Predicting skilled delivery service use in Ethiopia: dual application of logistic regression and machine learning algorithms.

Background: Skilled assistance during childbirth is essential to reduce maternal deaths. However, in Ethiopia, which is among the six countries contributing to more than half of the global maternal deaths, the coverage of births attended by skilled health personnel remains very low. The aim of this...

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Publicado en:BMC Medical Informatics & Decision Making Vol. 19; no. 1; pp. 1 - 11
Autores principales: Tesfaye, Brook, Atique, Suleman, Azim, Tariq, Kebede, Mihiretu M.
Formato: Journal Article
Publicado: BioMed Central 11/5/2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 11/5/2019
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      pub: BioMed Central
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        10.1186/s12911-019-0942-5
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        atl: Predicting skilled delivery service use in Ethiopia: dual application of logistic regression and machine learning algorithms.
      aug:
        au:
          Tesfaye, Brook
          Atique, Suleman
          Azim, Tariq
          Kebede, Mihiretu M.
        affil: World Health Organization, Kenya Country Representative Office, United Nations Office in Nairobi (UNON), Gigiri Complex, Block
      sug:
        subj:
          Maternal Health Services Administration
          Young Adult
          Delivery, Obstetric
          Cross Sectional Studies
          Maternal Health Services Statistics and Numerical Data
          Pregnancy
          Logistic Regression
          Adolescence
          Middle Age
          Ethiopia
          Probability
          Female
          Surveys
          Adult
          Questionnaires
          Scales
          Social Readjustment Rating Scale
          Adolescent: 13-18 years
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Female
      ab: Background: Skilled assistance during childbirth is essential to reduce maternal deaths. However, in Ethiopia, which is among the six countries contributing to more than half of the global maternal deaths, the coverage of births attended by skilled health personnel remains very low. The aim of this study was to identify determinants and develop a predictive model for skilled delivery service use in Ethiopia by applying logistic regression and machine-learning techniques.Methods: Data from the 2016 Ethiopian Demographic and Health Survey (EDHS) was used for this study. Statistical Package for Social Sciences (SPSS) and Waikato Environment for Knowledge Analysis (WEKA) tools were used for logistic regression and model building respectively. Classification algorithms namely J48, Naïve Bayes, Support Vector Machine (SVM), and Artificial Neural Network (ANN) were used for model development. The validation of the predictive models was assessed using accuracy, sensitivity, specificity, and area under Receiver Operating Characteristics (ROC) curve.Results: Only 27.7% women received skilled delivery assistance in Ethiopia. First antenatal care (ANC) [AOR = 1.83, 95% CI (1.24-2.69)], birth order [AOR = 0.22, 95% CI (0.11-0.46)], television ownership [AOR = 6.83, 95% CI (2.52-18.52)], contraceptive use [AOR = 1.92, 95% CI (1.26-2.97)], cost needed for healthcare [AOR = 2.17, 95% CI (1.47-3.21)], age at first birth [AOR = 1.96, 95% CI (1.31-2.94)], and age at first sex [AOR = 2.72, 95% CI (1.55-4.76)] were determinants for utilizing skilled delivery services during the childbirth. Predictive models were developed and the J48 model had superior predictive accuracy (98%), sensitivity (96%), specificity (99%) and, the area under ROC (98%).Conclusions: First ANC and contraceptive uses were among the determinants of utilization of skilled delivery services. A predictive model was developed to forecast the likelihood of a pregnant woman seeking skilled delivery assistance; therefore, the predictive model can help to decide targeted interventions for a pregnant woman to ensure skilled assistance at childbirth. The model developed through the J48 algorithm has better predictive accuracy. Web-based application can be build based on results of this study.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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