Exploring Spatial Variation of Women’s Tetanus Vaccination in Ethiopia: Spatial Analysis of Ethiopian Demographic and Health Survey 2016

Abstract

Tetanus is a bacterial infection that causes painful muscular contractions throughout the body, usually starting in the jaw. Every year, 15,000 to 30,000 maternal deaths occur due to tetanus related to the delivery process. Exploring variations of women’s tetanus immunization is crucial for programmers’ planning and monitoring. As a result, this study aims to evaluate the spatial distribution of women’s tetanus vaccination coverage and risk areas of women’s tetanus vaccination clustering in Ethiopia. The study used Ethiopian Demographic and Health Survey data, which was conducted in 2016 using the Ethiopia Population and Housing Census 2007 sampling frame. From 15,683 women aged 15 to 49, a sample of 7,193 women was selected using eligible criteria. This study used spatial data analysis. To determine geographical danger zones for tetanus vaccination of women, cluster, hotspot analysis, spatial interpolation, and spatial scan statistics were used. At the regional level of Ethiopia, tetanus vaccination was spatially clustered (Global Moran’s I = 0.066, p = .0001). Western Tigray, eastern SNNP, and northern Oromia were identified as hotspots of poor tetanus vaccine coverage, whereas western Oromia, Afar, and southeast Amhara regions were designated as non-risky areas of Ethiopia. The spatial Bayesian kriging interpolation analysis predicted high-risk areas were the southwestern and eastern parts of Oromia, western Tigray, Harari, and Dire Dawa Western Tigray, the eastern SNNP, southern Amhara, and northern Oromia have been recognized as a significant hotspot. Health workers, programmers, government, and non-governmental organizations in Ethiopia will implement spatially based strategic interventions for women’s tetanus immunization.