Abstract
Studies on factors of low birth weight in Malawi have neglected the flexible approach of using smooth functions for some covariates in models. Such flexible approach reveals detailed relationship of covariates with the response. The study aimed at investigating risk factors of low birth weight in Malawi by assuming a flexible approach for continuous covariates and geographical random effect. A Bayesian geo-additive model for birth weight in kilograms and size of the child at birth (less than average or average and higher) with district as a spatial effect using the 2010 Malawi demographic and health survey data was adopted. A Gaussian model for birth weight in kilograms and a binary logistic model for the binary outcome (size of child at birth) were fitted. Continuous covariates were modelled by the penalized (p) splines and spatial effects were smoothed by the two dimensional p-spline. The study found that child birth order, mother weight and height are significant predictors of birth weight. Secondary education for mother, birth order categories 2-3 and 4-5, wealth index of richer family and mother height were significant predictors of child size at birth. The area associated with low birth weight was Chitipa and areas with increased risk to less than average size at birth were Chitipa and Mchinji. The study found support for the flexible modelling of some covariates that clearly have nonlinear influences. Nevertheless there is no strong support for inclusion of geographical spatial analysis. The spatial patterns though point to the influence of omitted variables with some spatial structure or possibly epidemiological processes that account for this spatial structure and the maps generated could be used for targeting development efforts at a glance.
Highlights
Low birth weight (LBW) has been defined by World Health Organization [1] as weight less than 2.5kg
According to UNICEF and WHO [2], half of low birth weight children are in the South Central Asia where more than a quarter of all born children are less than 2.5kg, representing 27% of all new births with LBW
The percentage of low birth weight infants is higher for first births than for the subsequent births
Summary
Low birth weight (LBW) has been defined by World Health Organization [1] as weight less than 2.5kg. LBW is a leading cause of prenatal and neonatal deaths as such it is a world wide issue and one of the most important public health problems. According to UNICEF and WHO [2], half of low birth weight children are in the South Central Asia where more than a quarter of all born children are less than 2.5kg, representing 27% of all new births with LBW. Saharan Africa has the second highest incidence of LBW, pegged at 15%. Malawi is part of subSaharan Africa with the latest LBW incidence at 12% [3]
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