Contextual risk factors for low birth weight: a multilevel analysis

Area of Science:

• Public Health
• Epidemiology
• Maternal and Child Health

Background:

• Low birth weight (LBW) is a critical determinant of neonatal mortality and a significant contributor to infant and under-five mortality.
• Prevalence of LBW has stagnated in sub-Saharan Africa and Asia over the past decade.
• Limited understanding exists regarding contextual risk factors for LBW, particularly in sub-Saharan Africa.

Purpose of the Study:

• To identify contextual risk factors associated with Low Birth Weight (LBW) in Ghana.
• To investigate the influence of community-level factors on LBW prevalence.
• To inform targeted public health interventions for LBW reduction.

Main Methods:

• Multivariable multilevel logistic regression analysis was employed.
• Data from 6,900 mothers across 412 communities in Ghana (2003 and 2008 Demographic and Health Surveys) were analyzed.
• Contextual factors at the community level were assessed for their association with LBW.

Main Results:

• Rural residence was associated with a 43% increased likelihood of LBW (OR 1.43).
• Living in poverty-concentrated communities doubled the risk of LBW (OR 2.16).
• High coverage of safe water supply in neighborhoods reduced LBW odds by 28% (OR 0.74).

Conclusions:

• Contextual factors exert independent effects on LBW prevalence.
• Rurality, community poverty concentration, and low safe water coverage are significant risk factors for LBW.
• Community-based interventions addressing these contextual factors are crucial for reducing LBW incidence.