Daniel Asmelash ^1* WONDAYA FENTA ZEWDIA ^2* Yemane Asmelash ³

• ¹ College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
• ² Department of Statistics, College of Science, Bahir Dar University, Bahirdar, Ethiopia
• ³ Department of Statistics, College of Natural and Computational Sciences, Aksum University, Aksum, Ethiopia

The process of childbirth involves significant risks, particularly when certain highrisk fertility behaviors (HRFB) are present. HRFB of birth explained by maternal age under 18 or over 34 at time childbirth, child born after a short birth interval (24 months) and high parity (>3 children). The majority of child stunting were linked to high-risk reproductive practices. Stunted children are those whose height-for-age Z-score is less than minus two (-2 St.dev) from the reference population's median. This study aimed to investigate the spatial association between HRFB of birth and stunting in children under five across Ethiopia's administrative zones.The source of this study was cross-sectional data taken from the latest Mini Ethiopian Demographic and Health 2019 Survey, including a weighted sample of 4,969 under five children from 64 administrative zones. Spatial model analysis, specifically the Spatial Durbin Model was used to examine the association between HRFB of birth and stunting in children. For analysis ArcGIS 10.8 were used for Mapping and SAS 9.4 were used model analysis.The mean proportion of HRFB of birth and stunting status of children rates in the zonal level in Ethiopia were observed on average 58% and 36%, respectively across Ethiopian zones.Children who were experience both HRFB of birth problem and stunting were to the extent of (24%) of them at all times. The median value of HRFB of birth and stunting were 0.61 and 0.36, respectively. The spatial variation of the average vegetable index and the livestock index were 0.57 and 0.12, respectively, across Ethiopian zones. For the selected Spatial Durbin Model, the value of deviance was very small, showing that the model was a good fit to the data.The study found high prevalence and significant spatial variation of both HRFB of birth and stunting across Ethiopian zones. The spatial distribution of both HRFB of birth and stunting were found significantly clustered in administrative zones of Ethiopia. These results underscore the need for targeted interventions to address HRFB and stunting, aiding Ethiopia's sustainable development goals.