Spatial heterogeneity of low-birthweight deliveries on the Kenyan coast

BMC Pregnancy and Childbirth

卷:23

Research

Amek Nyaguara¹  David Amadi¹  Stella Mwakio¹  James A. Berkley²  Philip Bejon³  Moses M. Musau⁴  Alice Kamau⁴  Robert W. Snow⁵ 

[1] Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Programme, Kilifi, Kenya;

[2] Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Programme, Kilifi, Kenya;Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, UK;

[3] Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Programme, Kilifi, Kenya;Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK;

[4] Population & Health Unit, Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Programme, Nairobi, Kenya;

[5] Population & Health Unit, Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Programme, Nairobi, Kenya;Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK;

关键词: Low birthweight;    Spatial heterogeneity;    Accessibility;    Kilifi;    Kenya;   

DOI  :  10.1186/s12884-023-05586-6

 received in 2023-01-18, accepted in 2023-04-08,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundUnderstanding spatial variations in health outcomes is a fundamental component in the design of effective, efficient public health strategies. Here we analyse the spatial heterogeneity of low birthweight (LBW) hospital deliveries from a demographic surveillance site on the Kenyan coast.MethodsA secondary data analysis on singleton livebirths that occurred between 2011 and 2021 within the rural areas of the Kilifi Health and demographic surveillance system (KHDSS) was undertaken. Individual-level data was aggregated at enumeration zone (EZ) and sub-location level to estimate the incidence of LBW adjusted for accessibility index using the Gravity model. Finally, spatial variations in LBW were assessed using Martin Kulldorf’s spatial scan statistic under Discrete Poisson distribution.ResultsAccess adjusted LBW incidence was estimated as 87 per 1,000 person years in the under 1 population (95% CI: 80, 97) at the sub-location level similar to EZ. The adjusted incidence ranged from 35 to 159 per 1,000 person years in the under 1 population at sub-location level. There were six significant clusters identified at sub-location level and 17 at EZ level using the spatial scan statistic.ConclusionsLBW is a significant health risk on the Kenya coast, possibly under-estimated from previous health information systems, and the risk of LBW is not homogenously distributed across areas served by the County hospital.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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