BIOSTATISTICS AND HEALTH INFORMATICS
Permanent URI for this collectionhttps://repository.mu.edu.et/handle/123456789/901
Browse
1 results
Search Results
Item GEOGRAPHIC DISPARITIES AND DETERMINANTS OF FAMILY HEALTH SERVICE UTILIZATION IN POST-WAR TIGRAY: A SPATIAL AND LATENT CLASS APPROACH(Mekelle University, 2025-06-25) MOHAMEDAWEL MOHAMEDNIGUSSBackground: Family health services are services that mainly emphasize the well-being of a mother and her baby. The recent war in Tigray has significantly disrupted the utilization of family health services. Despite the availability of studies that assessed family health service utilization in Tigray during the post-war period, none of these studies have attempted to identify latent classes of family health service utilization and evaluate their spatial distribution patterns. Objective: To assess the geographic disparities and determinants of family health service utilization in post-war Tigray Methods and Materials: Secondary data of 2342 women collected through a community-based cross-sectional study design was used. The data were collected from January 16 to February 14, 2024. This study included 24 districts and 78 enumeration areas in the Tigray region of Ethiopia selected by a multistage stratified random sampling technique. A structured checklist was developed to extract data. The outcome variable was the latent class of family health service utilization and classified as good, fair, and poor. The data were analysed using descriptive statistics, latent class analysis, and hotspot analysis. Result: The median age of the women was 28 years. Concerning class distribution, 685 (29.25%, 95% CI: 27.43% to 31.12%), 1462 (62.43%, 95% CI: 60.45% to 64.37%), and 195 (8.33%, 95% CI: 7.26% to 9.50%) of women belonged to the good, fair, and poor classes, respectively. Factors that increased the likelihood of being in the poor or combined fair and poor classes included being a teenager (AOR=3.72, 95% CI: 2.10, 6.58), being a mother with no formal education (AOR=1.82, 95% CI: 1.26, 2.64), husband with no formal education (AOR=1.63,95% CI: 1.25, 2.14), husband with primary education (AOR=1.28, 95% CI:1.01, 1.62), living in rural areas (AOR=2.94, 95% CI:1.69, 5.13), lack of media exposure (AOR=1.42, 95% CI: 1.18, 1.71), multiparity (AOR=2.45, 95% CI: 1.60, 3.76) and grand multiparity (AOR=3.34, 95% CI: 2.27, 4.91). The latent classes showed a significant spatial clustering (Moran’s I = 0.119, Z-score = 13.008, and p < 0.001), with hot-spot areas of poor family health service utilization identified in districts such as Hintalo, Abergelle Yechila, Kola Temben, Hawzen, Enderta, Degua Temben, and Geralta. Conclusions and recommendations: Several factors were associated with a higher likelihood of belonging to the poor or combined poor and fair classes. This study also identified geographically underserved areas in terms of utilization of family health services. Therefore, more emphasis and priority should be given to these underserved areas. Women's empowerment should be taken into account in terms of access to education, media, and family health services. The media-driven health education programs should be strengthened.