Abstract
BackgroundHigh-risk fertility behavior is associated with numerous unfavorable child and maternal health outcomes such as chronic undernutrition, anemia, and child mortality. As far as our knowledge goes, there is not much study on determinants of high-risk fertility behavior in Ethiopia. Therefore, this study aimed to assess determinants of high-risk fertility behavior among reproductive-age women in Ethiopia.MethodThe study was based on secondary data analysis from the 2016 Ethiopia Demography and Health Survey. A total of 11,022 women who gave birth 5 years preceding the survey were included in this study. Kid’s Record (KR) dataset was used. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) was calculated for those variables included in the multilevel logistic regression model. P value ≤ 0.05 was employed to declare the statistically significant variables.ResultsMore than three-fourths (76.9%) of (95% CI 76.11 to 77.69) reproductive-age women had at least one high-risk fertility behavior. Attended primary and secondary education adjusted odds ratio (AOR) (AOR = 0.71; 95% CI 0.63, 0.80 and AOR = 0.73; 95% CI 0.60, 0.89, respectively), never used contraceptive (AOR = 1.25, 95% CI 1.12, 1.40), unwanted pregnancies (AOR = 1.40, 95% CI 1.23, 1.59), had no ANC visit (AOR = 1.19, 95% CI 1.05, 1.35), rural-dwelling (AOR = 1.26, 95% CI 1.04, 1.51), regions of Ethiopia [Somalia (AOR = 1.70; 95% CI 1.24, 2.32) and Amhara (AOR = 0.72; 95% CI 0.53, 0.96)] were determinants of high-risk fertility behavior.ConclusionEducation, rural residence, unwanted pregnancies, no antenatal care follow-up, and never used contraceptives were determinants of high-risk fertility behavior. Therefore, increased maternal health services, special intervention for hotspot areas, and giving special attention to rural dweller women were highly recommended.
Highlights
High-risk fertility behavior is associated with numerous unfavorable child and maternal health outcomes such as chronic undernutrition, anemia, and child mortality
Ethiopia is one of the countries with the highest maternal mortality ratio, with 412 deaths per 100,000 live births according to the 2016 Ethiopian Demographic and Health Survey (EDHS) reports, of which most of the deaths were attributed to high-risk fertility behavior [5, 6]
Anemia, and child and maternal mortality are unfavorable children and maternal health associated with highrisk fertility behavior [10,11,12]
Summary
High-risk fertility behavior is associated with numerous unfavorable child and maternal health outcomes such as chronic undernutrition, anemia, and child mortality. This study aimed to assess determinants of high-risk fertility behavior among reproductive-age women in Ethiopia. Between 2000 and 2017, the maternal mortality ratio (MMR, the number of maternal deaths per 100,000 live births) dropped by about 38% worldwide. Ethiopia is one of the countries with the highest maternal mortality ratio, with 412 deaths per 100,000 live births according to the 2016 EDHS reports, of which most of the deaths were attributed to high-risk fertility behavior [5, 6]. Anemia, and child and maternal mortality are unfavorable children and maternal health associated with highrisk fertility behavior [10,11,12]. Early-age women marriage is another problem for high-risk fertility problems in Ethiopia and other low- and middleincome countries [18]
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