DETERMINANTS OF OBSTETRIC FISTULA IN ETHIOPIA: AN APPLICATION OF BINARY AND MULTILEVEL LOGISTIC REGRESSION MODELS

Obstetric fistula is a maternal morbidity creating devastating health problems for the women who
are affected. Continuous and uncontrollable leaking of urine or faeces from the vagina can lead to
life changing stigmatization for women in third world countries. This study examined and
identifies the determinants of obstetric fistula in Ethiopia based on the Ethiopian demographic and
health survey (EDHS, 2005) data conducted by Central Statistical Agency (CSA). The survey
collected information on a total of 14,070 women were interviewed face to face on their
background characteristics as well as reproductive health issues, out of which 3178 women were
complete measurements and considered in this study. In order to meet our objective descriptive,
multiple logistic regression and multilevel logistic regression statistical techniques were used for
data analysis using demographic, socio-economic, health and environmental related variables as
explanatory variable and status of obstetric fistula as response variable. The results of multiple
logistic regression showed that geographical region, place of residence, educational status, age at
first birth, age at first marriage, employment status, place of delivery and follow up of antenatal
care during pregnancy are a significant determinant factors of obstetric fistula in Ethiopia. The
results of multilevel logistic regression analysis showed that the random intercept and fixed
coefficient model provided the best fit for the data under consideration. The variance of the
random component related to the intercept term was found to be statistically significant implying
differences in prevalence of obstetric fistula among the regions. It also found that place of
residence, educational status, age at first birth, age at first marriage, employment status, place of
delivery and follow up of antenatal care were significant determinant factors of variations of
prevalence of obstetric fistula among regions. However, the significant predictors did not show
underlying variation from region to region