Spatial distribution and factors associated with low birth weight in Ethiopia using data from Ethiopian demographic and health survey 2016: spatial and multilevel analysis

Background Low birth weight (LBW) was a leading cause of neonatal mortality. It showed an increasing trend in Sub-Saharan Africa for the last one and half decade. Moreover, it was a public health problem in Ethiopia. Even though different studies were conducted to identify its predictors, contextual factors were insufficiently addressed in Ethiopia. There was also limited evidence on the spatial distribution of low birth weight. Therefore, this study aimed to explore spatial distribution and factors associated with low birth weight in Ethiopia. Method Secondary data analysis was conducted using the 2016 EDHS data. A total of 1502 (weighted sample) mothers whose neonates were weighed at birth five years preceding the survey were included. GIS 10.1, SaTscan, stata, and Excel were used for data cleaning and analysis. A multi-level mixed-effects logistic regression model was fitted to identify factors associated with low birth weight. Finally, hotspot areas from GIS results, log-likelihood ratio (LLR) and relative risk with p-value of spatial scan statistics, AOR with 95% CI and random effects for mixed-effects logistic regression model were reported. Results Low birth weight was spatially clustered in Ethiopia. Primary ( LLR=11.57; P=0.002) clusters were detected in the Amhara region. Whereas secondary (LLR=11.4; P=0.003;LLR=10.14,P=0.0075 ) clusters were identified at Southwest Oromia, north Oromia, south Afar, and Southeast Amhara regions. Being severely anemic (AOR=1.47;95%CI1.04,2.01), having no education (AOR=1.82;95%CI1.12,2.96), Prematurity (AOR=5.91;95%CI3.21,10.10) female neonate (AOR=1.38;95%CI1.04,1.84)were significantly associated with LBW Conclusion LBW was spatially clustered in Ethiopia with high-risk areas in Amhara,Oromia, and Afar regions and it was affected by socio demographic factors. Therefore, focusing the policy intervention in those geogrsphically low birth weight risk areas and improving maternal education and nutrtion could be vital to reduce the low birth weight disparity in Ethiopia.