This study aimed to identify both the individual and community level factors of protection of last live birth against neonatal tetanus based on the data from EDHS 2016. ANC visit, wealth status and place of delivery were individual-level factors that associated with protection of last live birth against neonatal tetanus in Ethiopia. The community-level variables that could explain the variation in the protection of neonatal tetanus among communities were regional variation and community media exposure.
The current study revealed that women’s who utilized ANC had higher odds protection of last live birth against neonatal tetanus than those women who had not utilized ANC visits. This is similar with studies conducted in SNNP of Ethiopia, Northern Ethiopia and Eastern Ethiopia [8–10]. This might be due to health professionals provide women who come to health facilities for ANC visits with health education including the advantages and schedule of mother's vaccination.
The odds of neonatal tetanus were higher among mothers having wealth of richer than women’s having poorest wealth status. This is in line with studies conducted in north India, Pakistan[15, 16] and Ethiopia [12, 13]. This could be due to the reason that having good income uses to get health access and more informed to the health facility to get tetanus vaccination.
This study shows that women who gave birth at home were less likely to protect their last birth as compared to those mothers who have given birth at the health facility. This is similar to the Indonesian, Pakistan, and Ethiopia study's [9, 16, 17]. The possible reason might be because of the opportunity for health education and advice and the provision of the mother with at least the first dose of TT just immediately after delivery procedures.
Region of residence was revealed to be a significant predictor of neonatal tetanus in the current study. Mothers from Oromia, Hariri, and Diredawa regions had higher odds of protections of neonatal tetanus as compared to those from the Addis Ababa region. Tigray region had lower odds of protection of last live birth against neonatal tetanus. The reason could be due to geographical difference and access of health service as of studies in Africa [18, 19]. Another reason might be due to a lack of uniform performance commitment to implement Tetanus Toxoid vaccination services in all regions of the country.
The odds of protections of last live birth against neonatal tetanus were higher in those who were from a community with a low proportion of media utilization. This finding is similar to the study conducted in Sub-Saharan African countries [8, 9, 20]. This might be due to media programs play a great role in delivering information for the large population.