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Individual and Area Level Factors of Low Birth Weight in Ethiopia: Evidence from Ethiopian Demographic Health Survey 2016: Multilevel Modeling

Kibrom Taame Weldemariam, Kebede Embaye Gezae, Haftom Temesgen Abebe, Tsegay Teklu

Background: Low birth weight is one of the critical issues in Ethiopia that causes many babies’ short- term and long-term health consequences. In Ethiopia, low birth weight is increasing; however, limited evidences of multilevel factors associated with low birth weight in the study setting, Ethiopia.

Objectives: The objective of this study was to assess individual and area level factors of Low Birth Weight in Ethiopia: from Ethiopia Demographic and Health Survey 2016.

Methods: The data were extracted from the 2016 Ethiopia Demographic and Health Survey. For analysis a sample of 2110 birth weights within five years preceding the survey were included. The analysis was carried out using STATA software version 14. A two level mixed effects logistic regression analysis was used to estimate both the fixed effects of the individual and contextual factors and the random effects of the between cluster difference. Adjusted Odds Ratio with 95% Confidence Interval to express measures of association and Intra Class Correlation to express measures of variation were used.

Results: A total of 2110 children nested within 445 clusters were included in the analysis. Among them, 13% were with low birth weight. The ICC implied 11.7% of the variance in low birth weight was attributable to Area level unobservable factors. At individual level; multiple birth (AOR=2.74; 95%CI: 1.450-5.184), preterm birth (AOR=4.83; 95%CI: 2.644-8.830), anemic mothers (AOR=1.49; 95% CI: 1.069-2.092), six and above birth order (AOR=0.42; 95%CI: 0.242-0.752), mothers with primary educational level (AOR=0.61; 95%CI: 0.418-0.896) and secondary/higher educational level (AOR=0.39; 95%CI: 0.252-0.612) as well as region from Area level were significantly associated with low birth weight.

Conclusion: The results of this study showed that multiple births, anemic mothers, birth order, not-educated mothers and preterm gestational age at birth were significant factors of low birth weight. Hence, switching off/on the significant factors accordingly could reduce the risk of having low birth weight child.