Spatial variation and associated factors of lack of awareness about obstetric fistula among women aged 15–24 years in Ethiopia: A geographically weighted regression analysis

Abstract Childbirth complications remain a major public health challenge worldwide, particularly in low‐resource settings such as Ethiopia, where poor living conditions and limited access to maternal health services persist. Among these complications, obstetric fistula (OF) continues to be a significant concern affecting women's health and well‐being. Awareness of OF and associated factors is essential for prevention and elimination efforts. However, evidence on its spatial distribution and determinants among young women in Ethiopia remains limited. Therefore, this study aimed to assess the spatial variation and predictors of lack of awareness about OF among women aged 15–24 years in Ethiopia using geographically weighted regression analysis. A cross‐sectional study was conducted using data from the 2016 Ethiopian Demographic and Health Survey. Spatial autocorrelation analysis (Global Moran's I), hot spot analysis, ordinary least squares regression, and geographically weighted regression were performed to examine the spatial distribution and identify location‐specific predictors of lack of awareness about OF. Model performance was evaluated using the corrected Akaike information criterion (AICc) and adjusted R 2 values. Statistical significance was declared at P ≤ 0.05. Lack of awareness about OF was significantly clustered across Ethiopia (Global Moran's I = 0.33, z ‐score = 20.25, P < 0.001), indicating a non‐random geographic distribution. Hot spot areas with a high proportion of women lacking awareness were identified in Afar, Amhara, Gambella, Oromia, Southern Nations, Nationalities and Peoples', and Somali regions. The geographically weighted regression model demonstrated significant spatial variation in the effects of educational level, perceived distance to health facilities, employment status, internet use, and sexual experience on lack of awareness, with the magnitude and direction of associations varying across geographic locations. Lack of awareness about OF is spatially clustered across Ethiopia and is associated with geographically varying socioeconomic and healthcare access factors. Targeted interventions focusing on disadvantaged areas are needed to improve awareness among young women and support OF prevention efforts.