Ensemble learning to predict short birth interval among reproductive-age women in Ethiopia: evidence from EDHS 2016-2019.

Background: A birth interval of less than 33 months was considered short, and in low- income countries like Ethiopia, a short birth interval is the primary cause of approximately 822 maternal deaths every day. Due to that this study aimed to predict short birth interval and associated factors among women (15-49) in Ethiopia using ensemble learning algorithms.

Methods: A secondary data analysis of Ethiopian demographic health servey from 2016 to 2019 was performed. a total of weighted sample of 12,573 women in the reproductive age group was included in this study. Data have been extracted and processed with Stata version 17. The dataset was then imported into a Jupyter notebook for further detailed analysis and visualization. An ensemble Machin learning algorithm using different classification models were implemented. All analysis and calculation were performed using Python 3 programming language in Jupyter Notebook using imblearn, sklearn, and xgboost pakages.

Results: Random forest demonstrated the best performance with an accuracy 97.84%, recall of 99.70%, F1-score of 97.81%, 98.95% precision on test data and AUC (98%). Region, residency, age of women, sex of child, respondent education, distance health facility, husband education and religion were top predicting factors of short birth interval among women in Ethiopia.

Conclusion: Random forest was best predictive models with improved performance. "The most significant features that contribute to the accuracy of the top-performing models, notably the Random Forest should be highlighted because they outperformed the other model in the analysis.In general, ensemble learning algorithms can accurately predict short birth interval status, making them potentially useful as decision-support tools for the pertinent stakeholders.