Geographically vary determinants of High-Risk Fertility Behavior among Reproductive age women in Ethiopia. Geographically Weighted Regression Analysis

Abstract Background Maternal and child mortality is the main public health problem worldwide and it is the major health concern in developing countries such as Africa and Asia. Fertility behavior of women characterized in relation to maternal age, birth spacing, and order which has an impact on the health of women and children. The aim of this study was to assess the geographically vary Risk factors of High-Risk Fertility Behavior(HRFB) among reproductive-age women in Ethiopia. Methods A total of 11,022 reproductive-age women were included in this study. The data was cleaned and weighted by STATA 14.1 software. Bernoulli based spatial scan statistics were used to identify the presence of purely spatial clusters HRFB using Kulldorff’s SaTScan version 9.6 software. ArcGIS 10.7 was used to visualize spatial distribution for HRFB. Geographical weighted regression analysis was employed by Multiscale Geographical weighted regression version 2.0 software. A P-value of less than 0.05 was used to declare statistically significant predictors locally. Results Overall, 76% with 95% confidence interval of 75.60 to 77.20 of reproductive age women were faced with High-Risk Fertility problems in Ethiopia. High-Risk Fertility Behavior was highly clustered at the Somali, and Afar regions of Ethiopia. SaTScan identified 385 primary spatial clusters (RR= 1.13, P < 0.001) located at Somali, Afar, and some parts of Oromia Regional State of Ethiopia. Women live in primary clusters were 13% more likely venerable HRFB than outside the cluster. In geographically weighted regression not contraceptive use, and home delivery were statistically significant spatially vary risk factors affecting HRFB. Conclusion In Ethiopia, HRFB had to vary geographically across regions. Statistically, a significant-high hot spot of HRFB was identified at Somali and Afar. This study showed that predictor variables for HRFB were varied spatially in Ethiopia. Not use a contraceptive, and home delivery were statistically significant predictors locally in different regions of Ethiopia. Therefore, policymakers and health planners should design an effective intervention program at Somali, and Afar to reduce HRFB and Special attention needs about health education on the advantage of contraceptive utilization and health facility delivery to reduce HRFB.