Abstract
BackgroundLow birth weight (LBW) remains to be a leading cause of neonatal death and a major contributor to infant and under-five mortality. Its prevalence has not declined in the last decade in sub-Saharan Africa (SSA) and Asia. Some individual level factors have been identified as risk factors for LBW but knowledge is limited on contextual risk factors for LBW especially in SSA.MethodsContextual risk factors for LBW in Ghana were identified by performing multivariable multilevel logistic regression analysis of 6,900 mothers dwelling in 412 communities that participated in the 2003 and 2008 Demographic and Health Surveys in Ghana.ResultsContextual-level factors were significantly associated with LBW: Being a rural dweller increased the likelihood of having a LBW infant by 43% (OR 1.43; 95% CI 1.01–2.01; P-value <0.05) while living in poverty-concentrated communities increased the risk of having a LBW infant twofold (OR 2.16; 95% CI 1.29–3.61; P-value <0.01). In neighbourhoods with a high coverage of safe water supply the odds of having a LBW infant reduced by 28% (OR 0.74; 95% CI 0.57–0.96; P-value <0.05).ConclusionThis study showed contextual risk factors to have independent effects on the prevalence of LBW infants. Being a rural dweller, living in a community with a high concentration of poverty and a low coverage of safe water supply were found to increase the prevalence of LBW infants. Implementing appropriate community-based intervention programmes will likely reduce the occurrence of LBW infants.
Highlights
Low birth weight (LBW) remains to be a leading cause of neonatal death and a major contributor to infant and under-five mortality
The prevalence of LBW was estimated at 16.9 percent, and observed to be higher among rural dwellers, and in communities with low coverage of safe water supply, poor access to healthcare, a high proportion of illiterates and those living in extreme poverty
Being a rural dweller increased the likelihood of having a LBW infant by 43%
Summary
Low birth weight (LBW) remains to be a leading cause of neonatal death and a major contributor to infant and under-five mortality. Some individual level factors have been identified as risk factors for LBW but knowledge is limited on contextual risk factors for LBW especially in SSA. Deliveries in low and middle income countries are often complicated by adverse birth outcomes such as stillbirth, early neonatal mortality and morbidity. Low birth weight (LBW) remains to be a leading cause of neonatal death [1], and is a major contributor to infant and under-five mortality [2]. Due to the devastating public health implications of LBW, the United Nations incorporated LBW into its action plans and aimed to reduce its incidence by one-third by 2015 [14]
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