INTRODUCTION Malnutrition is one of the most devastating problems in Ethiopia and is inextricably linked with poverty. Women in the reproductive age group and children are most vulnerable to malnutrition due to low dietary intakes, inequitable distribution of food within the household, improper food storage and preparation, dietary taboos, infectious diseases, and care. Therefore, this study aimed to assess the spatial distribution and determinants of undernutrition among reproductive age of Ethiopia. METHODS The study was based on the 2016 Ethiopian Demographic and Health Survey. The study included a total sampled weight of 15,139 women aged 15-49 years. The ArcGIS version 10.7 and SaTScan version 9.6 statistical software were used for exploring the spatial distribution of undernutrition. A multilevel logistic regression model was fitted to determine the individual and community level factors associated with women undernutrition. Finally, the factors which were significant at 95% confidence interval were reported. RESULT The spatial analysis revealed that women undernutrition was significantly varied across the country. The SaTScan analysis identified a total of 144 significant hotspot areas of maternal undernutrition with three significant spatial windows. Of these, 134 clusters were primary. The primary spatial window was identified in the southeast Tigray, northwest Afar, central and north Amhara regions (LLR = 57.48, P<0.01, RR = 1.51). Age at first marriage (AOR = 1.57: CI 1.33, 1.99), middle wealth index (AOR = 3.15: CI 1.4, 6.97), rural residence (AOR = 2.82: CI 1.22, 6.52), being in Afar region, Tigray region and Harari region (AOR = 4.88: CI 1.71, 13.91), (AOR = 4.17: CI 1.57, 11.06) and (AOR = 3.01: CI 1.05, 8.68) respectively were significantly associated with women undernutrition. CONCLUSION In Ethiopia, undernutrition had significant spatial variations across the country. Residence, age at first marriage, wealth index and region were significantly associated with undernutrition. Therefore, public health interventions that reduce reproductive age women undernutrition and enhance women awareness towards undernutrition in hotspot areas of undernutrition is crucial.

中文翻译：

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埃塞俄比亚育龄妇女营养不良的空间分布和决定因素：多层次分析。

引言 营养不良是埃塞俄比亚最具破坏性的问题之一，与贫困有着千丝万缕的联系。由于饮食摄入量低、家庭内食物分配不公平、食物储存和准备不当、饮食禁忌、传染病和护理，育龄妇女和儿童最容易出现营养不良。因此，本研究旨在评估埃塞俄比亚育龄人口营养不良的空间分布和决定因素。方法 该研究基于 2016 年埃塞俄比亚人口和健康调查。该研究总共纳入了 15,139 名 15-49 岁女性的样本体重。使用ArcGIS 10.7版和SaTScan 9.6版统计软件探索营养不良的空间分布。采用多级逻辑回归模型来确定与妇女营养不良相关的个人和社区层面的因素。最后，报告了在 95% 置信区间显着的因素。结果 空间分析显示，全国各地妇女营养不良状况差异显着。SaTScan 分析总共确定了 144 个孕产妇营养不良的重要热点区域，并具有三个重要的空间窗口。其中，134 个簇是主要簇。主要空间窗口位于提格雷东南部、阿法尔西北部、阿姆哈拉中部和北部地区（LLR = 57.48，P<0.01，RR = 1.51）。初婚年龄（AOR = 1.57：CI 1.33、1.99）、中等财富指数（AOR = 3.15：CI 1.4、6.97）、农村居住（AOR = 2.82：CI 1.22、6.52）、居住在阿法尔地区、提格雷地区和哈拉里地区（AOR = 4.88：CI 1.71、13.91）、（AOR = 4.17：CI 1.57、11.06）和（AOR = 3.01：CI 1.05、8.68）分别与女性营养不良显着相关。结论 在埃塞俄比亚，营养不良在全国范围内存在显着的空间差异。居住地、初婚年龄、财富指数和地区与营养不良显着相关。因此，在营养不良热点地区采取公共卫生干预措施，减少育龄妇女营养不良现象，提高妇女对营养不良的认识至关重要。