Background
Methods
Study design and study settings
Data source
Population and sample
Data and variables
Spatial analysis
Spatial autocorrelation analysis
Incremental autocorrelation
Hot spot analysis (Getis-OrdGi* statistic)
Spatial scan statistical analysis
Spatial interpolation
Statistical analysis
Data processing and analysis
Results
Characteristics of the sample
Variables | Count (%) | % of 4 or more ANC visit (optimal) |
---|---|---|
An optimal completion of ANC visit | ||
No | 5526 (68.86) | |
Yes | 2499 (31.14) | 100 |
Marital status | ||
Never in union | 7656 (95.4) | 30.88 |
Currently in union | 369 (4.60) | 36.52 |
Sex of household headed | ||
Male | 6870 (85.60) | 30.02 |
Female | 1155 (14.40) | 37.79 |
Place of Residence | ||
Urban | 968 (12.07) | 62.95 |
Rural | 7057 (87.93) | 26.77 |
Age | ||
15–19 | 260 (3.24) | 28.60 |
20–24 | 1500 (18.69) | 30.61 |
25–29 | 2503 (31.19) | 32.58 |
30–34 | 1795 (22.37) | 31.40 |
35–39 | 1322 (16.47) | 32.01 |
40–44 | 447 (5.56) | 25.45 |
45–49 | 199 (2.48) | 25.02 |
Birth order | ||
1 | 1632 (20.33) | 39.42 |
2–4 | 3399 (42.35) | 32.15 |
> =5 | 2995 (37.32) | 25.48 |
Women Level of education | ||
Unable to read and write | 5203 (64.83) | 25.71 |
Primary education | 2198 (27.38) | 36.04 |
Secondary education | 414 (5.16) | 58.04 |
Higher education | 211 (2.63) | 60.67 |
Husband level of education(n = 7578) | ||
Unable to read and write | 3761 (49.64) | 25.06 |
Primary education | 2878 (37.98) | 31.77 |
Secondary education | 598 (7.89) | 50.03 |
Higher education | 341 (4.49) | 53.04 |
Wealth quartile | ||
Poor | 3649 (45.47) | 22.74 |
middle | 1613 (20.10) | 29.25 |
rich | 2763 (34.43) | 43.21 |
Parity | ||
1 | 2145 (30.54) | 38.55 |
2–5 | 3095 (38.57) | 37.13 |
> 5 | 2479 (30.89) | 24.32 |
Distance to health facility | ||
Big problem | 4823 (60.10) | 46.76 |
Not big problem | 3202 (39.90) | 54.24 |
Media Exposure | ||
Exposure | 5399 (68.24) | 58.03 |
Non Exposed | 2513 (31.76) | 41.97 |
Region | ||
Tigray | 532 (6.63) | 57.10 |
Afar | 78 (0.97) | 19.99 |
Amhara | 1671 (20.83) | 30.73 |
Oromia | 3436 (42.82) | 22.22 |
Somalia | 322 (4.01) | 10.43 |
Benishangul Gumuz | 88 (1.10) | 41.52 |
SNNP | 1623 (20.33) | 38.09 |
Gambela | 22 (0.27) | 41.53 |
Harari | 19 (0.24) | 32.54 |
Addis Ababa | 198 (2.47) | 89.08 |
Dire Dawa | 34 (0.43) | 64.32 |
Community level ANC | ||
low | 2776 (32.09) | 19.86 |
high | 5450 (67.91) | 55.00 |
Community level literacy | ||
low | 3524 (43.91) | 39.64 |
high | 4502 (56.09) | 24.48 |
Timing of ANC | ||
Less than 12 weeks | 1092 (13.61) | 23.29 |
More than 12 weeks | 6933 (86.39) | 76.71 |
Spatial analysis results
Spatial autocorrelation
Spatial distribution of subjects who completed the optimal number of ANC visits in Ethiopia
Incremental autocorrelation
Hot spot analysis of optimal ANC visit in Ethiopia
Interpolation of an ANC visit
Spatial SaTScan analysis of an optimal ANC visit Bernoulli based model
Cluster | EA (enumeration Area) | Coordinate or Radi | RR | LLR | P-value |
---|---|---|---|---|---|
Primary(55) | 236, 252, 83, 353, 475, 261, 539, 451, 61, 225, 264, 110, 302, 293, 330, 159, 19, 211, 645, 59, 608, 155, 195, 145, 487, 314, 639, 428,635, 414, 509, 560, 305, 15, 582, 147, 100, 108, 247, 31, 107, 626, 153, 170, 402, 369, 339, 91, 11, 532, 464, 144, 90, 287, 463, 112 | (8.883803 N, 38.778503 E) / 21.03 km | 2.94 | 145.88 | < 0.001 |
Secondary(56) | 89, 479, 45, 461, 84, 598, 404, 481, 413, 604, 81, 590, 400, 226, 597, 341, 355, 636, 103, 129, 117, 192, 156, 584, 196, 181, 430, 579,263, 623, 528, 134, 255, 99, 298, 575, 551, 98, 220, 127, 78, 362 94, 237, 550, 605, 340, 235, 538, 384, 424, 188, 583, 585, 268, 421, 160 | (14.438634 N, 39.085800 E) / 143.67 km | 1.91 | 60.98 | < 0.001 |
Determinants for an optimal ANC visit
Variables | COR(95%CI) | AOR(95%CI) |
---|---|---|
Marital status | ||
Never in union | ref | |
Currently in union | 0.99 (0.97,1.03) | 0.95 (0.91,1.00) |
Sex of household headed | ||
Male | Ref | |
Female | 1.02 (0.99,1.05) | 1.13 (0.98,1.37) |
Place of Residence | ||
Urban | Ref | |
Rural | 0.66 (0.63,0.69) | 0.59 (0.45,0.77)** |
Age | ||
15–19 | Ref | Ref |
20–24 | 1.02 (0.97,1.08) | 1.07 (0.76,1.50) |
25–29 | 1.02 (0.97,1.08) | 1.18 (0.82,1.68) |
30–34 | 1.02 (0.96,1.07) | 1.23 (0.84,1.80) |
35–39 | 1.03 (0.97,1.08) | 1.32 (0.88,1.98) |
40–44 | 0.95 (0.91,1.04) | 1.01 (0.63,1.60) |
45–49 | 0.96 (0.89,1.05) | 1.02 (0.57,1.83) |
Religion | ||
Orthodox | Ref | Ref |
Muslim | 0.52 (0.44,0.62) | 1.03 (0.82, 1.28) |
Protestant | 0.60 (0.49,0.73) | 0.71 (0.55,0.91)* |
Catholic & traditional | 0.53 (0.37,0.75) | 0.52 (0.33,0.83)* |
Birth order | ||
1 | Ref | |
2–4 | 0.96 (0.93,0.98) | 0.88 (0.71,1.09) |
> =5 | 0.93 (0.91,0.96) | 0.85 (0.62,1.17) |
Women Level of education | ||
Unable to read and write | Ref | |
Primary education | 1.05 (1.02,1.07) | 0.96 (0.82,1.13) |
Secondary education | 1.16 (1.11,1.21) | 1.02 (0.77,1.35) |
Higher education | 1.23 (1.16,1.31) | 1.02 (0.67,1.56) |
Parity | ||
1 | Ref | Ref |
2–5 | 0.80 (0.72,0.89) | 0.92 (0.75,1.14) |
≥ 5 | 0.74 (0.65,0.83) | 0.94 (0.68,1.29) |
Wealth quartile | ||
Poor | Ref | |
middle | 1.04 (1.01,1.07) | 1.09 (0.91,1.31) |
rich | 1.17 (1.14,1.21) | 1.10 (0.91,1.33) |
Distance to the health institution | ||
Not a big problem | ref | ref |
A big problem | 1.44 (1.30,1.59) | 1.21 (1.04,1.39)* |
Exposure to media | ||
Yes | Ref | Ref |
No | 1.55 (1.39,1.72) | 1.09 (0.94,1.28) |
Partner’s level of education | ||
no education | Ref | ref |
Primary | 1.19 (1.07,1.33) | 1.06 (0.92,1.22) |
Secondary | 1.81 (1.53,2.14) | 1.33 (1.05,1.67) |
Higher | 1.69 (1.40,2.05) | 1.02 (0.76,1.36) |
Region | ||
Tigray | 0.73 (0.67,0.79) | 0.48 (0.28,0.82)* |
Afar | 0.48 (0.44,0.52) | 0.13 (0.07,0.24)* |
Amhara | 0.56 (0.51,0.61) | 0.24 (0.14,0.42)* |
Oromia | 0.52 (0.48,0.56) | 0.25 (0.15,0.43)* |
Somalia | 0.45 (0.42,0.49) | 0.08 (0.05,0.15)* |
Benishangul Gumuz | 0.62 (0.57,0.68) | 0.48 (0.28, 0.84)* |
SNNP | 0.61 (0.56,0.66) | 0.48 (0.28,0.83)* |
Gambela | 0.59 (0.54,0.64) | 0.37 (0.21,0.66)* |
Harari | 0.60 (0.55,0.56) | 0.16 (0.09,0.28)* |
Addis Ababa | Ref | Ref |
Dire Dawa | 0.80 (0.71,0.88) | 0.52 (0.29,0.93)* |
Community level ANC utilization | ||
high | Ref | Ref |
low | 1.54 (1.49,1.59) | 2.67 (2.21,3.24)* |
Community level literacy | ||
low | Ref | Ref |
high | 1.38 (1.32,1.43) | 1.07 (1.03,1.12)* |
Community level media exposure | ||
Higher media exposure | Ref | Ref |
Lower media exposure | 1.50 (1.05,1.75) | 1.16 (0.95,1.42) |
Timing of ANC | ||
Less than 12 weeks | Ref | Ref |
More than 12 weeks | 0.80 (0.58,0.90) | 0.70 (0.60,0.82) |