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DOI: 10.1371/journal.pone.0124718
论文题名:
Why Do Women Deliver at Home? Multilevel Modeling of Ethiopian National Demographic and Health Survey Data
作者: Henock Yebyo; Mussie Alemayehu; Alemayehu Kahsay
刊名: PLOS ONE
ISSN: 1932-6203
出版年: 2015
发表日期: 2015-4-15
卷: 10, 期:4
语种: 英语
英文关键词: Labor and delivery ; Antenatal care ; Ethiopia ; Socioeconomic aspects of health ; Educational attainment ; Demography ; Health surveys ; Rural areas
英文摘要: Background Despite of the existing intensive efforts to improve maternal health in Ethiopia, the proportion of birth delivered at home remains high and is still the top priority among the national health threats. Objective The study aimed to examine effects of individual women and community-level factors of women’s decision on place of delivery in Ethiopia. Methods Data were obtained from the nationally representative 2011 Ethiopian Demographic and Health Survey (EDHS) which used a two-stage cluster sampling design with rural-urban and regions as strata. The EDHS collected data from a big sample size but our study focused on a sample of 7,908 women whose most recent birth was within five years preceding 2011 and 576 communities in which the women were living in. The data were analyzed using a two-level mixed-effects logistic regression to determine fixed-effects of individual- and community-level factors and random-intercept of between-cluster characteristics. Results In the current study, 6980 out of 7908 deliveries (88.3%) took place at home. Lower educational levels (OR=2.74, 95%CI:1.84,4.70; p<0.0001), making no or only a limited number of ANC visits (OR=3.72,95%CI:2.85, 4.83; p<0.0001), non-exposure to media (OR=1.51, 95%CI 1.13, 2.01; p=0.004), higher parity (OR=2.68, 95%CI:1.96,3.68; p<0.0001), and perceived distance problem to reach health facilities (OR=1.29, 95%CI:1.03,1.62; p=0.022) were positively associated with home delivery. About 75% of the total variance in the odds of giving birth at home was accounted for the between-community differences of characteristics (ICC=0.75, p<0.0001). With regard to community-level characteristics, rural communities (OR=4.67, 95%CI:3.06,7.11; p<0.0001), pastoralist communities (OR=4.53, 95%CI:2.81,7.28; p<0.0001), communities with higher poverty levels (OR=1.49 95%CI:1.08,2.22; p=0.048), with lower levels of ANC utilization (OR=2.01, 95%CI:1.42,2.85; p<0.0001) and problem of distance to a health facility (OR=1.29, 95%CI:1.03,1.62; p=0.004) had a positive influence on women to give birth at home. Conclusions Not only individual characteristics of women, but also community-level factors determine women’s decision to deliver at home.
URL: http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0124718&type=printable
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资源类型: 期刊论文
标识符: http://119.78.100.158/handle/2HF3EXSE/22294
Appears in Collections:过去全球变化的重建
影响、适应和脆弱性
科学计划与规划
气候变化与战略
全球变化的国际研究计划
气候减缓与适应
气候变化事实与影响

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作者单位: Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia;Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia;Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia

Recommended Citation:
Henock Yebyo,Mussie Alemayehu,Alemayehu Kahsay. Why Do Women Deliver at Home? Multilevel Modeling of Ethiopian National Demographic and Health Survey Data[J]. PLOS ONE,2015-01-01,10(4)
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