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However, the country's performance regarding non-communicable diseases, including car … This indicates that child diarrhea increased by 74% for children age group between 0 and 11 months when compared to children whose age group between 24 and 59 months. Furthermore, Table 2 presents that the estimated constant log odds ratios, which provides information about association between households within the same cluster. The magnitude of maternal mortality is considerably high but has shown a decreasing trend. The aggregation of maternal death around delivery or immediately after delivery also means that mothers should have access to health facilities to receive skilled care during this period. 2002;109:5–8. In the current study, there were 543 pregnancy-related deaths per 100,000 live births during the seven-year period. Lancet. From Table 2, it was indicated that a statistically significant relation between sex of child and diarrheal disease. Fuentes R, Pfütze T, Seck P. 2006/5 a logistic analysis of diarrhea incidence and access to water and sanitation; 2006. J Epidemiol Global Health. The estimated pregnancy related mortality ratio was 543 per 100,000 live births (95% CI: 437, 663). Reducing the huge burden of maternal mortality remains the single most serious challenge in Ethiopia. For diarrhea as a response, alternating logistic regression analysis revealed that the covariates: male children, 0–11 months aged children, 12–23 months aged children, anemic children, husband with a lower education, mothers paid employment, Afar, Amhara, Dire Dawa, Gambela, Oromia, SNNPR and Tigray regions were significantly associated with higher odds of diarrhea. Lancet. Table 1 indicates that higher prevalence of both diseases among children of age group between 12 to 23 months, 17.9% diarrhea and 19.5% fever (diarrhea, p-value < 0.000, fever, p-value < 0.000). Abdella A. Maternal Mortality Trend in Ethiopia. In subsequent years, however, the rate persistently became higher in the winter season until the end of the surveillance period with the highest rate observed in 2011 (Fig. As a result, ALR model was the better model in explaining the population average association among diarrhea and the selected predictor variables. For fever as an outcome variable, 0–11 months aged children, 12–23 months aged children, children of never in union mother, children of separated mother, non-breastfed children, husband with a lower education, mothers paid employment, Benishangul, Somali and Tigray were significantly associated with higher odds of fever. Estimates developed by the UN Inter-agency Group for Child Mortality Estimation. Newborn death accounts for nearly half of under-five death. The findings of this study demonstrated that the lifetime risk of maternal death is nearly 1 in 23. “Proportion of maternal deaths among female deaths” was the number of maternal deaths divided by the total number of deaths among reproductive aged women in the same period. Verbal Autopsy Standards. Glob Health Action. The findings of this study have valuable implications to support strategies and interventions to address diarrhea and fever in children aged five or younger. BMC Women's Health 18, 198 (2018). This analysis examines survival outcomes for children whose mothers die during or shortly after childbirth in Butajira, Ethiopia. Liang KY, Zeger SL. Bogale GG, Gelaye KA, Degefie DT, Gelaw YA. Ethiopia has been successful in reducing deaths related to communicable, maternal, neonatal, and nutritional deficiency diseases and injuries by 65%, despite unacceptably high maternal and neonatal mortality rates. The purpose of building a statistical model is to find an optimal model characterized by principles of generalizability, goodness-of-fit and parsimony based on model selection criteria. Descriptive statistics consisting of frequency and proportion were performed to summarize the main variables. The findings and conclusions in this report are of the authors and not the funders. Health Sector Development Programme IV-2010/11–2014/15 2010. Maternal mortality fact sheet no 384 [Internet]. 1993;80(3):517–26. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. statement and From all the women deaths in the reproductive age, the data of those women who were not pregnant or beyond 42 days after birth during the time of death were excluded. Cookies policy. Niger J Paediatr. Am J Trop Med Hyg. This result is in agreement with previous findings such as [24, 25] among others. PubMed  Regardless of the considerable improvement in reducing childhood death, childhood survival persists a critical concern. Figure 1 shows the prevalence of diarrhea by region in Ethiopia. By using this website, you agree to our Besides, the results of cross-tabulation analysis for children morbidity are summarized in Table 1. Furthermore, the differential results in the magnitude of maternal mortality across different estimates for Ethiopia calls for more rigorous and locally generated evidence [3, 7, 20]. Infect Dis Poverty. Using direct surveillance methods in the current study, it was possible to estimate the MMR. Table 3 presents that the estimated constant log odds ratios, which provides information about association between households within the same cluster. According to the UNICEF report in 2016, approximately 5.6 million children under age of five die every year, which is decreased from over 12 million in 1990. Consequently, the response variable was coded with 1 for child had diarrhea and/or fever and with 0 for child had no diarrhea and/or fever. The field coordinator checked 1% of the questionnaires in a similar manner. Therefore, there is a need for children morbidity interventions intended to improve child health outcomes in the country. Ethiopia is not an exception and has one of the world’s highest rates of maternal deaths. Using the current data, we are unable to make inferences that compare the women who died with the women who survived childbirth. The QIC for GEE and ALR are almost equal. The measurement of maternal mortality using data from the direct surveillance system is the current gold standard method of determining the MMR. In addition, the results show that risk of diarrhea is lower among female children than among male children. WHO. The finding highlights that since the winter season has heavy rain falls, the road may get muddy, the rivers might become full and rural bridges could be damaged. 2014. WHO. The odds that female children had diarrheal disease is exp. Then, the odds ratio of variable can computed as (OR= \( {e}^{\beta_j} \)). For fever as an outcome variable, the model with child age, mother marital status, anemia level, breastfeeding status, husband education level, mother work status and region as predictor were found to be the best-fit model with the smallest QIC value. Regardless of the noticeable improvement in the reduction of under-five death in Ethiopia, childhood diarrhea and fever are still the leading cause of death. There were more pregnancies in that year, which might be associated with a high agricultural production in the preceding year that enhanced an increased number of families formed among young couples in the district. Godefay H, Byass P, Kinsman J, Mulugeta A. Mother marital status is the other important covariate that has a statistically significant relation with child fever disease. All authors read and approved the final manuscript. HIV is a leading cause of death and a health threat to millions worldwide. The QIC for GEE and ALR are almost the same. Children whose age group between 12 and 23 months had exp. (− 0.1979) = 0.82 times lower than the estimated odds for mothers paid employment. 2016;6(3):131–40. Maternal care utilisation in Butajira HDSS, Ethiopia. Setting Nation-wide census samples from three African countries participating in the 2010 African Census round. With regards to the place of treatment, among the mothers who received some treatment, a substantial proportion (80.8%) received treatment at home assisted by traditional healers. the first 28 days of life. Bull World Health Organ. Another possible explanation for this may be that, as the VA data used in the present study is prone to misclassification of maternal deaths, the examiners might have misdiagnosed obstructed labour that leads to haemorrhage. UN. This survey is the fourth cross-sectional investigation administered at household level. This finding is almost similar to the national average (353 per 100,000 live births) but below the sub-Saharan average (546 per 100,000 live births) [3]. Privacy Geneva; 2006. However, this finding is higher as compared to the sub-Saharan African (1 in 39) and national level (1 in 52) [34, 35]. Furthermore, it was found that residing in a HDSS site has a positive influence on maternal health [26]. Switzerland: WHO; 2006. WHO. The Millennium Development Goals Report. Spatial analysis of risk factors for childhood morbidity in Nigeria. We thank, ORC marco, measure DHS for giving us access for the data file. As it can be shown from Table 3, mothers work status is significantly related to child fever disease. From Table 3, the analysis under ALR specifies that child age is significantly related to fever disease and it was observed that children who were between age group 0–11 months had exp. 2010;375(9726):14. World Health Organization. High maternal mortality in rural south-west Ethiopia: estimate by using the sisterhood method. Generally, we found the leading cause of maternal death during the study period to be postpartum haemorrhage. For every 1000 live births in the study area during the seven year period, about three women died during pregnancy, childbirth or within 42 days of childbirth. Children whose age group between 12 and 23 months are more probable to had diarrhea and fever morbidity than whose age group between 24 and 59 months. The results of the study are similar to a study conducted in Mozambique, in which it was reported that a combination of partner violence and injury were the fourth leading cause of maternal death [32]. Finally, using selected predictors, alternative logistic regression model which provides information about pairwise association of observations among two households within the same cluster was fitted. Child mortality reflects a country’s level of socio-economic development and quality of life. African Center of Excellence in Data Science, University of Rwanda, Kigali, Rwanda, School of Mathematics, Statistics and Computer Sciences, University of KwaZulu-Natal, Durban, South Africa, College of Science and Technology, University of Rwanda, Kigali, Rwanda, You can also search for this author in Reducing the huge burden of maternal mortality remains the single most serious challenge in Ethiopia. This study utilized 2016 Ethiopian Demographic and Health Survey data to identify the risk factors associated with diarrhea and fever among children of under-five in Ethiopia. Part of Once the interview is completed, the VA questionnaires were passed on to at least two physicians to assign the cause of death using the International Classification of Diseases (ICD)-10 codes. As the study done in the Eastern part of Ethiopia at Kersa Health and Demographic surveillance indicated bacterial sepsis is the leading cause accounting for 31.2% followed by birth asphyxia and perinatal respiratory distress 28.2 Children caught by anemia are at higher risk of diarrhea and fever morbidity as compared to non-anemic children. Finally the remaining data of all deceased women during pregnancy, birth or within 42 days of delivery were considered for the analysis. Due to the sensitive nature of the issue, abortion-related maternal deaths were likely to be underreported. Addis Ababa, Ethiopia, Calverton, Maryland, USA: Central Statistical Agency of Ethiopia, 2014. Abhulimhen-Iyoha BI, Okolo AA. In 2016, globally acute respiratory infections, diarrhea and malaria were the leading causes of children under five death particularly 8% of deaths among children under age five caused by diarrhea [1]. Switzerland: WHO; 2012. Article  With regards to injuries or accidents, only 3% of the deceased mothers were known to have a history of injuries or accidents, such as suicide and insect bites, surrounding their deaths. PubMed  (0.8402) =2.32 time more odds of had diarrhea than whose age group between 24 and 59 months. Household wealth, residential status and the incidence of diarrhea among children under-five years in Ghana. 2012;39(2):71–4. 2015 [cited 28/12/2015]. Global J Med Public Health. These approaches have included improving access to and strengthening facility-based maternal health services [7]. To obtain the LTR, we first calculated maternal mortality rate (Mmrate) by dividing the number of maternal deaths by the total number of reproductive aged women in the study area during the same period. Key demographic indicators for Ethiopia: Under-Five Mortality Rate, Population. J. Epidemiol. 2014;13:12. Thiam S, Diène AN, Fuhrimann S, Winkler MS, Sy I, Ndione JA, Schindler C, Vounatsou P, Utzinger J, Faye O, Cissé G. Prevalence of diarrhoea and risk factors among children under five years old in Mbour, Senegal: a cross-sectional study. 2016;26(6):581–8. According to the country’s 2014 population projection, the district has an estimated total population of 205,628. Pneumonia is the leading cause of child mortality 5.4 million children under five years old died in 2017. The number of maternal deaths per each year and the corresponding MMRs with confidence intervals are presented in Table 2. Some of previous studies revealed that as diarrhea and fever are among the prevalent diseases that contributes to the burden of childhood morbidity and mortality [3]. With respect to mothers paid employment effect, it was indicated that mothers paid employment is significantly related to child diarrheal disease. A child’s risk of dying is highest in the neonatal period, i.e. 2, except in 2010, 2012 and 2013, the highest rates of maternal mortality persistently occurred in the age group 20–29 years. PLoS One. California Privacy Statement, 2015;5(1):010404. Generalized Estimating Equation (GEE) and Alternating Logistic Regression (ALR) were used to model childhood morbidity, and compare the odds of a child being had diarrhea and /or fever given the various risk factors considered. Carey V, Zeger SL, Diggle P. Modelling multivariate binary data with alternating logistic regressions. Moreover, the use of a small sample for the analysis made it difficult to draw inferences to the general population. Maternal mortality remains the leading cause of death and disability for reproductive-age women in resource-poor countries. Biometrika. The University of Newcastle, Australia has supported the student. The estimated odds of had fever for children from Benishangul, Somali and Tigray regions are respectively 46, 64 and 86% less than the estimated odds of children from the central region (Addis Ababa) except for Tigray region. Int J Environ Res Public Health. The health messages targeting these group of mothers should be tailored to their needs and match their level of literacy in order to bring better health outcomes. Source population Diggle P. Modelling multivariate binary data with alternating logistic regressions among the serious... Analyses [ 12, 16, 17 ] disorders of pregnancy five clinics development and quality life. 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