adjusted Odds Ratio (AOR) with respect to a 95% confidence interval was used for declaring statistical significance. In the multivariable analysis, a p-value≤0.05 was considered as a cut point of statistical significance with the outcome variable.
The spatial distribution of newborn care was not random and the overall prevalence was 48.39%. Secondary educational level (Adjusted Odds Ratio (AOR = 1.5;95% CI 1.06,2.62), college and above (AOR = 2.47; 95% CI 1.22,5.01), number of antenatal cares three (AOR = 1.5; 95% CI 1.10, 2.04), antenatal care four and above (AOR = 1.6; 95% CI 1.22; 2.19), place of delivery (AOR = 9.67; 7.44, 12.57) and child is a twin (AOR = 3.33; 95% CI 1.23, 9.00) were variables significantly associated with newborn care.
Newborn care practice in Ethiopia is below half per hundred participants. Even the distribution was not random. There is a need to pay attention to those cold spot areas and factors significantly associated with newborn care. Improving women's educational levels secondary and above, and consolidating the continuation of antenatal care and health facility delivery were the priority areas to improve newborn care in Ethiopia. Maternal and neonatal health program managers and policymakers should pay attention to those cold spots of newborn care to achieve the sustainable development goal.
在埃塞俄比亚等发展中国家，新生儿死亡率普遍存在。尽管通过整合简单、低成本和耗时较少的基本护理可以预防新生儿死亡的风险，但关于埃塞俄比亚新生儿护理的空间分布的证据仍然稀缺。
本研究旨在展示埃塞俄比亚产后 2 天内新生儿护理的空间分布和决定因素。
本研究采用基于埃塞俄比亚人口与健康调查 2016 年数据的横断面研究设计，共纳入 2796 名产后妇女。使用 ArcGIS 版本 10.7 和 SaTScan 版本 9.6 软件。使用 STATA 版本 14 软件进行混合效应分析。进行双变量分析，选择 p 值<0.2 的变量作为多水平多变量逻辑回归的候选变量。使用组内相关系数（ICC）、方差变化比例（PCV）和中位数优势比（MOR）进行模型比较，并使用调整后的优势比（AOR）和 95%置信区间表示统计学意义。在多变量分析中，以 p 值≤0.05 作为因变量的统计学显著性截断点。
新生儿护理的空间分布并非随机，总体流行率为 48.39%。中等教育水平（调整后的优势比（AOR=1.5；95%置信区间 1.06，2.62），高等教育水平（AOR=2.47；95%置信区间 1.22，5.01），接受三次产前护理（AOR=1.5；95%置信区间 1.10，2.04），接受四次及以上产前护理（AOR=1.6；95%置信区间 1.22；2.19），分娩地点（AOR=9.67；7.44，12.57）和双胞胎（AOR=3.33；95%置信区间 1.23，9.00）是与新生儿护理显著相关的变量。
埃塞俄比亚的新生儿护理实践低于每百名参与者的一半。即使分布也不是随机的。需要关注那些冷点地区和与新生儿护理显著相关的因素。提高妇女中等教育水平及以上水平，并巩固继续产前护理和在医疗保健机构分娩是改善埃塞俄比亚新生儿护理的优先领域。孕产妇和新生儿健康方案管理人员和政策制定者应关注新生儿护理的这些冷点地区，以实现可持续发展目标。
