Appropriate Complementary Feeding Practice and Its Associated Factors among Mothers Who Have Children Aged between 6 and 24 Months in Ethiopia: Systematic Review and Meta-Analysis.

Background: Appropriate complementary feeding practices prevent malnutrition among children. The proportion and determinant factors of appropriate complementary feeding practices identified by different studies were inconsistent in Ethiopia. Therefore, this systematic review and meta-analysis aimed to assess the pooled proportion and determinants of appropriate complementary feeding practices among mothers. Methods: Databases (PubMed, HINARI, Google Scholar, Cochrane Library, and Web of Science) and university repositories were used to search for important articles. A critical appraisal of the studies was conducted. Data analysis was conducted using STATA version 11. Cochran (Q test) and I2 test were used to test the heterogeneity of the studies. Publication bias was checked using the funnel plot for asymmetry and Egger's regression test. Results: Seventeen primary studies with a total sample size of 9166 mothers were involved in this study. The pooled proportion of appropriate complementary feeding practices among mothers who had infants and young children aged between 6 and 24 months was 21.77 (with a 95% CI: 14.07-29.48). Mothers' educational status of secondary school and above (OR = 3.36 with a 95% CI: 3.03-3.69), having repeated antenatal care visits (OR = 4.77 with a 95% CI: 3.49-6.05), child's age between 12 and 24 months (OR = 3.7 with a 95% CI: 2.75-4.65), having repeated postnatal care visits (OR = 3.17 with a 95% CI: 1.96-4.38), health education (OR = 4.88 with a 95% CI: 3.86-5.9), knowledge of mothers (OR = 4.85 with a 95% CI: 3.77-5.93), maternal age between 18 and 35 years (AOR = 2.67 with a 95% CI: 1.64-3.72), institutional delivery (OR = 2.23 with a 95% CI: 1.79-2.68), and higher household wealth (OR = 2.65 with a 95% CI: 1.46-3.84) were found to be statistically significant associated factors of appropriate complementary feeding practices among mothers. Conclusions: The pooled proportion of appropriate complementary feeding practices was low in Ethiopia. Knowledge of mothers and maternal health service uptake such as antenatal care, postnatal care, and institutional delivery increase appropriate complementary feeding practices. More focus is required for mothers who have children aged less than 12 months, mothers aged above 35 years and less than 18 years, lower mothers' educational status, and lower household wealth. Therefore, integrated interventions are still required to improve appropriate complementary feeding practices.

Importance of male partner's involvement in prevention of mother to child transmission of HIV/AIDS in Ethiopia: a systematic review and meta analysis until June 2021.

BACKGROUND: To promote the prevention of mother-to-child transmission (PMTCT) of HIV/AIDS male partners play a significant role, especially in developing country were men's are a decision maker in domestic activity. When men are involved in PMTCT it would boost the service utilization and uptake of ART drugs. Thus this systematic review and Meta analysis aims to assess importance of male partner involvement in prevention of mother to child transmission of HIV/AIDS in Ethiopia. METHODS: Studies were accessed through an electronic web-based search mechanism from PubMed, Advanced Google Scholar, WHO databases and journals (African Health Monitor, Pan African Journal of Public Health), using independent and combinations of key terms together with a reference list of included studies. Two reviewers independently screened and assessed the quality of studies based on pre-specified criteria. When a disagreement between the two reviewers happened; the third reviewer was invited and resolve it based on the stated objectives and inclusion criteria. Measures of effects were pooled and random effect meta analysis was conducted. RESULTS: Ten studies met the inclusion criteria. The pooled prevalence of male involvement in PMTCT was 31.8% (95% CI; 22.3-41.3 I2 = 98.4%, p = 0.00). being urban residence(AOR = 2.43 95%CI;1.42-4.18), partner knowledge (AOR = 2.84 95%CI;1.90-4.22), knowledge on Antenatal care(AOR = 3.5 95%CI;1.80-6.76), partners who had no negative perception towards for PMTCT (AOR = 3.21 95%CI;2.18-4.72), government employee(AOR = 2.57 95%CI;1.76-3.75), partners informed of need to go for PMTCT(AOR = 3.83 95%CI;1.88-7.79), health institution related barriers(AOR = 2.6 95%CI;1.882-3.622), primary (AOR = 2.21 95%CI;1.29-3.80), and secondary education(AOR = 2.67 95%CI;1.69-4.19) were significant factors related with male partner involvement in prevention of mother to child transmission of HIV/AIDS. CONCLUSION: The proportion of male involvement in the Prevention of mother-to-child transmission of HIV in Ethiopia was low. Interventions aimed at improving male participation in the Prevention of mother-to-child transmission should consider the factors related to it. Healthcare services may need to be inclusive and could help men active engagement in PMTCT programs.

Postpartum haemorrhage and associated factors among mothers who gave birth in South Gondar Zone public health facilities, Ethiopia: a cross-sectional study.

BACKGROUND: Postpartum haemorrhage is one of the direct and the leading causes of maternal morbidity and mortality. There are many risk factors of postpartum haemorrhage, which vary in different settings. Therefore, the purpose of this study was to assess postpartum haemorrhage and associated factors among mothers who gave birth in public health facilities. METHODS: A cross-sectional study was employed from 17 November 2019 to 15 February 2020. The study participants were selected using a systematic sampling technique. The data were entered and cleaned using EpiData V.3.1 then exported to SPSS V.20 for analysis. Factors associated with postpartum haemorrhage were selected for multiple logistic regression at the probability value (p value) of less than 0.2 in the χ2 analysis. Statistically significant associated factors were identified at probability value (p value) less than 0.05 and adjusted OR (AOR) with a 95% CI. RESULTS: The mean age of participants was 31.3 (SD ±5.7) years. This study found that the prevalence of postpartum haemorrhage was 13.6% (67). Age of participants (AOR 12.5, 95% CI 4.0 to 38.6), disrespectful maternity care (AOR 8.4, 95% CI 3.2 to 22.0), labour induction and augmentation (AOR 6.97, 95% CI 2.34 to 20.8), the prolonged second stage of labour (AOR 9.9, 95% CI 2.6 to 37.1) and no antenatal care visit (AOR 10.1, 95% CI 3.4 to 29.7) were statistically significant associated factors of postpartum haemorrhage. CONCLUSIONS: The prevalence of postpartum haemorrhage is high. The age of the participants, disrespectful maternity care, labour induction and augmentation, the prolonged second stage of labour and no antenatal care visit were independent predictors of postpartum haemorrhage.

Implementation of evidence-based practice: The experience of nurses and midwives.

BACKGROUND: Implementation of evidence-based practice in clinical practice is crucial. Nurses and midwives play a vital role in using updated evidence. However, limited support and barriers to implementing evidence-based practice hamper the use of up-to-date evidence in clinical decision-making practice. Therefore, this study aimed to explore the implementation of evidence-based practice of nurses and midwives working in public hospitals. METHODS: A qualitative descriptive study was conducted to explore the experience of implementing evidence-based practice among nurses and midwives working in public hospitals. A total of 86 participants, of which, 25 in-depth interviews, 5 FGDs having 47 participants and 14 participants were involved during observations, were considered in Amhara Region public hospitals from November 17, 2019 to April 25, 2020. The observational data, interview and FGD transcripts were imported into NVivo 12 plus to manage and analyze the data using the Computer-Assisted Data Analysis Software Program (CAQDAS). The data were analyzed through thematic content analysis. RESULTS: Nurses and midwives perceived that implementation of evidence-based practice is the use of research findings, guidelines, hospital protocols, books, and expert experience in clinical decision-making practice. However, there was limited support for the implementation of evidence-based practice by nurses and midwives. The lack of knowledge and skill to use evidence like research findings, time mismanagement, the lack of motivation, the lack of resources and training were the perceived barriers to the implementation of evidence-based practice. Stick to the traditional practice due to lack of incentive and unclear job description between diploma and BSc nurses and midwives were the perceived causes of the lack of motivation. CONCLUSIONS: The experience of evidence-based practice of nurses and midwives indicated that there was limited support for the implementation of evidence-based practice. However, research findings were rarely used in clinical decision-making practice The Knowledge, attitude towards implementing evidence-based practice, lack of resources and training, time mismanagement and lack of motivation were the barriers to the implementation of evidence-based practice. Therefore, the promotion of adopting the implementation of evidence-based practice and training on the identified barriers are mandatory.

Women's Satisfaction and Its Associated Factors with Antenatal Care Services at Public Health Facilities: A Cross-Sectional Study.

BACKGROUND: Regular monitoring and evaluation improves the quality of health services. Client satisfaction is an indicator of the quality of a health service. Poor maternal satisfaction with antenatal care services has negative outcomes. Currently, women's satisfaction with antenatal care services is below standard in low-income countries such as Ethiopia. Therefore, this study aimed to assess women's satisfaction and its associated factors with antenatal care services. METHODS: A facility-based cross-sectional study was conducted from September 23 to October 23, 2019. A total of 405 women were involved in the study. A systematic random sampling technique was used. The data were coded manually and checked visually for completeness. The data were entered using Epi Info version 7 and exported to SPSS version 20 for analysis. Descriptive statistic was computed. Thechi-squared test was performed and factors associated with women's satisfaction with antenatal care services were selected for multiple logistic regression at a probability value (p-value) of <0.2 in the chi-squared analysis. Statistically significant associated factors were identified at a p-value of ≤0.05, and with adjusted odds ratios and 95% confidence intervals. RESULTS: Among 405 participants, 53.8% (95% CI=48.7-59%) of women were satisfied with the antenatal care services. Age of mothers (AOR=6.04, 95% CI=2.3-15.9), advice on danger signs in pregnancy (AOR=4.53, 95% CI=2.7-7.52), previous antenatal care visits (AOR=3.8, 95% CI=2.0-7.52), respectful maternity care (AOR=8.2, 95% CI=3.3-20.4), and planned pregnancy (AOR=2.8, 95% CI=1.6-4.8) were statistically significantly associated with women's satisfaction with antenatal care services. CONCLUSION: About half of the participants were satisfied with the antenatal care services. Age of participants, respectful maternity care, advice on danger signs in pregnancy, previous antenatal care visits, and planned pregnancy were found to be predictors of women's satisfaction with antenatal care services.

Research utilisation in clinical practice: the experience of nurses and midwives working in public hospitals.

BACKGROUND: Nurses and midwives play a vital role to utilise research in clinical decision-making practice. However, limited support for research utilisation and barriers of research utilisation hamper to utilise up-to-date research findings in clinical practice. Therefore, this study aimed to explore nurses' and midwives' experience of research utilisation in public hospitals. METHODS: A qualitative descriptive approach was conducted to explore nurses' and midwives' experience of research utilisation in clinical practice within South Gondar Zone public hospitals from January 3 to June 28, 2020. A total of 20 interviewees, 40 participants of FGDs, and 8 observations were considered in the study. Data from the interview, FGD, and observation were imported into NVivo 12 plus to manage and analyze the data using the Computer-Assisted Data Analysis Software Program (CAQDAS). The data were analyzed through thematic content analysis. RESULTS: Nurses' and midwives' experience of using research findings in clinical decision-making emerged as "the non-intentional research utilisation" the main theme. Data analysis produced as "the belief towards research utilisation", "the limited support for nurses and midwives", and, "the perceived barriers of research utilisation" as the three themes. Participants believed that the non-use of the primary research was recommended due to fear of accountability for client harm. The limited support for nurses' and midwives' experience of research utilisation decrease nurses' and midwives' confidence to utilise research in clinical practice. Knowledge, attitude, time mismanagement, and the lack of motivation were perceived barriers to research utilisation. The lack of training and access to systematic review and meta-analysis research findings limited the research utilisation in clinical practice. CONCLUSIONS: The experience of research utilisation indicated that there was limited support for nurses and midwives to utilise research. Nurses and midwives did not utilise research in their clinical practice intentionally. This study identified that knowledge, negative attitude towards research utilisation, lack of training; time mismanagement, and lack of motivation were the perceived barriers to research utilisation. Therefore, the promotion of adopting the research utilisation and training on the identified barriers are mandatory. Nurses and midwives play a vital role to utilise research in clinical decision-making practice. However, the limited support for research utilisation and barriers of research utilisation hamper the utilisation of up-to-date research in clinical practice. Therefore, this study aimed to explore nurses' and midwives' experience of using the knowledge obtained from research findings in clinical and healthcare decision-making practice within public hospitals. The experience of research utilisation among nurses and midwives working in public hospitals was studied. There was limited support for nurses' and midwives' experience of research utilisation. Nurses and midwives did not utilise research in their clinical practice intentionally. The knowledge, negative attitude towards research utilisation, lack of training, time mismanagement, and lack of motivation were the perceived barriers to research utilisation. Therefore, the promotion of adopting the research utilisation and training on the identified barriers are mandatory.

Implementation of evidence-based practice and associated factors among nurses and midwives working in Amhara Region government hospitals: a cross-sectional study.

BACKGROUND: Implementation of evidence-based practice is crucial to enhance quality health care, professional development, and cost-effective health service. However, many factors influence the implementation of evidence-based practice. Therefore, this study aimed to assess the implementation of evidence-based practice and associated factors among nurses and midwives. METHODS: Institutional-based cross-sectional study design was conducted to assess the implementation of evidence-based practice and associated factors from February 15 to March 15, 2019, among 790 nurses and midwives. Data were entered into EpiData version 3.1 then exported to SPSS version 20 for statistical analysis. Categorical variables were presented as frequency tables. Continuous variables were presented as descriptive measures, expressed as mean and standard deviation. Cronbach's alpha was used to measure reliability, mean, standard deviation, and inter-items correlation of the factors. Independent variables with a probability value (P-value) of less than 0.2 in the Chi-square analysis were entered in the multivariable logistic regression model. Statistically significant associated factors were identified at probability value (P-value) less than 0.05 and adjusted odds ratio with a 95% confidence interval. RESULTS: The mean age of participants was 28.35 (SD ± 4.5) years. This study revealed that 34.7% (95% CI 31.5-38%) of participants implemented evidence-based practice moderately or desirably. Age of participants (AOR = 5.98, CI 1.34-26.7), barriers of implementation of evidence-based practice (AOR = 4.8, CI 2.2-10.6), the attitude of participants (AOR = 5.02, CI 1.2-21.5), nursing/midwifery work index (AOR = 3.9, CI 1.4-10.87), self-efficacy of implementation of evidence-based practice skills (AOR = 12.5, CI 5.7-27.5) and knowledge of participants (AOR = 3.06, CI 1.6-5.77) were statistically significant associated factors of implementation of evidence-based practice CONCUSSION: Implementation of evidence-based practice of nurses and midwives was poor. Age of participants, barriers of implementation of evidence-based practice, the attitude of participants, self-efficacy of implementation of evidence-based practice skills, nursing/midwifery work index, and knowledge of participants were found to be predictors of implementation of evidence-based practice. Insufficient time and difficulty in judging the quality of research papers and reports were the most common barriers to the implementation of evidence-based practice.

Factors affecting research utilisation of nurses and midwives working in North Gondar and West Gojjam Zone public hospitals, Ethiopia: a cross-sectional study.

BACKGROUND: Research utilisation in clinical decision-making is crucial to enhance quality healthcare, professional development and cost-effective health service. Nurses and midwives have a vital role in research utilisation. However, many factors influence research utilisation of nurses and midwives. OBJECTIVES: To determine research utilisation and identify factors that affect research utilisation among nurses and midwives. METHODS: An institutional-based, cross-sectional study was conducted from 23 May to 30 June 2019. A total of 631 nurses and midwives participated in the study. Categorical variables were coded with dummy variables and multiple linear regression model was carried out. The level of significance was set at p value less than or equal to 0.05 with 95% CI. RESULTS: Participants' total mean score in the research utilisation scale was 2.27 (SD±0.77) and their mean age was 28.41 (SD±4.71) years. The study revealed that 70.4% (444) of participants had poor research utilisation. Self-efficacy in research utilisation skills (B=0.86, 95% CI 0.75 to 0.97), support for research utilisation (B=0.4, 95% CI 0.25 to 0.55), attitude (B=0.23, 95% CI 0.07 to 0.38), barriers to research utilisation (B=-0.63, 95% CI -0.72 to -0.54), nursing/midwifery work index (B=0.07, 95% CI 0.04 to 0.11) and hospital's level of healthcare (B=4.5, 95% CI 2.13 to 6.9) were statistically significantly associated factors of research utilisation. CONCLUSIONS: This study revealed poor research utilisation among nurses and midwives. Barriers to research utilisation, supporting factors for research utilisation, attitude, self-efficacy in research utilisation skills, hospital's level of healthcare and nursing/midwifery work index were found to be statistically significant predictors of research utilisation. The most common barriers to research utilisation were insufficient time and inability to understand statistical terms used in research articles.

Assessment of breast self- examination practice and associated factors among female workers in Debre Tabor Town public health facilities, North West Ethiopia, 2018: Cross- sectional study.

BACKGROUND: Although breast Self-Examination is no longer tenable as a standard method to detect early breast cancer, world health organization recommends breast self -examination for raising awareness of women about breast cancer. Secondary prevention through monthly breast self-examination is the best option to tackle the rising incidence of breast cancer. Therefore, the aim of this study was to assess breast self -examination practice and associated factors. METHODS: This cross-sectional study was conducted from April 23 to May 23, 2018. A total of 421 female workers in Debre Tabor Town public health facilities were included. The study participants were selected using simple random sampling technique from the study population. The collected data were checked for completeness. The data were entered and cleaned using EpiData version 3.1 then exported to SPSS version 20 for analysis. Crude odd ratio and probability value were identified for each independent variable and all independent variables with probability value of less than 0.2 were entered into multivariables logistic regression. Statistically significant associated factors were identified based on probability value (p-value) less than 0.05 and adjusted odd ratio with 95% confidence interval. RESULT: The mean age of participants was 25.2 (S.D = 4.12) and 137 (32.5%) of the participants had practiced breast self -examination and 64 (15.2%) of them performed it monthly. Family history of breast cancer (adjusted OR = 6.5, CI = 1.54-21.4), Knowledge about breast -self examination (adjusted OR = 5.74, CI = 2.3-14.4) and self- efficacy in practicing breast self -examination (adjusted OR = 4.7, CI = 1.84-12.11) were significantly associated with breast self -examination practice. CONCLUSIONS: The study showed that the prevalence of breast self-examination was low. Family history of breast cancer, knowledge about breast self -examination and self- efficacy in practicing breast self- examination did have statistically significant association with breast self-examination practice.

Appropriate complementary feeding practice and associated factors among mothers having children aged 6-24 months in Debre Tabor Hospital, North West Ethiopia, 2016.

OBJECTIVE: This study was aimed to assess appropriate complementary feeding practice and associated factors among mothers having children aged 6-24 months in Debre Tabor Hospital, North West Ethiopia, 2016. RESULTS: In this study, 37.2% of mothers had appropriate complementary feeding practice. Mothers' level of education above grade 12 (AOR = 2.96, CI 1.2-7.62), husbands' occupation (AOR = 4.01, CI 1.3-12.44), mothers 'having exclusive breast feeding practice (AOR = 6.12, CI 3.04-12.3), health education about exclusive breast feeding during antenatal care visit (AOR = 5.59, CI 1.24-25.17) and advice on appropriate complementary feeding practice during antenatal care visit (AOR = 6.34, CI 1.5-26.91), and mothers who have got under 5 unit service due to infant and young children illness (AOR = 0.44, CI 0.22-0.89) were statistically significant variables for appropriate complementary feeding practice.