PDF(Pubmed)
Abstract：
OBJECTIVE: Low birth weight (LBW) is an important indicator of newborn health and can have long-term implications for a child\'s development. Spatial exploratory analysis provides a toolkit to gain insight into inequalities in LBW. Few studies in Ghana have explored the spatial distribution of LBW to understand the extent of the problem geographically. This study explores individual and cluster-level distributions of LBW using spatial exploration components for common determinants from nationally representative survey data.
METHODS: We used data from the 2017 Ghana Maternal Health Survey and conducted individual-level and cluster-level analyses of LBW with place and zone of residence in both bivariate and multivariate analyses. By incorporating spatial and survey designs methodology, logistic and Poisson regression models were used to model LBW.
METHODS: Ghana.
METHODS: A total of 4127 women aged between 15 and 49 years were included in the individual-level analysis and 864 clusters corresponding to birth weight.
METHODS: Individual and cluster-level distribution for LBW using spatial components for common determinants.
RESULTS: In the individual-level analysis, place and zone of residence were significantly associated with LBW in the bivariate model but not in a multivariate model. Hotspot analysis indicated the presence of LBW clusters in the middle and northern zones of Ghana. Compared with rural areas, clusters in urban areas had significantly lower LBW (p=0.017). Clusters in the northern zone were significantly associated with higher LBW (p=0.018) compared with the coastal zones.
CONCLUSIONS: Our findings from choropleth hotspot maps suggest LBW clusters in Ghana\'s northern and middle zones. Disparities between the rural and urban continuum require specific attention to bridge the healthcare system gap for Ghana\'s northern and middle zones.
METHODS: We used data from the 2017 Ghana Maternal Health Survey and conducted individual-level and cluster-level analyses of LBW with place and zone of residence in both bivariate and multivariate analyses. By incorporating spatial and survey designs methodology, logistic and Poisson regression models were used to model LBW.
METHODS: Ghana.
METHODS: A total of 4127 women aged between 15 and 49 years were included in the individual-level analysis and 864 clusters corresponding to birth weight.
METHODS: Individual and cluster-level distribution for LBW using spatial components for common determinants.
RESULTS: In the individual-level analysis, place and zone of residence were significantly associated with LBW in the bivariate model but not in a multivariate model. Hotspot analysis indicated the presence of LBW clusters in the middle and northern zones of Ghana. Compared with rural areas, clusters in urban areas had significantly lower LBW (p=0.017). Clusters in the northern zone were significantly associated with higher LBW (p=0.018) compared with the coastal zones.
CONCLUSIONS: Our findings from choropleth hotspot maps suggest LBW clusters in Ghana\'s northern and middle zones. Disparities between the rural and urban continuum require specific attention to bridge the healthcare system gap for Ghana\'s northern and middle zones.
摘要：
目的：低出生体重（LBW）是新生儿健康的重要指标，可对儿童的发育产生长期影响。空间探索性分析提供了一个工具包，可以深入了解LBW中的不平等。加纳很少有研究探索LBW的空间分布，以了解地理上问题的程度。本研究使用具有国家代表性的调查数据中的共同决定因素的空间探索成分，探索了LBW的个体和聚类水平分布。
方法：我们使用来自2017年加纳孕产妇健康调查的数据，并在双变量和多变量分析中对LBW的位置和居住区域进行了个体水平和聚类水平分析。通过结合空间和勘测设计方法，使用logistic和泊松回归模型对LBW进行建模。
方法：加纳。
方法：共有4127名年龄在15至49岁之间的女性被纳入个体水平分析，864个聚类对应于出生体重。
方法：使用共同决定因素的空间分量对LBW进行个体和集群级分布。
结果：在个体水平分析中，在双变量模型中,居住地和居住区域与LBW显著相关,但在多变量模型中不显著.热点分析表明，加纳中部和北部地区存在LBW集群。与农村相比,城市地区的集群具有显著较低的LBW(p=0.017)。与沿海地区相比，北部地区的集群与较高的LBW（p=0.018）显着相关。
结论：我们从Choropleth热点图的发现表明，加纳北部和中部地区的LBW集群。农村和城市连续体之间的差异需要特别注意，以弥合加纳北部和中部地区的医疗保健系统差距。
方法：我们使用来自2017年加纳孕产妇健康调查的数据，并在双变量和多变量分析中对LBW的位置和居住区域进行了个体水平和聚类水平分析。通过结合空间和勘测设计方法，使用logistic和泊松回归模型对LBW进行建模。
方法：加纳。
方法：共有4127名年龄在15至49岁之间的女性被纳入个体水平分析，864个聚类对应于出生体重。
方法：使用共同决定因素的空间分量对LBW进行个体和集群级分布。
结果：在个体水平分析中，在双变量模型中,居住地和居住区域与LBW显著相关,但在多变量模型中不显著.热点分析表明，加纳中部和北部地区存在LBW集群。与农村相比,城市地区的集群具有显著较低的LBW(p=0.017)。与沿海地区相比，北部地区的集群与较高的LBW（p=0.018）显着相关。
结论：我们从Choropleth热点图的发现表明，加纳北部和中部地区的LBW集群。农村和城市连续体之间的差异需要特别注意，以弥合加纳北部和中部地区的医疗保健系统差距。
