Browsing by Author "Temesgen, Shibru(PhD)"

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    Determinants of Time-To-Under-Five Mortality in Ethiopia: A Comparison of Various Parametric Shared Frailty Models
    (Addis Abeba university, 2016-06) Argaw, Abebe; Temesgen, Shibru(PhD)
    Analysis of clustering effect in modeling the determinants of time-to-under-five mortality in Ethiopia. Abebe Argaw Addis Ababa University, 2016 Under-five mortality is one of the critical indicator of development of a country. It tells of children’s access to basic health interventions such as vaccinations, medical treatment and inadequate nutrition (WHO, 2013). According to preliminary estimates, the global U5MR has declined by more than half, dropping from 90 to 43 deaths per 1,000 live births between 1990 and 2015. But, at today’s rate of progress, it will take about 10 more years to reach the global target (UNICEF, 2015). The main objective of this study is to identify the determinants of time to under-five mortality in Ethiopia. The data for the study were taken from the 2014 Ethiopian Mini Demographic and Health Survey of women in the age group15-49 years. Mothers’ educational level, mothers’ age at first birth, place of residence, household size, sex of child born, preceding birth interval, economic status of family, place of delivery, marital status of family, and source of drinking water were identified as determinant factors that affect the time to under-five mortality from the socio-economic and demographic variables, and environmental factors. Regions of study were used as clusters which was taken care of the frailty term at regional level and shared frailty models were explored. Comparison of the model was done by using AIC, and Weibull-Gamma shared frailty model was selected for time-to-under-five mortality in Ethiopia. Based on the result of selected model, except marital status of family and age of mothers’ at first birth, all the identified predictor variables had significant effect on time to under-five mortality. Great attention should be given to these predictor variables while planning to increase child survival time. Key words: Heterogeneity, Frailty, Laplace transformations, penalized partial likelihood
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    Multilevel Survival Analysis of Time to Age at First Marriage Among Women in Ethiopia
    (Addis Abeba university, 2017-05) Gualu, Molalign; Temesgen, Shibru(PhD)
    A marriage can be viewed as a social union or legally recognized union between a man and a woman in which they are united sexually; cooperate economically, and may have children through birth or adoption. (Ikamari, 2005). Age at marriage is the age at which individuals get married and this varies across communities and individuals. (UNICEF,2005). The main objective of this study is to model time to age at first marriage amongst women in Ethiopia. The data set in this study were obtained from Demography and Health survey conducted in Ethiopia in 2011. Women’s work status, religion, place of residence, head education level, women education level, head occupation, access to media and wealth index are variables which were considered as the potential determinant of time to age at first marriage in this study. In this study, we used multilevel survival models to account for the loss of independence that arises from the clustering of women in region of Ethiopia and also we used AIC to compare two different multilevel survival models. Of all 12066 women aged 15-49, 9466(78.45%) were married and the median & mean age at first marriage for women living in Ethiopia were 16 years and 16.2 years respectively, while the minimum and maximum age at first marriage observed were 8 years and 49 years respectively. Based on the result of selected model (Log logistic-Gamma shared frailty model), place of residence of women, religion of women, education level of women, wealth index of household and head education were significant at 5% level of significance. In contrast work status of women, head occupation and access to media were not significant at 5% level of significance. The clustering effect was significant for modeling time-to-age at first marriage dataset and there was heterogeneity among the regions on age at first marriage
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    Risk Factors for Anemia Levels among Women of Reproductive Age in Ethiopia: a Partial Proportional Odds Model Approach
    (Addis Abeba university, 2014-09) Zelalem, Birhane; Temesgen, Shibru(PhD)
    Anaemia is defined as a lower than normal level of hemoglobin in the blood. Normal levels of hemoglobin are different for pregnant women, non pregnant women, men, child etc. The prevalence of anaemia in the world according to WHO, based on the studies conducted from 1993 to 2005 was 24.8 percent and it affected 1.62 billion people worldwide. It is one of the global widespread public health and nutritional problems affecting both developing and developed countries, and occurs at all stages of life cycle but it is prominent in pregnant women, young and other women of reproductive age (WHO, 2008). According to the 2011 EDHS data the prevalence of anaemia is 17 percent among Ethiopian women aged 15-49. The objective of this study was to identify determinants of anaemia levels among women of reproductive age (between 15 and 49) in Ethiopia using the 2011 EDHS data. To achieve the objective of this study descriptive statistics, chi-square test of association and partial proportional odds model and related tests were used for data analysis using socio-economic, demographic and health related variables as explanatory variables and anaemia levels of reproductive age of women as the response variables. The result of the analysis revealed that the variables education level, region, parity, pregnancy status, body mass index, place of residence, contraceptive methods and marital status were found to be significant determinants of anaemia levels among women in the reproductive age group in Ethiopia and from the result it also suggested that pregnant women were more likely to be moderate anemic and severe anemic than none pregnant women. Women who had a large number of children were found to be more likely of being mild anemic than those who had no child. Rural resident women were more likely of being mild, moderate and severe anemic than urban resident
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    Stunting Status of Under-Five Children in Rural Ethiopia: Multilevel Logistic Regression Analysis
    (Addis Abeba university, 2014-05) Bayko, Tizazu; Temesgen, Shibru(PhD)
    Stunting is a well-established child health indicator for chronic malnutrition related to environmental and socio-economic circumstances (WHO, 1995 and 1996). According to the 2011 EDHS report by the Ethiopia CSA, nationally, 44 percent of children under age five are stunted, and 21 percent of children are severely stunted. This study aimed to identify socioeconomic and demographic determinants of under-five child stunting in rural Ethiopia using EDHS 2011 data. In order to achieve our objective descriptive, cross-tabulation, binary logistic regression and multilevel logistic regression statistical techniques were used for data analysis using socio-economic, demographic and health and environmental variables as explanatory variables, and status of stunting as the response variable. The results of the analysis show that age of child, mother’s educational level, wealth index, employment status of mother, source of drinking water, types of toilet facilities, had diarrhea two weeks before the survey, had fever two weeks before the survey, educational level of partner and geographical region were found to be significant determinants of stunting status of under-five children in rural Ethiopia. The result also suggested that children from poor families were more likely to be stunted than children from rich families in rural Ethiopia. It is found that children from uneducated mothers are at higher risk of stunting. It is recommended that design and implement primary health care and nutrition programs which would fit the features of each region to safeguard children from nutritional deficiency
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    Under nutritional Status of Children in Ethiopia (Application of Partial Proportional Odds Model
    (Addis Abeba university, 2014-06) Adelo, Belete; Temesgen, Shibru(PhD)
    Malnutrition is one of the most important causes for improper physical and mental development of children. This study is an attempt to identify factors affecting the severity status of children malnutrition in Ethiopia by using malnutrition severity models for under age five Ethiopian children. Malnutrition severity is categorized into three levels in order of increasing of severity. The parallel-lines assumption of commonly applied proportional odds model is usually too restricting. This assumption may be violated only by one or a few of the included variables. A partial proportional odds model where the parallel-lines constraint is relaxed only for those variables when it is not justified is applied in this study. Partial proportional odds models were used for the severity status of children malnutrition in Ethiopia using 2011 EDHS data. The partial proportional odds models perform consistently better than the other two models (POM and BLR). By using partial proportional odds models, the interpretation of the parameters allows better insight concerning contributing factors, i.e., it revealed the increasing malnutrition severity due to age categories of children and incidence of diarrhea in the last two weeks before the survey. The significant factors affecting the severity of children malnutrition cover demographic, socioeconomic, and health related factors: age of child, sex of child, birth order, education of mother and father, wealth status of household, place of residence, mother’s nutritional status, incidence of diarrhea and fever. Mother’s education level has been identified as the most significant factor influencing children malnutrition. Thus, based on these findings more efficient countermeasures can be developed to mitigate children malnutrition severity. Furthermore, the influence of these factors can be used in the development of strategies of intervention for reducing severity of child malnutrition
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    Vaccination Incompletion of Children Aged 12 to 59 Months in Ethiopia
    (Addis Abeba university, 2014-06) Aragaw, Kidanie; Temesgen, Shibru(PhD)
    More children in Ethiopia start and do not complete all expanded programme on immunization (EPI) recommended for routine immunization (RI) vaccines than those who complete their vaccine schedule. This group of defaulter is bigger than the group that has no vaccines. However, both groups of children that have no vaccines and those that have partial vaccination are in similar risk of acquiring vaccine preventable diseases. This study aims to assess demographic, socio economic, environmental and health service factors affecting childhood vaccination incompletion, and to determine the extent of incomplete vaccination within and between regions in Ethiopia based on EDHS 2011 data. In this study a total of 6797 children 12 to 59 months of age were included (mean age of 36 and standard deviation 13.655 months). Among these children 33.76% were completely immunized while 66.24% were partially vaccinated. Descriptive data analyses, binary logistic, and multilevel logistic regression analyses were used. This study identified that region, wealth index, sex of household head, birth order of a child, being of wise of a mother to have balanced family life, frequency of a mother listening to radio, and mothers’ getting of prenatal care and assistant from a health professional were statistically significant at 5% level for a child 12 to 59 month of age being partially immunized. The multilevel logistic regression analysis revealed that there was heterogeneity across regions. Between regional variations for vaccination incompletion of children 12 to 59 months of age was 1.0596 with standard error 0.4603. Intraclass correlation between two individual mothers in the same region was 0.322067. A low ICC indicates relatively small between regional variations, but in this study it was high. Region Tigray, Afar, Oromia, Somali (at 10% significance level), Gambela, Addis Ababa and Dire Dawa were statistically significant regions for the variation of children vaccination defaulting in the country. The chance of a child 12 to 59 month of age being partially immunized was 67% on average in the country. The average probability of a child 12 to 59 months of age being under vaccinated was below the average (0.6661) in Tigray (0.3747), Addis Abeba (0.1773) and DireDawa (0.4596) while it was higher in Afar (0.8997), Oromia (0.7969), Somali (0.7809), and Gamble (0.8310) regions