Spatial distribution and associated factors of poor tetanus toxoid immunization among pregnant women in Ethiopia: spatial and multilevel analysis
BackgroundNeonatal mortality from tetanus can be reduced by 94% when pregnant women receive at least two doses of tetanus toxoid. In Ethiopia, immunization programs are suboptimal despite their importance. Therefore, the aim of this study was to examine the geographic distribution and associated fac...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Global Women's Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fgwh.2023.1138579/full |
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| author | Desale Bihonegn Asmamaw Wubshet Debebe Negash Fantu Mamo Aragaw Habitu Birhan Eshetu Melaku Hunie Asratie Tadele Biresaw Belachew |
| author_facet | Desale Bihonegn Asmamaw Wubshet Debebe Negash Fantu Mamo Aragaw Habitu Birhan Eshetu Melaku Hunie Asratie Tadele Biresaw Belachew |
| author_sort | Desale Bihonegn Asmamaw |
| collection | DOAJ |
| description | BackgroundNeonatal mortality from tetanus can be reduced by 94% when pregnant women receive at least two doses of tetanus toxoid. In Ethiopia, immunization programs are suboptimal despite their importance. Therefore, the aim of this study was to examine the geographic distribution and associated factors of poor tetanus toxoid (TT) immunization among pregnant women in Ethiopia.MethodsSecondary data analysis was used using the 2016 Ethiopian Demographic and Health Survey (EDHS). ArcGIS version 10.8 statistical software was used to explore the spatial distribution of poor TT immunization and SaTScan version 9.6 software was used to identify significant hotspot areas of poor TT immunization. For associated factors, a multilevel binary logistic regression model was fitted using STATA version 14 software. In the multivariable multilevel analysis, adjusted OR (AOR) with 95% CI was reported to reveal significantly associated factors of poor TT immunization.ResultIn Ethiopia, the spatial distribution of poor tetanus toxoid immunization was clustered with Global Moran's I = 0.59 at p-value of <0.0001. The highest poor TT immunization clusters were observed in the East and South Tigray, the central part of Amhara, West Afar, East Somali, and West Gambella. Pregnant women with no Antenatal care (ANC) visits [Adjusted Odds Ratio (aOR) = 10.46, 95% CI: (8.82, 12.41))], pregnant women with 1–3 ANC visits [aOR = 1.51, 95% CI: (1.31, 1.73)], media exposure [aOR = 1.45, 95% CI: (1.26, 1.67)], poor wealth index [aOR = 1.22; 95% CI: (1.03, 1.45)], middle wealth index [aOR = 1.23; 95% CI: (1.03, 1.47)], family planning use [aOR = 1.28; 95% CI: (1.11, 1.57)] and community level education [aOR = 1.43, 95% CI: (1.14, 1.80)] were significantly associated with poor tetanus toxoid immunization.ConclusionPoor tetanus toxoid immunization among pregnant women varies in Ethiopia. It was highest in East and South Tigray, the central part of Amhara, West Afar, East Somali, and West Gambella. Therefore, public health programs should design targeted interventions in identified hot spots to improve tetanus toxoid immunization. Health programmers should be promoting optimal ANC visits, women's education, and family planning use. |
| first_indexed | 2024-03-12T02:49:41Z |
| format | Article |
| id | doaj.art-dfa9c70d9f0e42f9a752c478300051e6 |
| institution | Directory Open Access Journal |
| issn | 2673-5059 |
| language | English |
| last_indexed | 2024-03-12T02:49:41Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Global Women's Health |
| spelling | doaj.art-dfa9c70d9f0e42f9a752c478300051e62023-09-04T05:50:25ZengFrontiers Media S.A.Frontiers in Global Women's Health2673-50592023-09-01410.3389/fgwh.2023.11385791138579Spatial distribution and associated factors of poor tetanus toxoid immunization among pregnant women in Ethiopia: spatial and multilevel analysisDesale Bihonegn Asmamaw0Wubshet Debebe Negash1Fantu Mamo Aragaw2Habitu Birhan Eshetu3Melaku Hunie Asratie4Tadele Biresaw Belachew5Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaBackgroundNeonatal mortality from tetanus can be reduced by 94% when pregnant women receive at least two doses of tetanus toxoid. In Ethiopia, immunization programs are suboptimal despite their importance. Therefore, the aim of this study was to examine the geographic distribution and associated factors of poor tetanus toxoid (TT) immunization among pregnant women in Ethiopia.MethodsSecondary data analysis was used using the 2016 Ethiopian Demographic and Health Survey (EDHS). ArcGIS version 10.8 statistical software was used to explore the spatial distribution of poor TT immunization and SaTScan version 9.6 software was used to identify significant hotspot areas of poor TT immunization. For associated factors, a multilevel binary logistic regression model was fitted using STATA version 14 software. In the multivariable multilevel analysis, adjusted OR (AOR) with 95% CI was reported to reveal significantly associated factors of poor TT immunization.ResultIn Ethiopia, the spatial distribution of poor tetanus toxoid immunization was clustered with Global Moran's I = 0.59 at p-value of <0.0001. The highest poor TT immunization clusters were observed in the East and South Tigray, the central part of Amhara, West Afar, East Somali, and West Gambella. Pregnant women with no Antenatal care (ANC) visits [Adjusted Odds Ratio (aOR) = 10.46, 95% CI: (8.82, 12.41))], pregnant women with 1–3 ANC visits [aOR = 1.51, 95% CI: (1.31, 1.73)], media exposure [aOR = 1.45, 95% CI: (1.26, 1.67)], poor wealth index [aOR = 1.22; 95% CI: (1.03, 1.45)], middle wealth index [aOR = 1.23; 95% CI: (1.03, 1.47)], family planning use [aOR = 1.28; 95% CI: (1.11, 1.57)] and community level education [aOR = 1.43, 95% CI: (1.14, 1.80)] were significantly associated with poor tetanus toxoid immunization.ConclusionPoor tetanus toxoid immunization among pregnant women varies in Ethiopia. It was highest in East and South Tigray, the central part of Amhara, West Afar, East Somali, and West Gambella. Therefore, public health programs should design targeted interventions in identified hot spots to improve tetanus toxoid immunization. Health programmers should be promoting optimal ANC visits, women's education, and family planning use.https://www.frontiersin.org/articles/10.3389/fgwh.2023.1138579/fulltetanus toxoidimmunizationspatialEthiopiaEDHS |
| spellingShingle | Desale Bihonegn Asmamaw Wubshet Debebe Negash Fantu Mamo Aragaw Habitu Birhan Eshetu Melaku Hunie Asratie Tadele Biresaw Belachew Spatial distribution and associated factors of poor tetanus toxoid immunization among pregnant women in Ethiopia: spatial and multilevel analysis Frontiers in Global Women's Health tetanus toxoid immunization spatial Ethiopia EDHS |
| title | Spatial distribution and associated factors of poor tetanus toxoid immunization among pregnant women in Ethiopia: spatial and multilevel analysis |
| title_full | Spatial distribution and associated factors of poor tetanus toxoid immunization among pregnant women in Ethiopia: spatial and multilevel analysis |
| title_fullStr | Spatial distribution and associated factors of poor tetanus toxoid immunization among pregnant women in Ethiopia: spatial and multilevel analysis |
| title_full_unstemmed | Spatial distribution and associated factors of poor tetanus toxoid immunization among pregnant women in Ethiopia: spatial and multilevel analysis |
| title_short | Spatial distribution and associated factors of poor tetanus toxoid immunization among pregnant women in Ethiopia: spatial and multilevel analysis |
| title_sort | spatial distribution and associated factors of poor tetanus toxoid immunization among pregnant women in ethiopia spatial and multilevel analysis |
| topic | tetanus toxoid immunization spatial Ethiopia EDHS |
| url | https://www.frontiersin.org/articles/10.3389/fgwh.2023.1138579/full |
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