Spatial distribution and determinants of undernutrition among reproductive age women of Ethiopia: A multilevel analysis.

<h4>Introduction</h4>Malnutrition is one of the most devastating problems in Ethiopia and is inextricably linked with poverty. Women in the reproductive age group and children are most vulnerable to malnutrition due to low dietary intakes, inequitable distribution of food within the hous...

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Main Authors: Ayenew Kassie Tesema, Alemneh Mekuriaw Liyew, Adugnaw Zeleke Alem, Yigizie Yeshaw, Getayeneh Antehunegn Tesema, Achamyeleh Birhanu Teshale
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0257664
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author Ayenew Kassie Tesema
Alemneh Mekuriaw Liyew
Adugnaw Zeleke Alem
Yigizie Yeshaw
Getayeneh Antehunegn Tesema
Achamyeleh Birhanu Teshale
author_facet Ayenew Kassie Tesema
Alemneh Mekuriaw Liyew
Adugnaw Zeleke Alem
Yigizie Yeshaw
Getayeneh Antehunegn Tesema
Achamyeleh Birhanu Teshale
author_sort Ayenew Kassie Tesema
collection DOAJ
description <h4>Introduction</h4>Malnutrition is one of the most devastating problems in Ethiopia and is inextricably linked with poverty. Women in the reproductive age group and children are most vulnerable to malnutrition due to low dietary intakes, inequitable distribution of food within the household, improper food storage and preparation, dietary taboos, infectious diseases, and care. Therefore, this study aimed to assess the spatial distribution and determinants of undernutrition among reproductive age of Ethiopia.<h4>Methods</h4>The study was based on the 2016 Ethiopian Demographic and Health Survey. The study included a total sampled weight of 15,139 women aged 15-49 years. The ArcGIS version 10.7 and SaTScan version 9.6 statistical software were used for exploring the spatial distribution of undernutrition. A multilevel logistic regression model was fitted to determine the individual and community level factors associated with women undernutrition. Finally, the factors which were significant at 95% confidence interval were reported.<h4>Result</h4>The spatial analysis revealed that women undernutrition was significantly varied across the country. The SaTScan analysis identified a total of 144 significant hotspot areas of maternal undernutrition with three significant spatial windows. Of these, 134 clusters were primary. The primary spatial window was identified in the southeast Tigray, northwest Afar, central and north Amhara regions (LLR = 57.48, P<0.01, RR = 1.51). Age at first marriage (AOR = 1.57: CI 1.33, 1.99), middle wealth index (AOR = 3.15: CI 1.4, 6.97), rural residence (AOR = 2.82: CI 1.22, 6.52), being in Afar region, Tigray region and Harari region (AOR = 4.88: CI 1.71, 13.91), (AOR = 4.17: CI 1.57, 11.06) and (AOR = 3.01: CI 1.05, 8.68) respectively were significantly associated with women undernutrition.<h4>Conclusion</h4>In Ethiopia, undernutrition had significant spatial variations across the country. Residence, age at first marriage, wealth index and region were significantly associated with undernutrition. Therefore, public health interventions that reduce reproductive age women undernutrition and enhance women awareness towards undernutrition in hotspot areas of undernutrition is crucial.
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spelling doaj.art-ef600d89e82b4618ab4e2c97489d1ef02022-12-21T23:10:30ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01169e025766410.1371/journal.pone.0257664Spatial distribution and determinants of undernutrition among reproductive age women of Ethiopia: A multilevel analysis.Ayenew Kassie TesemaAlemneh Mekuriaw LiyewAdugnaw Zeleke AlemYigizie YeshawGetayeneh Antehunegn TesemaAchamyeleh Birhanu Teshale<h4>Introduction</h4>Malnutrition is one of the most devastating problems in Ethiopia and is inextricably linked with poverty. Women in the reproductive age group and children are most vulnerable to malnutrition due to low dietary intakes, inequitable distribution of food within the household, improper food storage and preparation, dietary taboos, infectious diseases, and care. Therefore, this study aimed to assess the spatial distribution and determinants of undernutrition among reproductive age of Ethiopia.<h4>Methods</h4>The study was based on the 2016 Ethiopian Demographic and Health Survey. The study included a total sampled weight of 15,139 women aged 15-49 years. The ArcGIS version 10.7 and SaTScan version 9.6 statistical software were used for exploring the spatial distribution of undernutrition. A multilevel logistic regression model was fitted to determine the individual and community level factors associated with women undernutrition. Finally, the factors which were significant at 95% confidence interval were reported.<h4>Result</h4>The spatial analysis revealed that women undernutrition was significantly varied across the country. The SaTScan analysis identified a total of 144 significant hotspot areas of maternal undernutrition with three significant spatial windows. Of these, 134 clusters were primary. The primary spatial window was identified in the southeast Tigray, northwest Afar, central and north Amhara regions (LLR = 57.48, P<0.01, RR = 1.51). Age at first marriage (AOR = 1.57: CI 1.33, 1.99), middle wealth index (AOR = 3.15: CI 1.4, 6.97), rural residence (AOR = 2.82: CI 1.22, 6.52), being in Afar region, Tigray region and Harari region (AOR = 4.88: CI 1.71, 13.91), (AOR = 4.17: CI 1.57, 11.06) and (AOR = 3.01: CI 1.05, 8.68) respectively were significantly associated with women undernutrition.<h4>Conclusion</h4>In Ethiopia, undernutrition had significant spatial variations across the country. Residence, age at first marriage, wealth index and region were significantly associated with undernutrition. Therefore, public health interventions that reduce reproductive age women undernutrition and enhance women awareness towards undernutrition in hotspot areas of undernutrition is crucial.https://doi.org/10.1371/journal.pone.0257664
spellingShingle Ayenew Kassie Tesema
Alemneh Mekuriaw Liyew
Adugnaw Zeleke Alem
Yigizie Yeshaw
Getayeneh Antehunegn Tesema
Achamyeleh Birhanu Teshale
Spatial distribution and determinants of undernutrition among reproductive age women of Ethiopia: A multilevel analysis.
PLoS ONE
title Spatial distribution and determinants of undernutrition among reproductive age women of Ethiopia: A multilevel analysis.
title_full Spatial distribution and determinants of undernutrition among reproductive age women of Ethiopia: A multilevel analysis.
title_fullStr Spatial distribution and determinants of undernutrition among reproductive age women of Ethiopia: A multilevel analysis.
title_full_unstemmed Spatial distribution and determinants of undernutrition among reproductive age women of Ethiopia: A multilevel analysis.
title_short Spatial distribution and determinants of undernutrition among reproductive age women of Ethiopia: A multilevel analysis.
title_sort spatial distribution and determinants of undernutrition among reproductive age women of ethiopia a multilevel analysis
url https://doi.org/10.1371/journal.pone.0257664
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