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Abstract：
BACKGROUND: Early sexual initiation has negative health, social, and economic consequences for both women and future generations. The trend of early sexual initiation is increasing globally, leading to higher rates of sexually transmitted diseases and unplanned pregnancies. Ethiopia has been challenged various disasters that makes women vulnerable and position them at heightened risk of early sexual initiation in the last four years. The spatial patterns and factors of early sexual initiation in the post-conflict-post pandemic settings is not well understood. Hence this research aimed at mapping Spatial Patterns and identifying determinant factors in the Post-COVID-Post-Conflict Settings.
METHODS: The study was conducted on secondary data from the PMA 2021 cross-sectional survey which conducted nationally from November 2021 to January 2022 which is in the post pandemic and post-war period. Total weighted sample of 6,036 reproductive age women were included in the analysis. ArcGIS Pro and SaTScan software were used to handle spatial analysis. Multilevel logistic regression model was used to estimate the effects of independent variables on early sexual initiation at individual and community level factors. Adjusted odds ratio with the 95% confidence interval was reported to declare the strength and statistical significance of the association.
RESULTS: The spatial distribution of early sexual initiation was clustered in Ethiopia with a global Moran\'s I index value of 0.09 and Z-score 6.01 (p-value < 0.001).Significant hotspots were detected in East Gojjam zone of Amhara region, Bale, Arsi, West Hararge, East Wellega and Horo Gudru Wellega zones of Oromia region. The odds of having early sexual initiation was higher in women with primary education (AOR = 1.23, 95%CI: 1.03, 1.47), secondary or above education (AOR = 4.36, 95%CI: 3.49, 5.44), Women aged 26 to 25 (AOR = 1.91, 95%CI: 1.61, 2.26), women aged 36 to 49(AOR = 1.51, 95%CI: 1.24, 1.84). However, there was a significant lower likelihood of early sexual initiation in rural resident women (AOR = 0.53, 95%CI: 0.35, 0.81) and women living in 5 to 7 family size (AOR = 0.79, 95%CI: 0.68, 0.92), and more than 7 members (AOR = 0.63, 95%CI: 0.49, 0.81).
CONCLUSIONS: The spatial distribution of early sexual initiation was clustered in Ethiopia. Interventions should be taken to eliminate the observed variation by mobilizing resources to high-risk areas. Policies and interventions targeted to this problem may also take the identified associated factors into account for better results.
METHODS: The study was conducted on secondary data from the PMA 2021 cross-sectional survey which conducted nationally from November 2021 to January 2022 which is in the post pandemic and post-war period. Total weighted sample of 6,036 reproductive age women were included in the analysis. ArcGIS Pro and SaTScan software were used to handle spatial analysis. Multilevel logistic regression model was used to estimate the effects of independent variables on early sexual initiation at individual and community level factors. Adjusted odds ratio with the 95% confidence interval was reported to declare the strength and statistical significance of the association.
RESULTS: The spatial distribution of early sexual initiation was clustered in Ethiopia with a global Moran\'s I index value of 0.09 and Z-score 6.01 (p-value < 0.001).Significant hotspots were detected in East Gojjam zone of Amhara region, Bale, Arsi, West Hararge, East Wellega and Horo Gudru Wellega zones of Oromia region. The odds of having early sexual initiation was higher in women with primary education (AOR = 1.23, 95%CI: 1.03, 1.47), secondary or above education (AOR = 4.36, 95%CI: 3.49, 5.44), Women aged 26 to 25 (AOR = 1.91, 95%CI: 1.61, 2.26), women aged 36 to 49(AOR = 1.51, 95%CI: 1.24, 1.84). However, there was a significant lower likelihood of early sexual initiation in rural resident women (AOR = 0.53, 95%CI: 0.35, 0.81) and women living in 5 to 7 family size (AOR = 0.79, 95%CI: 0.68, 0.92), and more than 7 members (AOR = 0.63, 95%CI: 0.49, 0.81).
CONCLUSIONS: The spatial distribution of early sexual initiation was clustered in Ethiopia. Interventions should be taken to eliminate the observed variation by mobilizing resources to high-risk areas. Policies and interventions targeted to this problem may also take the identified associated factors into account for better results.
摘要：
背景：早期性开始对健康不利，社会,以及对妇女和后代的经济后果。在全球范围内，早期性开始的趋势正在增加，导致更高的性传播疾病和意外怀孕率。在过去四年中，埃塞俄比亚遭受了各种灾难的挑战，这些灾难使妇女处于脆弱状态，并使她们面临更高的早期性行为风险。冲突后大流行环境中早期性启动的空间模式和因素尚不清楚。因此，这项研究旨在绘制空间模式，并确定冲突后设置中的决定因素。
方法：该研究是根据PMA2021横断面调查的次要数据进行的，该调查于2021年11月至2022年1月在全国范围内进行，该调查处于大流行后和战后时期。分析中包括6,036名育龄女性的总加权样本。使用ArcGISPro和SaTScan软件进行空间分析。使用多水平逻辑回归模型来估计独立变量对个体和社区水平因素的早期性开始的影响。据报道，具有95％置信区间的调整后的优势比表明了关联的强度和统计意义。
结果：早期性开始的空间分布在埃塞俄比亚，总体Moran\sI指数值为0.09，Z评分为6.01（p值<0.001）。在阿姆哈拉地区的东Gojjam地区发现了重要的热点，贝尔，Arsi,西哈拉格,Oromia地区的EastWellega和HoroGudruWellega地区。在初等教育的女性中，早期性开始的几率更高(AOR=1.23,95CI:1.03,1.47)，中等或以上学历（AOR=4.36，95CI：3.49，5.44），26至25岁的女性（AOR=1.91，95CI：1.61，2.26），36至49岁的女性（AOR=1.51，95CI：1.24，1.84）。然而,农村居民妇女（AOR=0.53，95CI：0.35，0.81）和生活在5至7个家庭中的妇女（AOR=0.79，95CI：0.68，0.92），7名以上成员（AOR=0.63，95CI：0.49，0.81）。
结论：早期性启动的空间分布在埃塞俄比亚呈聚集状态。应采取干预措施，通过向高风险地区调动资源来消除观察到的差异。针对这一问题的政策和干预措施也可以考虑已确定的相关因素，以取得更好的结果。
方法：该研究是根据PMA2021横断面调查的次要数据进行的，该调查于2021年11月至2022年1月在全国范围内进行，该调查处于大流行后和战后时期。分析中包括6,036名育龄女性的总加权样本。使用ArcGISPro和SaTScan软件进行空间分析。使用多水平逻辑回归模型来估计独立变量对个体和社区水平因素的早期性开始的影响。据报道，具有95％置信区间的调整后的优势比表明了关联的强度和统计意义。
结果：早期性开始的空间分布在埃塞俄比亚，总体Moran\sI指数值为0.09，Z评分为6.01（p值<0.001）。在阿姆哈拉地区的东Gojjam地区发现了重要的热点，贝尔，Arsi,西哈拉格,Oromia地区的EastWellega和HoroGudruWellega地区。在初等教育的女性中，早期性开始的几率更高(AOR=1.23,95CI:1.03,1.47)，中等或以上学历（AOR=4.36，95CI：3.49，5.44），26至25岁的女性（AOR=1.91，95CI：1.61，2.26），36至49岁的女性（AOR=1.51，95CI：1.24，1.84）。然而,农村居民妇女（AOR=0.53，95CI：0.35，0.81）和生活在5至7个家庭中的妇女（AOR=0.79，95CI：0.68，0.92），7名以上成员（AOR=0.63，95CI：0.49，0.81）。
结论：早期性启动的空间分布在埃塞俄比亚呈聚集状态。应采取干预措施，通过向高风险地区调动资源来消除观察到的差异。针对这一问题的政策和干预措施也可以考虑已确定的相关因素，以取得更好的结果。
