Determinants of injuries and accidents in Ethiopia: A Multilevel Analysis

Abstract

Background: Injury is a major health issue worldwide, especially in developingcountries such as Ethiopia, where no comprehensive national injury data exists.There is a need to better define the epidemiology of injury and determinants asa basis for the formulation of violence and injury prevention strategies.Objective: This study aimed to determine individual and community-levelfactors associated with injuries and accidents in Ethiopia.Methods: Using the latest nationally representative data obtained fromEthiopia Demographic and Health Survey (EDHS) 2016, the survey collectedinformation about the occurrence of injuries in the past 12 months among 12,841 members of 16,650 households. Sample from 645 clusters of 12372 un-weighted households and 12841 weighted households were selected from nine regions and two city administrations of Ethiopia using a stratified clustersampling procedure. Multilevel logistic regressions were used to identify thedeterminants of injuries. Four models were built to estimate both fixed effectsof the individual and community-level factors and random effects betweencluster variation on injuries and/or accidents.Results: The current study found that 3.4 % of injuries and accidents occurredin the reference 12-month period. At the final best-fitted model (model IV), asecondary educational level of household members (AOR= 0.54; 95 % CI (0.297,0.987), household members from middle-level wealth index (AOR = 1.72; 95 %CI (1.048, 2.807), and history of smoking within the last 24 hours (AOR = 0.28;95 % CI (0.092, 0.863) were significantly associated with injury and accidents.Conclusion: The study's analysis of injuries that occurred during the study'sreference 12-month period revealed that Ethiopia has low injury prevalence,considering Ethiopian demographic survey data limitations on major injuries.Additionally, having a secondary education, falling into the middle of thewealth index, and having a history of smoking were all significantly associatedwith injuries and accidents.