Author:
Musau Moses M.,Mwakio Stella,Amadi David,Nyaguara Amek,Bejon Philip,Berkley James A.,Snow Robert W.,Kamau Alice
Abstract
Abstract
Background
Understanding 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.
Methods
A 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.
Results
Access 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.
Conclusions
LBW 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.
Funder
Wellcome Trust Principal Research Fellowship
Wellcome Trust to the Core Award for the East Africa Major Overseas Programme
MRC/DFID/Wellcome Trust Joint Global Health Trials scheme
Bill and Melinda Gates Foundation
Publisher
Springer Science and Business Media LLC
Subject
Obstetrics and Gynecology
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