Agimas Muluken Chanie, Kidie Tesfie Tigabu, Derseh Nebiyu Mekonnen, Asmamaw Meron, Abuhay Habtamu Wagnew, Yismaw Getaneh Awoke
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine, University of Gondar, Gondar, Ethiopia.
PLoS One. 2024 Dec 30;19(12):e0309929. doi: 10.1371/journal.pone.0309929. eCollection 2024.
Postnatal care within 2 days after delivery is classified as early postnatal care. Maternal and neonate mortality during the early postnatal period is a global health problem. Sub-Saharan Africa contributes the highest maternal and newborn mortality rates. To reverse this problem, early postnatal care is the best strategy, but there is no study to show the spatial distribution and application of geographical weighted regression to show the effect of each predictor on early postnatal care across the geographic areas in Ethiopia using the recent EDHS 2019 data.
To assess the geospatial distribution and predictors of postnatal care utilization during the critical period in Ethiopia using EDHS 2019.
A secondary data analysis of a cross-sectional study was used among 2105 women. The data for this analysis was taken from the 2019 EDHS, and missing data was managed by imputation. The spatial variation of postnatal care during the critical time was assessed using the Getis-Ord Gi* statistic; Moran's I statistics were conducted to test the autocorrelation; and Sat Scan statistics were also used to show the statistically significant clusters of early PNC utilization in Ethiopia. The ordinary least squares method was used to select factors explaining the geographical variation of postnatal care during the critical time. Finally, the geographical weighted regression was used to show the spatial variation of the association between predictors and outcomes. Predictors at 95% CI with a p-value <0.05 were statistically significant factors for PNC during the critical time.
The overall prevalence of PNC utilization during critical time was 713 (34%, 95%CI: 31.5%-36.5%). The spatial distribution of postnatal care utilization during critical times was not randomly distributed across the area of Ethiopia. The hotspot areas of postnatal care utilization during the critical period in Ethiopia were found to be in Benishangul, Gumuz, and the western part of Tigray. Whereas, the cold spot area was in the western part of the southern nation and nationality of Ethiopia. Women with antenatal care visits, facility delivery, no education, and media exposure were the predictors of postnatal care utilization during the critical time in the hotspot areas of Ethiopia.
In Ethiopia, one-third of women utilize the PNC during critical times. Postnatal care utilization during critical times was not randomly distributed across the regions of Ethiopia. Antenatal care visits, facility delivery, lack of education, and media exposure were the predictors of postnatal care utilization during the critical time in Ethiopia. Therefore, encouraging facility delivery, awareness creation by expanding media access, and literacy are highly recommended to improve the utilization of PNC services during this critical time in Ethiopia.
分娩后2天内的产后护理被归类为早期产后护理。产后早期的孕产妇和新生儿死亡率是一个全球性的健康问题。撒哈拉以南非洲的孕产妇和新生儿死亡率最高。为扭转这一问题，早期产后护理是最佳策略，但尚无研究利用埃塞俄比亚2019年最新的埃塞俄比亚 DHS数据，展示地理加权回归的空间分布及应用，以说明各预测因素对埃塞俄比亚不同地理区域早期产后护理的影响。
利用埃塞俄比亚2019年DHS评估埃塞俄比亚关键时期产后护理利用情况的地理空间分布及预测因素。
对2105名女性进行横断面研究的二次数据分析。该分析数据取自2019年埃塞俄比亚DHS，缺失数据通过插补法处理。使用Getis-Ord Gi*统计量评估关键时期产后护理的空间变异；进行Moran's I统计量检验自相关性；还使用Sat Scan统计量展示埃塞俄比亚早期产后护理利用的统计学显著聚类。采用普通最小二乘法选择解释关键时期产后护理地理变异的因素。最后，使用地理加权回归展示预测因素与结果之间关联的空间变异。95%置信区间内p值<0.05的预测因素是关键时期产后护理的统计学显著因素。
关键时期产后护理利用的总体患病率为713例（34%，95%置信区间：31.5%-36.5%）。关键时期产后护理利用的空间分布在埃塞俄比亚地区并非随机分布。发现埃塞俄比亚关键时期产后护理利用的热点地区位于贝尼尚古尔、古穆兹以及提格雷西部。而冷点地区位于埃塞俄比亚南方民族州的西部。在埃塞俄比亚热点地区，进行过产前检查、在医疗机构分娩、未接受教育以及接触过媒体的女性是关键时期产后护理利用的预测因素。
在埃塞俄比亚，三分之一的女性在关键时期利用产后护理。关键时期产后护理利用在埃塞俄比亚各地区并非随机分布。产前检查、在医疗机构分娩、缺乏教育以及接触过媒体是埃塞俄比亚关键时期产后护理利用的预测因素。因此，强烈建议鼓励在医疗机构分娩、通过扩大媒体接触提高认识以及提高识字率，以改善埃塞俄比亚这一关键时期产后护理服务的利用情况。
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