Determinants of injuries and accidents in Ethiopia: A Multilevel Analysis

Abstract

Background: Injury is a major health issue worldwide, especially in developing
countries such as Ethiopia, where no comprehensive national injury data exists.
There is a need to better define the epidemiology of injury and determinants as
a basis for the formulation of violence and injury prevention strategies.
Objective: This study aimed to determine individual and community-level
factors associated with injuries and accidents in Ethiopia.
Methods: Using the latest nationally representative data obtained from
Ethiopia Demographic and Health Survey (EDHS) 2016, the survey collected
information about the occurrence of injuries in the past 12 months among

12,841 members of 16,650 households. Sample from 645 clusters of 12372 un-
weighted households and 12841 weighted households were selected from nine

regions and two city administrations of Ethiopia using a stratified cluster
sampling procedure. Multilevel logistic regressions were used to identify the
determinants of injuries. Four models were built to estimate both fixed effects
of the individual and community-level factors and random effects between
cluster variation on injuries and/or accidents.
Results: The current study found that 3.4 % of injuries and accidents occurred
in the reference 12-month period. At the final best-fitted model (model IV), a
secondary educational level of household members (AOR= 0.54; 95 % CI (0.297,
0.987), household members from middle-level wealth index (AOR = 1.72; 95 %
CI (1.048, 2.807), and history of smoking within the last 24 hours (AOR = 0.28;
95 % CI (0.092, 0.863) were significantly associated with injury and accidents.
Conclusion: The study's analysis of injuries that occurred during the study's
reference 12-month period revealed that Ethiopia has low injury prevalence,
considering Ethiopian demographic survey data limitations on major injuries.
Additionally, having a secondary education, falling into the middle of the
wealth index, and having a history of smoking were all significantly associated
with injuries and accidents.