Cultural Beliefs and Traditional Practices During Pregnancy, Child Birth, and the Postpartum Period in East Gojjam Zone, Northwest Ethiopia: A Qualitative Study.

Introduction: Many countries invest in interventions to minimize maternal and neonatal morbidity and mortality but the progress has been slow, in developing countries, especially in Africa. Traditional taboos and malpractices like home deliveries owing to cultural beliefs and traditional practices during pregnancy, childbirth, and the postpartum period increase maternal and neonatal complications. Although there are different researches in Ethiopia, the reasons for practicing such traditional activities in the East Gojjam zone in northwest Ethiopia are not well understood. Ethical clearance was obtained from the research committee of Debre Markos University. Objective: This study aimed to explore cultural beliefs and traditional practices during pregnancy, childbirth, and the postpartum period in East Gojjam Zone, Northwest Ethiopia. Materials and Methods: Purposive and snowball nonprobability sampling techniques were used to select the study participants. Data were collected through in-depth interviews and focused group discussions until the information was saturated and it was categorized and analyzed after the interviews were completed. The translated text file was analyzed using thematic analysis using codes and terms to create themes. Information from the interview consists of the women's descriptions and explanations of their cultural practices during pregnancy, childbirth, and the postnatal period. Result: Respondents report many examples of cultural, traditional, and religious practices experienced by the community in East Gojjam Zone during pregnancy, childbirth, and postpartum period, whether they are beneficial or harmful for the mother and the fetus. Drinking holy water, praying to God and Mary, taking herbal medicine, food taboo, making a confinement period in a dark room, and other cultural ceremonies are among commonly experienced cultural, traditional, and religious practices in the study area. Conclusion: Traditional, cultural, and religious practices during pregnancy, childbirth, and the postpartum period are still popular among the community in the East Gojjam Zone. It is critical to identify the harmful practices and reinforce the positive healthy practices to make pregnancy, childbirth, and postpartum periods healthy and joyful.

Incidence and predictors of puerperal sepsis among postpartum women at Debre Markos comprehensive specialized hospital, northwest Ethiopia: A prospective cohort study.

Background: Puerperal sepsis is one of the leading causes of maternal mortality, particularly in low and middle-income countries where most maternal deaths occur. Women with puerperal sepsis are prone to long-term disabilities, such as chronic pelvic pain, blocked fallopian tubes, and secondary infertility. Besides this, puerperal sepsis has received less attention. For this reason, this study aimed to determine the incidence of puerperal sepsis and its predictors among postpartum women at Debre Markos Comprehensive Specialized Hospital. Methods: A prospective cohort study was conducted among 330 postpartum women from September 2020 to 2021. A pre-tested interviewer-administered questionnaire with a data extraction checklist was used to collect the data. Data were entered into Epi data 4.2 and analyzed using STATA 14.0. The incidence rate of puerperal sepsis was calculated, and a Kaplan-Meier survival curve was used to estimate the survival probability of developing puerperal sepsis. The cox-proportional hazards regression model was fitted to identify predictors of puerperal sepsis. Results: The study participants were followed for a total of 1685.3 person-week observations. The incidence rate of puerperal sepsis was 14.24 per 1,000 person-weeks. However, the overall incidence of puerperal sepsis was 7.27%. Not attending formal education [AHR: 3.55, 95% CI: (1.09-11.58)], a cesarean delivery [AHR: 4.50; 95% CI: (1.79-11.30)], premature rupture of the membranes [AHR: 3.25; 95% CI: (1.08-9.79)], complicated pregnancy [AHR: 4.80; 95% CI: (1.85-12.43)], being referred [AHR: 2.90; 95% CI: (1.10-7.65)], and not having birth preparedness and complication readiness plan [AHR: 2.95; 95% CI: (1.08-10.50)] were statistically significant predictors of puerperal sepsis. Conclusion: The incidence of puerperal sepsis was 7.27%. Not attending formal education, cesarean delivery, premature rupture of membranes, complicated pregnancy, referral status, and absence of birth preparedness and complication readiness plan were predictors associated with the incidence of puerperal sepsis.

COVID-19-related attitude and risk perception among pregnant women attending antenatal care, and the associated factors, at public health facilities of East Gojjam Zone, Ethiopia, 2020: a multi-center cross-sectional study.

Aim: This study aimed to assess COVID-19 (coronavirus disease 2019)-related attitude and risk perception among pregnant women attending antenatal care, and the associated factors, at public health facilities of the East Gojjam Zone, Ethiopia. Subjects and methods: A multi-center cross-sectional study was conducted, from December 1-30, 2020. A total of 847 pregnant women were included in the study using a simple random sampling technique. To collect the data, we used an interviewer-administered questionnaire. Bi-variable and multi-variable logistic regression analyses were used to identify factors associated with pregnancy-related anxiety. A p-value of < 0.05 with a 95% confidence level was used to declare statistical significance. Results: The magnitude of COVID-19-related positive attitude and high-level risk perception among pregnant women was 51.12% and 37.2% respectively. Having adequate knowledge [AOR: 2.09, 95% CI = (1.49-2.95)], ≥ 3 ANC visits [AOR: 1.43, 95% CI = 1.0-1.98], and a low level of risk perception [AOR: 6.27, 95% CI = (4.42-8.89)] were factors associated with a positive attitude of pregnant women with regard to the COVID-19 pandemic. Being urban residents [AOR: 2.24, 95% CI: 1.6-3.10], having wanted pregnancy [AOR: 3.35, 95% CI: 1.18-9.49], having a negative attitude [AOR: 6.21, 95% CI: 4.43-8.70], and a complicated pregnancy [AOR: 1.67, 95% CI: 1.02--2.75] were factors significantly associated with risk perception of pregnant women with regard to the COVID-19 pandemic. Conclusions: Despite its high fatality, COVID-19 pandemic-related attitude and risk perception among pregnant women were low. As a result, health caregivers and other concerned bodies should consider interventions to improve pregnant women's risk perception and attitude during antenatal care and through various community information platforms. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-022-01797-x.

Time to death among HIV-infected under-five children after initiation of anti-retroviral therapy and its predictors in Oromiya liyu zone, Amhara region, Ethiopia: a retrospective cohort study.

BACKGROUND: Human Immunodeficiency Virus (HIV) is infection which mainly attacks immune system of an individual. Its disease progress is rapid in children and if treatment is not initiated nearly half of infected children will die by the second year of infection. In Ethiopia, nearly twenty four percent of HIV related death is happen to under-five children; however studies done in this specific age group are limited are with poor evidence of predictors. OBJECTIVES: To determine time to death and identify predictors of death in HIV infected under- five children on antiretroviral therapy in Amhara regional state, Oromia 'liyu' zone, Northeast Ethiopia, from 2014 to 2019. METHODS: Institution based retrospective follow up study was conducted in 376 under-five HIV- infected children on antiretroviral therapy from January 2014 to December 2019 in health institutions in Oromia Liyu Zone, Amhara region, Ethiopia. Multivariable Cox-proportional hazard regression model was used to identify independent predictors of mortality in HIV- infected under-five children on antiretroviral therapy. RESULT: At the end of follow up, 304 (80.85%) of HIV-infected children were alive, 39 (10.95%) were lost to follow up, 12 (3.19%) were transferred out and 21 (5.59%) were reported dead due to HIV/AIDS. The cumulative survival probabilities of children after 3, 6, 12, 24 and 36 months were 0.99, 0.98, 0.97, 0.89 and 0.87 respectively. The overall mean time to death was 19.7 months (95%CI = 18.74-20.67) with incidence of 5.9 deaths per 100 child-months (95%CI: 3.89-9.09). Children with severe malnutrition at baseline (AHR = 4.9; 95 CI: 1.04, 23.50), advanced WHO clinical stage at enrolment (AHR = 3.9; CI: 1.37, 10.88), poor adherence to ART (AHR = 6.56; CI: 3.33, 10.14) and with no history of Isoniazide prophylaxis were significantly associated to higher mortality events (AHR = 3.6; CI: 1.24, 10.18). CONCLUSION: Death of HIV-infected under-five children on ART is high within the first one year after enrolment. The risk of death increased if the child was malnourished at beginning of treatment, had poor ART adherence, with advanced WHO clinical stages and lack of Isoniazide prophylaxis during their age of infancy.

Cultural malpractices during labor/delivery and associated factors among women who had at least one history of delivery in selected Zones of Amhara region, North West Ethiopia: community based cross-sectional study.

BACKGROUND: Every day, at least 810 women die worldwide from the complications of pregnancy and childbirth, 86% of which occurring in Southern Asia and Sub-Saharan Africa. One of the contributing factors for these problems is cultural malpractices during pregnancy and childbirth. The actual incidence of cultural malpractices in developing countries accounts for about 5-15% of maternal deaths. Thus, understanding the link between cultural affairs and maternal health is critical to saving the lives of women and their babies. Therefore, this research was aimed to assess cultural malpractices during labor and delivery and associated factors among women who had at least one history of delivery in selected Zones of the Amhara region, North West Ethiopia. METHOD: Community based cross-sectional study was conducted on women who had at least one delivery history in Awi, West, and East Gojjam Zones from January 1 to May 30, 2020. The multistage cluster sampling technique was used to select 845 study participants. Data was collected through a pre-tested and structured interview questionnaire, entered and cleaned using EPI info version 7.2, and exported to SPSS version 23 for analysis. Bivariable and multivariable logistic regression was employed to assess the association of the variables and a P-value less than 0.05 was declared as statistically significant. RESULT: Out of 845 women 162(19.2%) practiced nutritional taboo, 77(9.1%) women practiced abdominal massage and 273(32.3%) delivered their babies at home. Educational status of the respondents being un able to read and write (AOR = 14.35,95% CI: 3.12,65.96), husband's educational status (AOR = 3.80,95% CI: 1.24,11.64), residence (AOR = 2.93,95% CI: 1.41: 6.06), ethnicity (AOR = 2.20,95% CI:1.32, 3.67), pregnancy complications (AOR = 1.61,95% CI:1.02, 2.53), gravidity (AOR = 3.54,95% CI:1.38,9.08) and antenatal care follow up (AOR = 2.24, 95% CI:1.18,4.25) had statistically significant association with cultural malpractices during labor and delivery. CONCLUSION: This study showed that cultural malpractices during childbirth were high in Awi, West, and East Gojjam Zones relative to the country's maternal health service utilization plan. Working on antenatal care follow-up and women and husband education in a culturally acceptable manner may reduce cultural malpractices during labor and delivery.

Intention to use maternity waiting home and associated factors among pregnant women in Gamo Gofa zone, Southern Ethiopia, 2019.

BACKGROUND: A maternity waiting home is a temporary residence in which pregnant women from remote areas wait for their childbirth. It is an approach targeted to advance access to emergency obstetric care services especially, in hard-to-reach areas to escalate institutional delivery to reduce complications that occur during childbirth. Apart from the availability of this service, the intention of pregnant women to utilize the existing service is very important to achieve its goals. Thus, this study aimed to assess the intention to use maternity waiting homes and associated factors among pregnant women. METHODS: Community-based cross-sectional study was conducted among 605 pregnant women using a multistage sampling technique from March 10 to April 10, 2019, by using a structured questionnaire through a face-to-face interview. The collected data was entered into Epi-Data version 3.1 and analyzed using the SPSS version 24 statistical package. Logistic regression analysis was used to test the association. All variables at p-value < 0.25 in bivariate analysis were entered into multivariate analysis. Lastly, a significant association was declared at a P-value of < 0.05 with 95% CI. RESULTS: In this study, the intention to use maternity waiting homes was 295(48.8%, 95%CI: 47%-55%)). Occupation (government employee) (AOR:2.87,95%CI: 1.54-5.36), previous childbirth history (AOR:2.1,95%CI:1.22-3.57), past experience in maternity waiting home use AOR:4.35,95%CI:2.63-7.18), direct (AOR:1.57,95%CI:1.01-2.47) and indirect (AOR: 2.18, 1.38,3.44) subject norms and direct (AOR:3.00,95%CI:2.03-4.43), and indirect (AOR = 1.84,95%CI:1.25-2.71) perceived behavioral control of respondents were significantly associated variables with intention to use maternity waiting home. CONCLUSION: The magnitude of intention to use maternity waiting homes among pregnant women is low. Community disapproval, low self-efficacy, maternal employment, history of previous birth, and past experiences of MWHs utilization are predictors of intention to use MWHs, and intervention programs, such as health education, strengthening and integration of community in health system programs need to be provided.