Performance evaluation and comparative analysis of different machine learning algorithms in predicting postnatal care utilization: Evidence from the ethiopian demographic and health survey 2016

Daniel Niguse Mamo, Agmasie Damtew Walle, Eden Ketema Woldekidan, Jibril Bashir Adem, Yosef Haile Gebremariam, Meron Asmamaw Alemayehu, Ermias Bekele Enyew and Shimels Derso Kebede

PLOS Digital Health, 2025, vol. 4, issue 1, 1-25

Abstract: Postnatal care refers to the support provided to mothers and their newborns immediately after childbirth and during the first six weeks of life, a period when most maternal and neonatal deaths occur. In the 30 countries studied, nearly 40 percent of women did not receive a postpartum care check-up. This research aims to evaluate and compare the effectiveness of machine learning algorithms in predicting postnatal care utilization in Ethiopia and to identify the key factors involved. The study employs machine learning techniques to analyse secondary data from the 2016 Ethiopian Demographic and Health Survey. It aims to predict postnatal care utilization and identify key predictors via Python software, applying fifteen machine-learning algorithms to a sample of 7,193 women. Feature importance techniques were used to select the top predictors. The models’ effectiveness was evaluated using sensitivity, specificity, F1 score, precision, accuracy, and area under the curve. Among the four experiments, tenfold cross-validation with balancing using Synthetic Minority Over-sampling Technique was outperformed. From fifteen models, the MLP Classifier (f1 score = 0.9548, AUC = 0.99), Random Forest Classifier (f1 score = 0.9543, AUC = 0.98), and Bagging Classifier (f1 score = 0.9498, AUC = 0.98) performed excellently, with a strong ability to differentiate between classes. The Region, residence, maternal education, religion, wealth index, health insurance status, and place of delivery are identified as contributing factors that predict postnatal care utilization. This study assessed machine learning models for forecasting postnatal care usage. Ten-fold cross-validation with Synthetic Minority Oversampling Technique produced the best results, emphasizing the significance of addressing class imbalance in healthcare datasets. This approach enhances the accuracy and dependability of predictive models. Key findings reveal regional and socioeconomic factors influencing PNC utilization, which can guide targeted initiatives to improve postnatal care utilization and ultimately enhance maternal and child health.Author summary: The study indicated that, among the four experimental designs, tenfold cross-validation using the Synthetic Minority Oversampling Technique (SMOTE) produced the best results. The MLP Classifier, Random Forest Classifier, and Bagging Classifier all performed well in predicting postnatal care (PNC) utilization. The region, residency, maternal education, religion, wealth index, health insurance status, and place of delivery were all significant predictors. The study emphasizes the necessity of correcting class imbalance in healthcare datasets to improve predictive model accuracy and reliability, as well as the impact of geographical and socioeconomic factors on PNC utilization.

Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pdig00:0000707

DOI: 10.1371/journal.pdig.0000707

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