The receipt of health information on neonatal dangers signs during the immediate postpartum period and its determinants in Ethiopia: a multilevel mixed-effects logistic regression analysis of the 2016 Ethiopian demographic health survey report.

BACKGROUND: Identification of neonatal danger signs and immediate access to health care are two global efforts aimed at enhancing newborn and child survival by preventing 75% of neonatal deaths. Despite various small-scale studies on women's awareness of neonatal danger signs in Ethiopia, little is known about the level of receiving health information on those danger signs during the immediate postpartum period at the national level. Hence, this study aimed at assessing the level, and its determinants of the service uptake in Ethiopia. METHODS: The data for this study was taken from the Ethiopian Demographic and Health Survey (EDHS), which took place from January to June 2016 and covered all administrative regions of Ethiopia. A weighted sample of 7,589.8 women was analyzed using STATA version 16. To account for data clustering, a multivariable multilevel mixed-effect logistic regression analysis was employed to determine the effects of each predictor on the outcome variable. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the explanatory variables. RESULTS: The receipt of health information on neonatal danger signs during the immediate postpartum period was 10.70% [95% CI:10.01, 11.40]. Variables namely living in Metropolitans [AOR = 2.06; 95%CI: 1.48, 2.88] and Large central [AOR = 1.83; 95%CI: 1.38, 2.42] regions, being in the highest wealth quintile [AOR = 1.87; 95% CI: 1.23, 2.84], being nulliparous [AOR = 0.27; 95% CI: 0.08, 0.87] and primiparous[AOR = 0.61;95% CI: 0.46, 0.79], getting adequate antenatal visits [AOR = 2.42; 95% CI: 1.75, 3.33], institutional delivery [AOR = 5.91; 95% CI: 4.66, 7.53], and receipt of postnatal visits [AOR = 3.52; 95% CI: 2.84, 4.38] were identified as significant determinants of receiving health information on newborn danger signs. CONCLUSION: The findings revealed that unacceptably low uptake of health information on newborn danger signs during the immediate postpartum period in Ethiopia. A concerted effort is needed from all stakeholders in the health sector to enhance the uptake of maternal health services (antenatal care, skilled delivery service, and postnatal care). Healthcare providers should pay special attention to nulliparous and primiparous women during and after delivery, and the government should also focus on women of peripheral regions, who make up a large portion of the low coverage.

Abdominal obesity and associated factors among urban adults in Southwest Ethiopia: a community-based cross-sectional study.

Introduction: the obesity epidemic is growing faster in developing countries with no exception of Ethiopia. Currently, abdominal obesity is identified as a major risk factor for chronic diseases due to the accumulation of liable fat. However, despite the evidence of certain documented data, abdominal obesity has been on the rise in Ethiopia, especially in urban areas. Therefore, this study aimed to assess the prevalence and factors associated with abdominal obesity among adults in Jimma town, Southwest Ethiopia. Methods: a community-based cross-sectional study was employed on 845 adults selected using a multi-stage sampling technique. Data were collected using a pretested interviewer-administered questionnaire. Data were entered using Epi-data version 3.1 and exported to STATA version 14 for analysis. Simple linear regression was conducted to identify candidate variables. A multivariable linear regression model was fitted to identify factors associated with abdominal obesity. P-value<0.05 was used to declare statistical significance. Results: a total of 806 respondents participated in this study, making a response rate of 95.4%. The magnitude of abdominal obesity was found to be 24.6% (95% CI: 21.5, 27.5). Physical activity (ß= -2.053; 95%CI: -3.353, -0.454), alcohol consumption (ß=1.631; 95%CI: 0.176, 3.087), and age (ß=0.319; 95%CI: 0.250, 0.389) were significantly associated with abdominal obesity. Conclusion: the magnitude of abdominal obesity among adults in the study area was high compared to previous studies. Alcohol drinking, being physically inactive, and age were predictors of abdominal obesity. There is a need for intervention for adults with physical inactivity and alcohol consumption to reduce abdominal obesity.

Compliance with Standard Occupational Health and Safety Measures and Associated Factors Among Small-Scale Metal Industry Workers in Central Ethiopia.

Background: Compliance with workplace health and safety measures can result in considerable reduction in workplace injuries and fatalities and attributed economic costs. However, majority of studies conducted in small-scale industries in numerous countries, including Ethiopia focused on the prevalence of occupational injuries and there is a paucity of evidence on level of employees' adherence to safety measures and the associated factors. Therefore, this study was conducted to assess workers' compliance and factors associated with occupational health and safety practices in small-scale metal industries in Central Ethiopia. Methods: This study was conducted in Central Ethiopia. A total of 415 small-scale metal workers were included in this study. Study participants were selected using a simple random sampling technique. A structured interviewer-administered questionnaire was used to collect the data. The collected data were entered using EPI Info version 7.2 and exported to IBM-SPSS Version 22 for further cleaning and analysis. Bivariate and multivariate Binary Logistic Regression were conducted to determine association and during the multivariable regression variables with a p-value <0.05 were considered significantly associated factors. Results: The study found a 39.3% (95% CI: 34.7, 44.1) prevalence of good compliance with safety and health measures among small-scale metal workers. Temporary employed workers were less likely to adhere [AOR=0.43, 95% CI (0.21, 0.93)] and workers who received training were more likely to adhere [AOR=5.75, 95% CI (2.56, 12.9)] to safety precautions. Other significantly associated variables included work experience, working at night, and satisfaction with the current salary. Conclusion: This study sheds light on small-scale metal workers' commitment to workplace safety and health procedures, indicating a compliance rate of 39.3%, which is low. Temporary employees and less experienced workers are less likely to follow health and safety precautions. Workplace health and safety training are associated with increased safety precautions.

Musculoskeletal disorders and its associated factors among hospital cleaners in Addis Ababa, Ethiopia.

There is a paucity of published evidence about musculoskeletal disorders among hospital cleaners in Ethiopia. Therefore, this study was conducted to assess the prevalence of musculoskeletal disorders and its associated factors among hospital cleaners in Addis Ababa, Ethiopia. A total of 437 hospital cleaners participated in the study. A standardized questionnaire adapted from the Nordic musculoskeletal questionnaire was used for data collection. Bivariate and multivariable logistic regression analyses were used to determine factors associated with musculoskeletal disorders. The prevalence of work-related musculoskeletal disorders among hospital cleaners was 57.2% with 95% CI (52.6-62.0). Occupational safety training [AOR: 2.34, 95% CI (1.47-3.73)], repetitive tasks [AOR: 3.09, 95% CI (1.61-5.94)], heavy lifting [AOR: 5.21, 95% CI (3.20-8.48)], work-related stress [AOR: 2.42, 95% CI (1.48-3.97) and work-related dissatisfaction [AOR: 1.97, 95% CI (1.23-3.13)] were identified as associated factors for the development of musculoskeletal disorders. In conclusion the study revealed a high prevalence of musculoskeletal disorder. Notably, work related and organizational factors emerged as key contributing factors to the development of disorders. The identified associations underscore the importance of targeted interventions promoting organizational change involving managers to mitigate the risk of musculoskeletal disorders and enhance overall occupational health and well-being.

Compliance towards WHO recommendations on antenatal care for a positive pregnancy experience: Timeliness and adequacy of antenatal care visit in Sub-Saharan African countries: Evidence from the most recent standard Demographic Health Survey data.

BACKGROUND: Timely and adequate antenatal care (ANC) visits are known to reduce maternal mortality by 20%. Despite the World Health Organization updating its recommendations from four to eight antenatal care contacts, data reporting in the SSA region focused primarily on four visits, and evidence on the timing and adequacy of ANC based on the current recommendation was limited. Hence, this study aimed at assessing the level of timely and adequate ANC visits and their determinants in the 18 Sub-Saharan African countries with the most recent DHS report (2016-2021). METHODS: The data for this study were pooled from the most recent standardized Demographic and Health Survey data of sub-Saharan African countries from 2016-2021. A total of 171,183 (with a weighted frequency of 171,488) women were included and analyzed by using STATA version 16. To account for data clustering, a multivariable multilevel mixed-effect logistic regression analysis was run to determine the effects of each predictor on the receipt of timely and adequate ANC. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the independent variables. RESULTS: The receipt of timely and adequate antenatal care visits was 41.2% (95% CI: 40.9, 41.4) and 10.4% (95% CI: 9.9, 10.2), respectively. Wontedness of pregnancy [AOR = 1.18; 95% CI: 1.13, 1.24], being 1st birth order [AOR = 1.48; 95% CI: 1.41, 2.54], having a mobile phone [AOR = 1.49; 95% CI: 1.26, 2.32], and enrolled in Health insurance schemes [AOR = 2.03; 95% CI: 1.95, 2.42] were significantly associated with early initiation of ANC. Living in a lower community poverty level[AOR = 2.23; 95% CI: 1.90,2.66], being in the richest wealth quintile [AOR = 1.49; 95% CI: 1.36, 1.62], higher educational level [AOR = 3.63; 95% CI: 3.33, 3.96], the timing of ANC visit [AOR = 4.26; 95% CI: 4.08, 4.44], being autonomous in decision making [AOR = 2.29; 95% CI: 1.83, 2.54] and having a mobile phone [AOR = 1.89; 95% CI: 1.76, 2.52] were identified as significant predictors of adequate ANC uptake. CONCLUSION: The findings revealed a low coverage of timely and adequate ANC visits in SSA countries. Governments and healthcare managers in sub-Saharan African countries should leverage their efforts to prioritize and implement activities and interventions that increase women's autonomy, and economic capability, to improve their health-seeking behavior during pregnancy. More commitment is needed from governments to increase mobile phone distribution across countries, and then work on integrating mHealth into their health system. Finally, efforts should be made to increase the coverage of health insurance schemes enrolment for the citizens.

Towards a positive postnatal experience in Sub-Saharan African countries: the receipt of adequate services during the immediate postpartum period: a multilevel analysis.

Background: Existing studies in the Sub-Saharan African (SSA) region have focused mainly on the frequency of postnatal visits, with little emphasis on the adequacy of care provided during visits. Hence, this study aimed to investigate the magnitude of receiving an adequate number of World Health Organization-recommended contents of care during the immediate postpartum visit, and its predictors in SSA countries. Methods: The appended women file of the most recent (2016-2021) standardized Demographic and Health Survey report of eighteen Sub-Saharan African countries with a weighted sample of 56,673 women was used for the study. The influence of each predictor on the uptake of adequate postnatal care has been examined using multilevel mixed-effects logistic regression. Significant predictors were reported using the adjusted odds ratio (aOR) with their respective 95% confidence intervals (95% CI). Results: The pooled prevalence of adequate postnatal care service uptake was found to be 42.94% (95% CI: 34.14, 49.13). Living in the southern sub-region (aOR = 3.08 95% CI: 2.50, 3.80), institutional delivery (aOR = 3.15; 95% CI: 2.90, 3.43), early initiation of ANC (aOR = 1.74; 95% CI: 1.45, 2.09), quality of antenatal care (aOR = 1.59; 95% CI: 1.42, 1.78), Caesarean delivery (aOR = 1.59; 95% CI: 1.42, 1.78), autonomy in decision-making (aOR = 1.30; 95% CI: 1.11, 1.39), high acceptance toward wife beating attitude (aOR = 0.83; 95% CI: 0.73, 0.94), and reading newspapers (aOR = 1.37; 95% CI: 1.21, 1.56) were identified as predictors of receiving adequate postnatal services during the immediate postpartum period. Conclusion: The findings revealed low coverage of adequate postnatal care service uptake in the region. The Federal Ministry of Health and healthcare managers in each country should coordinate their efforts to develop interventions that promote women's empowerment to enhance their autonomy in decision-making and to reduce attitudes towards wife beating. Healthcare providers ought to strive to provide skilled delivery services and early initiation of antenatal care.

House-wall modification after indoor residual spraying in Shashogo district, southern Ethiopia.

BACKGROUND: Indoor residual spraying has been a key national malaria prevention and control strategy in Ethiopia. However, there is a gap in monitoring and evaluation of house-wall modification after indoor residual spraying before the end of residual lifespan. This study has determined the prevalence of house-wall modification after indoor residual spraying and identified the associated factors in Shashogo district, southern Ethiopia. METHODS: A community-based cross-sectional study was conducted from April to May 2022. Data were collected from 640 randomly selected households using a pre-tested questionnaire and an observational checklist. The binary logistic regression models were used to identify factors associated with house-wall modification after indoor residual spraying before the end of the potency period. RESULTS: The prevalence of house-wall modification after indoor residual spraying was found to be 30.4% (95% CI 27.4-34.2%). Educational status of could not read and write [AOR = 1.76, 95% CI (1.16, 2.68)], monthly income of more than birr 3000 [AOR = 3.27, 95% CI (1.78, 6.01)], low level of knowledge about indoor residual spraying [AOR = 3.81, 95% CI (2.39, 6.06)], lack of information within two weeks before spraying [AOR = 2.23, 95% CI (1.44, 3.46)], absence of supervision after spraying [AOR = 1.79, 95% CI (1.14, 2.81)], absence of stagnant water near house [AOR = 3.36, 95% CI (2.13, 5.39)], and thatched roof [AOR = 1.82, 95% CI (1.04, 3.16)] were factors significantly associated with house-wall modification after indoor residual spraying. CONCLUSION: This study has revealed that the prevalence of house-wall modification after indoor residual spraying before the end of the residual lifespan in the study area was higher compared to other studies in developing countries. Therefore, special emphasis should be given to providing community education about indoor residual spraying, conducting regular supervision before and after residual spraying, enforcing some legislative strategies for modifying the house-wall before six months after spraying, and improving environmental and housing conditions.

Women empowerment domains and unmet need for contraception among married and cohabiting fecund women in Sub-Saharan Africa: A multilevel analysis based on gender role framework.

BACKGROUND: Low women empowerment, is a known contributing factor to unmet needs for contraception by limiting access to health services through negative cultural beliefs and practices. However, little is known about the association between unmet needs and domains of women empowerment in Sub-Saharan African (SSA) countries. Hence, this study aimed at assessing the influence of women empowerment domains on the unmet need for contraception in the region using the most recent Demographic and Health Survey (DHS) data (2016-2021). METHODS: The data for the study was derived from the appended women's (IR) file of eighteen SSA countries. A weighted sample of 128,939 married women was analyzed by STATA version 16. The Harvard Institute's Gender Roles Framework, which comprised of influencer, resource, and decision-making domains was employed to identify and categorize the covariates across three levels. The effects of each predictor on the unmet need for spacing and limiting were examined using a multivariable multilevel mixed-effect multinomial logistic regression analysis. Adjusted relative risk ratio (aRRR) with its corresponding 95% confidence interval was used to declare the statistical significance of the independent variables. RESULTS: The pooled prevalence of unmet needs for contraception was 26.36% (95% CI: 24.83-30.40) in the region, with unmet needs for spacing and limiting being 16.74% (95% CI: 16.55, 17.02) and 9.62% (95% CI: 9.45, 12.78), respectively. Among variables in the influencer domain, educational level, family size of more than five, parity, number of children, attitude towards wife beating, and media exposure were substantially linked with an unmet need for spacing and limiting. Being in the poorest wealth quintile and enrollment in health insurance schemes, on the other hand, were the two variables in the resource domain that had a significant influence on unmet needs. The overall decision-making capacity of women was found to be the sole significant predictor of unmet needs among the covariates in the decision-making domain. CONCLUSION: Unmet needs for contraception in SSA countries were found to be high. Reproductive health program planners and contraceptive service providers should place due emphasis on women who lack formal education, are from low-income families, and have large family sizes. Governments should collaborate with insurance providers to increase health insurance coverage alongside incorporating family planning within the service package to minimize out-of-pocket costs. NGOs, government bodies, and program planners should collaborate across sectors to pool resources, advocate for policies, share best practices, and coordinate initiatives to maximize the capacity of women's decision-making autonomy.

The Prevalence of Occupational Accidents and the Associated Factors Among Janitorial Staff at a University Teaching Hospital in South Ethiopia.

Background: The healthcare industry is widely regarded as a high-risk environment for workers' occupational health and safety. As a result, healthcare workers are constantly exposed to a wide range of hazards, including biological, chemical, physical, ergonomic, and psychosocial hazards. Consequently, janitorial staff are the most vulnerable section of the healthcare workforce to occupational injuries when compared to others due to the nature of their work. Therefore, this study aims at assessing the magnitude of occupational accidents and associated factors among Janitorial staff at Dilla University Teaching Hospital. Methods: This cross-sectional institutional-based study was conducted from August to September 2022 at a University Teaching Hospital in South Ethiopia. A total of 105 janitorial staff were included in the study with a response rate of 93.8%. The data were collected using a structured interviewer-administered questionnaire. Data were entered using Epi Info version 7.2.5 and exported to IBM SPSS statistics 22 for further cleaning and analysis. The binary logistic regression model was used to identify predictors of occupational accidents and variables with a p-value of <0.05 during the multivariable analysis were considered statistically significant. Results: The prevalence of occupational accidents is 61% (95% CI: 51.4, 70.5). Of the total study participants, 52 (45.5%) and 33 (31.4%) of the participants had reported that they have experienced chemical splash and needle stick injury, respectively. The age of participants was one of the factors for occupational accidents. The participants who did not receive training were 3 times [AOR=2.9, 95% CI (1.04, 8.02)] more likely exposed. Having good practice was protective against occupational injuries. Conclusion: The study highlights the high prevalence of occupational accidents, particularly chemical splashes, and needle stick injuries, among janitors in the study settings. The study emphasizes the importance of age, training, awareness, and adherence to infection prevention and control strategies as factors influencing the likelihood of experiencing occupational injuries.

Status and Factors Affecting Patient Safety Culture at Dilla University Teaching Hospital: A Mixed-Method Cross-Sectional Study.

Background: Patient safety culture is now at the forefront of the global health agenda and has been designated as a human right. Assessing safety culture is seen to be a prerequisite for improving safety culture in health-care organizations. However, no research has been conducted to examine the current study setup. Therefore, this study aims at assessing the status and factors influencing patient safety culture at Dilla University Teaching Hospital. Methods: This cross-sectional institutional-based study was conducted from February to March 2022 at Dilla University Hospital. The study used both qualitative and quantitative methods. A total of 272 health professionals were included in the survey. The qualitative data was collected using Key Informant Interviews and In-depth Interviews and 10 health professionals were selected purposively to meet the study objective. Results: The overall composite positive patient safety culture response rate in the current study hospital was 37% (95% CI: 35.3, 38.8). Out of the 12 dimensions, teamwork within hospital units was the highest (75.3%), while frequency of event reporting was the lowest (20.7%) positive percentage response. Only two of the 12 dimensions scored above 50%. Factors affecting patient safety culture majorly at organizational and individual level were poor/low attitude of health professionals, poor documentation practice, and poor cooperation by clients, lack of training and continuous education, lack of standard operating procedure, Staff shortage and high work load. Conclusion: This study revealed that the overall composite positive patient safety culture response rate within the surveyed facility was alarmingly low compared to other hospitals in various countries. The results indicate that there is a need for improvement in areas such as event reporting, documentation, health-care workers' attitude, and staff training. Hospitals must prioritize patient safety by cultivating a strong safety culture through effective leadership, adequate staffing, and education to enhance overall patient care.

Exploring associations between household environmental factors and handwashing with essential agents in sub-Saharan Africa.

BACKGROUND: 3 billion people lack proper home hand hygiene facilities globally. Of these, 1.4 billion (18%) lack soap or water, while 1.6 billion (22%) have neither. This analysis explores the link between living conditions and the use of essential agents in sub-Saharan Africa. This secondary data analysis examines potential associations between the domiciliary environment and the use of essential agents in sub-Saharan Africa. METHODS: Eighteen demographic and health surveys were used to analyze the association between household environmental factors and handwashing with essential agents. STATA version 16 was used to analyze data from 203,311 households across weighted samples. Using a multivariable multilevel mixed effect logistic regression analysis, it was possible to determine how each independent factor affected the outcome while taking the data clustering into account. The adjusted odds ratio and its associated 95% confidence interval were used to assess the independent factors' statistical significance. RESULT: Only one in three households 34.84%, practiced handwashing with essential agents, with the highest prevalence in Angola (70.2%) and the lowest in Malawi (6.5%). Educational status [aOR = 1.77; 95%(CI = 1.68-1.86)], female headship[aOR = 1.09; 95%(CI = 1.06-1.2)], household wealth[aOR = 4.08; 95%(CI = 3.84-4.33)], not sharing toilets with other homes[aOR = 1.13; 95%(CI = 1.10-1.17)], having a fixed place for hand washing[aOR = 1.49; 95%(CI = 1.45-1.54)], not having regular access to water [aOR = 0.09; 95%(CI = 0.095-0.10)]and being a rural resident [aOR = 0.85; 95%(CI = 0.82-0.88)] were associated with handwashing. CONCLUSION: sub-Saharan nations are failing to demonstrate advancements in handwashing practices. There are still a lot of homes without access to basic infrastructure for handwashing and household water sources. For essential agent adoption programs to be successful in an environment with limited resources, Water, Sanitation, and Hygiene measures must be implemented. Furthermore, it is critical to include contextual factors from the current study as well as socio-cultural and psychological characteristics that dissuade people from using essential agents in intervention strategies.

Compliance toward key elements of kangaroo mother care and its predictors among postnatal mothers with preterm and/or low birth weight newborns in southern Ethiopia, 2021: A count analysis.

BACKGROUND: Although kangaroo mother care has been field-tested and found to be effective for preterm and/or low birth weight newborns at the health facility and community level, implementation and scale-up in low-income countries, including Ethiopia, have proven difficult. There was a dearth of evidence that shows compliance of mothers toward components of the kangaroo mother care. OBJECTIVES: Hence, this study aimed at assessing the compliance of postnatal mothers toward World Health Organization-recommended elements of kangaroo mother care and the factors that influence it in southern Ethiopia, 2021. DESIGN: A hospital-based cross-sectional study was conducted among 257 mothers with preterm and low birth weight newborns from 1 July to 30 August 2021. METHODS: A pretested, structured, interviewer-administered questionnaire and document review were used to collect data. The practice of kangaroo mother care was considered as a count variable. Analysis of variance and independent t-tests were used to examine the variation in the mean score of kangaroo mother care across covariates, and variables with a p value of 0.05 were eligible for the multivariable generalized linear regression model. The effect of each independent variable on the dependent variable was examined using multivariable generalized linear regression with a negative binomial log link. RESULTS: The mean (±standard deviation) practice score of kangaroo mother care items was 5.12 (±2.39), with 2 and 10 as the minimum and maximum item scores, respectively. Place of residence (adjusted odds ratio = 1.55; 95% confidence interval:1.33-2.29), mode of delivery (adjusted odds ratio = 1.37; 95% confidence interval: 1.11-2.21), birth preparedness and complication readiness plan (adjusted odds ratio = 1.63; 95% confidence interval:1.32-2.26), maternal knowledge of kangaroo mother care (adjusted odds ratio = 1.40; 95% confidence interval: 1.05-1.87), and place of delivery (adjusted odds ratio = 0.67; 95% confidence interval: 0.48-0.94) were identified as significant predictors of compliance toward key elements of kangaroo mother care. CONCLUSION: The overall practice of mothers toward key elements of kangaroo mother care was low in the study area. Health care providers who work in the maternal and child health service delivery points should pay special attention to women who come from rural areas and have had cesarean sections, by encouraging and guiding them to practice kangaroo mother care. Women should be counseled during antenatal care and after delivery to improve their knowledge of kangaroo mother care. Health workers in antenatal care clinics should place a strong emphasis on enhancing birth preparedness and complication readiness plans.

Using household survey data to explore the effects of the domiciliary environment on weight at birth: a multilevel mixed-effects analysis of the 2016 Ethiopian Demographic Health Survey.

BACKGROUND: Low birth weight (LBW) is associated with infant mortality and postpartum health complications. In previous studies, overall LBW has been found to be significantly associated with several sociodemographic factors, including ethnicity, maternal age, and family income. Few studies have evaluated the association between environmental risk factors and LBW rates. This study investigated the effect of pre-birth water, sanitation, and hygiene (WASH) and housing conditions on self-reported low birth weight. METHODS: The Ethiopian Demographic and Health Survey, which covered all administrative regions of Ethiopia from January to June 2016, provided data for this study. STATA version 16 was used to analyze 12,125 participants across weighted samples. Multivariable multilevel mixed-effect logistic regression analysis was conducted to determine the effects of each factor on the outcome while accounting for data clustering. The adjusted odds ratios and corresponding 95% confidence intervals were used to determine the statistical significance of the independent variables. RESULTS: One thousand five hundred and seventeen newborns, or 12.59% [95% CI (10.2- 15.3)], had low birth weights. When other factors were taken into account, the following factors were significantly associated with low birth weight: not using small-scale water treatment technology before using water [AOR (95% CI) 1.36 (1.08-2.23)], burning solid fuels for energy [AOR (95% CI) 1.99 (1.60-2.21)], living in homes with natural wall coverings [AOR (95% CI) 1.81 (1.47-2.21)], using a shared latrine within a woman's housing complex or compound [AOR (95% CI) 1.63(1.06-2.25)], and living in peripheral, isolated regions [AOR (95% CI) 1.38 (1.06-2.21)]. CONCLUSION: A little more than one out of every ten deliveries in Ethiopia was under normal (recommended) weight. This study shows that poor housing conditions and lack of household WASH infrastructure are independent predictors of poor birth outcomes among Ethiopian women, adding to the limited evidence that environmental factors within the domicile contribute to low birth weight. Interventions to address these issues may help lower the prevalence of LBW.

The uptake of WHO-recommended birth preparedness and complication readiness messages during pregnancy and its determinants among Ethiopian women: A multilevel mixed-effect analyses of 2016 demographic health survey.

BACKGROUND: Birth preparedness and complication readiness (BPCR) is a package of interventions recommended by the World Health Organization to improve maternal and newborn health and it is provided and implemented through a focused antenatal care program. This study aimed at assessing the uptake of birth preparedness and complication readiness messages, and compliance with each key message, among Ethiopian women during their recent pregnancies using the 2016 demographic health survey report. METHODS: The data for this study was taken from the Ethiopian Demographic and Health Survey, which was conducted from January to June 2016 and covered all administrative regions. STATA version 16 was used to analyze a total of 4,712 (with a weighted frequency of 4,771.49) women. A multilevel mixed-effects logistic, and multilevel mixed-effect negative binomial regressions were fitted, respectively. Adjusted odds ratio (AOR) and Incidence rate ratio (IRR) with their corresponding 95% confidence interval (CI) were used to report significant determinants. RESULTS: More than half, 56.02% [95% CI: 54.58, 57.41] of women received at least one birth preparedness and complication readiness message. Being in the richest wealth quintiles (AOR = 2.33; 95% CI: 1.43, 3.73), having two birth/s in the last five years (AOR = 1.54; 95% CI: 1.13, 2.10), receiving four or more antenatal visits(AOR = 3.33; 95% CI: 2.49, 4.45), and reading a newspaper at least once a week (AOR = 1.27; 95% CI: 1.07, 1.65) were the individual­level factors, whereas regions and residence(AOR = 1.54; 95% CI: 1.11, 1.96) were the community-level factors associated with the uptake of at least one BPCR message. On the other hand, receiving four or more antenatal visits (IRR = 2.78; 95% CI: 2.09, 3.71), getting permission to go to a health facility (IRR = 1.29; 95% CI: 1.028, 1.38), and not covered by health insurance schemes (IRR = 0.76; 95% CI: 0.68, 0.95) were identified as significant predictors of receiving key birth preparedness and complication readiness messages. CONCLUSION: The overall uptake of the WHO-recommended birth readiness and complication readiness message and compliance with each message in Ethiopia was found to be low. Managers and healthcare providers in the health sector must work to increase the number of antenatal visits. Policymakers should prioritize the implementation of activities and interventions that increase women's autonomy in decision-making, job opportunity, and economic capability to enhance their health-seeking behavior. The local administrative bodies should also work to enhance household enrollment in health insurance schemes.

Preconception care in sub-Saharan Africa: A systematic review and meta-analysis on the prevalence and its correlation with knowledge level among women in the reproductive age group.

Objective: Preconception care is aimed to promote optimal health in women before conception to reduce or prevent poor pregnancy outcomes. Although there are several published primary studies from sub-Saharan African countries on preconception care, they need to quantify the extent of preconception care utilization, the knowledge level about preconception care, and the association among women in the reproductive age group in this region. This systematic review and meta-analysis aimed to estimate the pooled utilization of preconception care, pooled knowledge level about preconception care, and their association among women in the reproductive age group in sub-Saharan Africa. Methods: Databases including PubMed, Science Direct, Hinari, Google Scholar, and Cochrane library were systematically searched for relevant literature. Additionally, the references of included articles were checked for additional possible sources. The Cochrane Q test statistics and I 2 tests were used to assess the heterogeneity of the included studies. A random-effect meta-analysis model was used to estimate the pooled prevalence of preconception care, knowledge level of preconception care, and their correlation among reproductive-aged women in sub-Saharan African countries. Results: Of the identified 1593 articles, 20 studies were included in the final analysis. The pooled utilization of preconception care and good knowledge level about preconception care among women of reproductive age were found to be 24.05% (95% confidence interval: 16.61, 31.49) and 33.27% (95% confidence interval: 24.78, 41.77), respectively. Women in the reproductive age group with good knowledge levels were greater than two times more likely to utilize the preconception care than the women with poor knowledge levels in sub-Saharan African countries (odds ratio: 2.35, 95% confidence interval: 1.16, 4.76). Conclusion: In sub-Saharan African countries, the utilization of preconception care and knowledge toward preconception care were low. Additionally, the current meta-analysis found good knowledge level to be significantly associated with the utilization of preconception care among women of reproductive age. These findings indicate that it is imperative to launch programs to improve the knowledge level about preconception care utilization among women in the reproductive age group in sub-Saharan African countries.

The prevalence of respectful maternity care during childbirth and its determinants in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Respectful maternity care is the provision of woman-centered health care during childbirth that is friendly, abuse-free, timely, and discrimination-free. Although several epidemiological studies on the magnitude and determinants of Respectful maternity care in Ethiopia have been conducted, the results have been inconsistent and varied. This makes drawing equivocal conclusions and evidence at the national level harder. Hence, this systematic review and meta-analysis aimed at estimating the pooled prevalence of respectful maternity care and its determinants in Ethiopia. METHODS: Studies conducted from 2013 to June 30, 2022, were searched by using PubMed, Google Scholar, Science Direct, Scopus, ProQuest, Web of Science, Cochrane Library, and Direct of Open Access Journals. Searching was carried out from May 15- June 30, 2022. In total, sixteen studies were considered in the final analysis. The data were extracted using Microsoft Excel and analyzed using STATA 16 software. The methodological quality of included studies was assessed by using Joanna Briggs Institute's critical appraisal checklist for prevalence studies. To estimate the pooled national prevalence of respectful maternity care, a random effect model with a DerSimonian Laird method was used. To assess the heterogeneity of the included studies, the Cochrane Q test statistics and I2 tests were used. To detect the presence of publication bias, a funnel plot and Begg's and Egger's tests were used. RESULTS: Sixteen studies were eligible for this systematic review and meta-analysis with a total of 6354 study participants. The overall pooled prevalence of respectful maternity care in Ethiopia was 48.44% (95% CI: 39.02-57.87). Receiving service by CRC-trained health care providers [AOR: 4.09, 95% CI: 1.73, 6.44], having ANC visits [AOR: 2.34, 95% CI: 1.62, 3.06], planning status of the pregnancy [AOR = 4.43, 95% CI: 2.74, 6.12], giving birth during the daytime [AOR: 2.61, 95% CI: 1.92, 3.31], and experiencing an obstetric complication[AOR: 0.46, 95% CI: 0.30, 0.61] were identified as determinants of RMC. CONCLUSION: As per this meta-analysis, the prevalence of respectful maternity care in Ethiopia was low. Managers in the health sector should give due emphasis to the provision of Compassionate, Respectful, and Care(CRC) training for healthcare providers, who work at maternity service delivery points. Stakeholders need to work to increase the uptake of prenatal care to improve client-provider relationships across a continuum of care. Human resource managers should assign an adequate number of health care providers to the night-shift duties to reduce the workload on obstetric providers.

Menstrual abnormality, maternal illiteracy, and household factors as main predictors of anemia among adolescent girls in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: Adolescent girls are more likely to develop anemia as a result of physical and physiological changes that place a greater strain on their nutritional needs. Primary studies, on the other hand, may not be sufficient to provide a complete picture of anemia in adolescent girls and its major risk factors. OBJECTIVE: The study aimed to describe the pooled prevalence of adolescent girls' anemia and the factors that contribute. METHODS: We conducted a systematic review of observational studies using the databases CINAHL (EBSCO), PubMed, Science Direct, Cochrane Library, and Google Scholar. The Newcastle-Ottawa Scale was used to assess the quality of the articles, and studies of fair to good quality were included. We pooled anemia prevalence among adolescents and odds ratio estimates for risk factors. Subgroup analysis employing sample size and study setup was computed to determine the source of heterogeneity, and the I2 test was used to identify the existence or absence of substantial heterogeneity during subgroup analysis. The pooled prevalence of adolescent girls' anemia was calculated using a random-effects meta-analysis model. RESULTS: The overall pooled prevalence of anemia among adolescent girls in Ethiopia was 23.03% (95% confidence interval: 17.07, 28.98). Low dietary diversity (odds ratio: 1.56; 95% confidence interval: 1.05, 2.32), illiterate mothers (odds ratio: 1.45; 95% confidence interval: 1.13, 1.86), household size greater than five (odds ratio: 1.65; 95% confidence interval: 1.14, 2.38), food-insecure households (odds ratio: 1.48; 95% confidence interval: 1.21, 1.82), and menstrual blood flow more than 5 days (odds ratio: 6.21; 95% confidence interval: 1.67, 23.12) were the identified factors associated with anemia among adolescent girls. CONCLUSION: The pooled prevalence of anemia among adolescent girls in Ethiopia was moderately high. Therefore, to combat the burden of anemia among adolescent girls offering nutritional education is crucial. Iron supplementation is also recommended for adolescent females who have a menstrual cycle that lasts longer than 5 days.

Water treatment at the point-of-use and treatment preferences among households in Ethiopia: A contemporaneous systematic review and meta-analysis.

BACKGROUND: Water is essential for maintaining human life, health, and dignity. Untreated water consumption causes 1.8 million deaths annually, over 99.8% of which happen in developing nations and 90% of which include children. Point-of-use water treatment enables people without reliable access to safe drinking water to reduce contamination and minimize microbial risk levels. This Systematic Review and Meta-analysis was, therefore, used to identify, select, and critically appraise relevant evidence about water treatment practices and their associated factors among Ethiopian households. METHODS: PubMed, Science Direct, Web of Science, Scopus, Embase, Google Scholar, ProQuest, and other databases were searched for studies published before May 5, 2022. The final synthesis included twelve investigations. Microsoft Excel was used to extract the data, and STATA 16 was used for the analysis. The Joanna Briggs Institute's Critical assessment checklist for prevalence studies was used to evaluate the quality of the included studies. Egger's test and funnel plot were used to assess publication bias. I2 statistics were calculated to check for study heterogeneity. The DerSimonian and Laird random-effects model was used to analyze the pooled effect size, odds ratios, and 95% confidence intervals across studies. Analysis of subgroups was done by publication year and geographic region. RESULTS: Of the 550 identified articles, 12 studies were eligible for analysis (n = 4849 participants). The pooled prevalence estimate of point-of-use water treatment practice among Ethiopian homes was 36.07% (95% CI: 21.94-50.19, I2 = 99.5%). Receiving training from Community health workers (OR, 1.7; 95% CI: 1.33-2.08), female headship (OR, 2.52; 95% CI: 1.60-3.44), and household wealth (OR, 1.6; 95% CI: 1.19-2.16) were significantly associated with point-of-use water treatment practice. CONCLUSION: Despite the absence of safely managed water sources, very few homes routinely treated their drinking water. Adoption of water treatment practices necessitates ongoing communication and assistance from health extension personnel. Moreover, program planners must be aware of the many user categories that households may fall under to guarantee that ongoing training messages and treatment products reach every home.

Intestinal Parasitosis and Associated Factors Among Food Handlers Working in the University of Southern Ethiopia.

Background: Intestinal parasite infections are major global public health problems. The majority of persons infected reside in Sub-Saharan Africa with a high burden of the disease. Very few studies have been done in Ethiopia and none exist at Wachemo University, Southern Ethiopia. The present study aimed to investigate intestinal parasitic infections and associated factors among Wachemo University students' cafeteria food handlers. Methods: Institution-based cross-sectional study was conducted on 212 randomly selected food handlers from 15, February to 05, March/2019. A structured questionnaire was used to collect data and standard laboratory procedures were employed to collect stool and finger specimens and analyzed them for intestinal parasites. Data were edited, cleaned, entered, using EPI data 3.3.1, and analyzed by statistical package for social science version 20. A stepwise logistic regression model was used to calculate the odds ratios and 95% confidence interval for the different factors. Results: Of 212, the majority 63.7% were females and 48.1% attended grades 9 to 10. Of the stool and fingernail specimens examined, 29.7 % and 5.6% were positive for different parasites, respectively. The most prevalent parasite is Ascaris lumbricoides (12.7%) followed by Hookworm (6.6%), Giardia lamblia (4.7%), Taenia saginata (2.4%), and mixed infection (3.3%). Although several factors showed significant association with intestinal parasitosis, attending secondary level education 94.5% (AOR: 0.055; 95% CI [0.007-0.413]), fingernail status (AOR: 0.330; 95% CI [0.113-0.965]), and hand washing with soap and water after toilet use (AOR: 0.332; 95% CI [0.125-0.884]) were the significant variables in multivariable analysis (P < .05). Conclusions: The results demonstrated intestinal parasite infections as a public health issue in Ethiopia that requires attention. Appropriate intervention programs like encouraging food handlers to practice good hygiene, routine hand washing at key times, and nail trimming should be implemented.

Towards universal health coverage: The level and determinants of enrollment in the Community-Based Health Insurance (CBHI) scheme in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Community-based health insurance (CBHI) is a risk-pooling approach that tries to disperse health expenditures across families with varying health profiles to provide greater access to healthcare services by allowing cross-subsidies from wealthy to poor populations. It is crucial to assess the level of CBHI enrolment and its determinants in Ethiopia, where government health spending is limited to less than 5% of GDP, far below the Alma Ata Declaration's benchmark of 15%. Although various epidemiological studies on CBHI enrolment status and its determinants have been undertaken in Ethiopia, the results have been inconsistent, with significant variability. However, no nationwide study assessing the pooled estimates exists today. Furthermore, the estimated strength of association at the country level varied and was inconsistent across studies. Hence, this systematic review and meta-analysis aimed at estimating the pooled prevalence of CBHI enrolment and its determinants in Ethiopia. METHODS: A comprehensive search of studies was done by using PubMed, EMBASE, Science Direct, HINARI, Scopus, Web of Science, and the Cochrane Library. The database search was complemented by google scholar and some repositories for grey literature. The search was carried out from February 11 to March 12, 2022. The relevant data were extracted using a Microsoft Excel 2013 spreadsheet and analyzed using STATATM Version 16. Studies reporting the level and determinants of CBHI enrolment in Ethiopia were considered. A weighted DerSimonian Laired random effect model was applied to estimate the pooled national prevalence of CBHI enrolment. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A funnel plot, Begg's and Egger's tests, were used to check for the presence of publication bias. RESULTS: Fifteen studies were eligible for this systematic review and meta-analysis with a total of 8418 study participants. The overall pooled prevalence of CBHI enrolment in Ethiopia was 45.5% (95% CI: 32.19, 58.50). Affordability of premium for the scheme[OR = 2.58, 95% CI 1.68, 3.47], knowledge of respondents on the CBHI scheme[OR = 4.35, 95% CI 2.69, 6.01], perceived quality of service[OR = 3.21, 95% CI 2.04, 4.38], trust in the scheme[OR = 2.32, 95% CI 1.57, 3.07], and the presence of a person with a chronic disease in the household [OR = 3.58, 95% CI 2.37, 4.78] were all found to influence CBHI enrolment. CONCLUSION: Community health workers (CHWs) need to make a high effort to improve knowledge of CBHI in rural communities by providing health education. To deal with the issue of affordability, due emphasis should be placed on building local solidarity groups and strengthening local initiatives to aid poor members. Stakeholders in the health service delivery points need to focus on the dimensions of high service quality. The financial gap created by the adverse selection of households with chronically ill members should be rectified by implementing targeted subsidies with robust plans.