Factors affecting birth interval among mothers in Dabat district, Amhara Regional state, Northwest Ethiopia: A community-based cross-sectional study, 2022.

Introduction: Birth interval is the time period from live birth to a successive pregnancy or successive live birth which is the recommended to be at least 2 years or at least 33 months respectively. Both short and long birth intervals are associated with poor health outcomes for both mothers and babies. Therefore, the main objective of this study is to assess the length of birth intervals and its predictors among reproductive-age women in Dabat district.Methods: community-based cross-sectional survey conducted from December 10/2020 to January 10/2021. This study was done on 1262 multi para women. Five days training was given for the data collectors and supervisors. Bivariable and multivariable ordinal logistic regression analysis were done. Those variables which had P-value less than 0.25 in the bi variable analysis were entered to multivariable ordinal logistic regression analysis. An adjusted odds ratio with a 95% confidence interval and P-value less than 0.05 was used to determine significant determinants of birth interval. Result: This study revealed that the magnitude of short and long birth interval was 30.59% and 22.82% respectively. Wealth status (poor: AOR = 0.72, CI: 0.53, 0.97), maternal education (Diploma and above: AOR = 2.79, CI: 1.18, 6.56), ANC follow up (having ante natal care: AOR = 2.15, CI: 1.72, 2.69), husband occupation (Employed: AOR = 1.77, CI: 1.03, 3.01) and history of abortion (abortion: AOR = 2.48, CI: 1.08, 5.66) were statistically significant factors. Conclusion: Higher percentage of mothers have either short or long birth interval. Birth interval is affected by socio demographic characteristics of mothers and husbands.

Magnitude of unmet need for family planning and associated factors among women in the extended postpartum period in Dabat district, Northwest Ethiopia. evidence from Dabat demographic health surveys.

BACKGROUND: Due to additional roles and emotional changes that occur during postpartum period, women use contraceptives differs from other times in their life. However, there is limited information about the unmet need for family planning (FP) among women in the extended postpartum period in the study area. Therefore, this study aimed to assess magnitude of unmet need for family planning and associated factors among women in the extended postpartum period in Dabat district, Northwest Ethiopia. METHODS: A secondary data analysis was performed using the Dabat Demographic and Health Survey 2021. A total sample of 634 women during the extended postpartum period was included in this study. Stata version 14 statistical software was used for data analysis. Descriptive statistics were described using frequencies, percentages, mean, and standard deviation. Multicollinearity was tested using the variance inflation factor (VIF) and we computed Hosmer and Lemeshow goodness of fit. Both bivariable and multivariable logistic regression analyses were carried out to determine the association between independent variables and outcome variable. Statistical significance was declared at a p-value ≤ 0.05 with a corresponding 95% confidence interval. RESULTS: The overall unmet need for FP during the extended postpartum women was 42.43% (95% CI: 38.62, 46.33), of which 33.44% was unmet need for spacing. Place of residence (AOR = 2.63, 95%CI: 1.61, 4.33), place of delivery (AOR = 2.09, 95%CI: 1.35, 3.24), and availability of radio and or TV (AOR = 1.58, 95% CI: 1.22, 2.13) were significantly associated with unmet need for family planning. CONCLUSION: The magnitude of unmet need for family planning among women during the extended postpartum period in the study area was high when compared to the national average and the United Nations sphere standard of unmet need for family planning. Place of residence, place of delivery, and availability of radio and or TV were significantly associated with unmet need for family planning. Hence, the concerned bodies are recommended to promote intuitional delivery and give spatial attention to those who are residing in rural areas and to those who have had no media exposure in order to reduce the unmet need for family planning among postpartum women.

Complete childhood vaccination and associated factors among children aged 12-23 months in Dabat demographic and health survey site, Ethiopia, 2022.

INTRODUCTION: Childhood immunization is one of the most cost-effective public health strategies to prevent children's mortality and morbidity from infectious diseases, but the Covid-19 pandemic and associated disruptions have strained health systems, and worldwide 25 million children missing out on vaccination in 2021. Of the 25 million, more than 60% of these children live in 10 countries including Ethiopia. Therefore, this study aimed to assess complete childhood vaccination coverage and associated factors in the Dabat district. METHOD: A community-based cross-sectional study was conducted from December 10/2020 to January 10/2021Gregorian Calendar. The data for this study was extracted from information collected for the assessment of maternal, Neonatal, and Child Health and health services utilization in the Dabat demographic and health survey site. Vaccine-related data were collected using an interviewer-administered questionnaire. An adjusted odds ratio with a 95% confidence interval was used to identify the presence and the direction of the association. RESULTS: Based on vaccination cards and mothers/caretakers' recall 30.9% (95%CI: 27.9-34.1%) of children aged 12-23 months in the Dabat district were completely immunized. Urban residency [AOR 1.813, 95% CI: (1.143, 2.878)], delivered in the health facility [AOR = 5.925, 95% CI: (3.680, 9.540)], ANC follow-up during their pregnancy [AOR 2.023, 95% CI: (1.352, 3.027)], rich wealth index [AOR = 2.392, 95% CI: (1.296, 4.415)], and parity [AOR 2.737, 95% CI: (1.664, 4.500)] were significantly associated with complete child vaccination. RECOMMENDATION AND CONCLUSION: Complete vaccination coverage among children aged 12-23 months in the Dabat district was lower than the Global vaccine plan and Ethiopian ministry of health goal in 2020. Therefore, Health care providers and other stakeholders should mobilize the community to improve mothers' health-seeking behavior toward pregnancy follow-up and health facility delivery to improve childhood vaccination. Besides, expanding the service to remote areas are necessary to increase the immunization access.

Inadequate receipt of ANC components and associated factors among pregnant women in Northwest Ethiopia, 2020-2021: a community-based cross-sectional study.

BACKGROUND: Women's health and pregnancy outcomes are directly depends on the extent of ANC components received during their ANC visits. There are limited information about the components of ANC and associated factors. Therefore, the aim of this study was to assess the magnitude of inadequate recipient of ANC components and associated factors in northwest Ethiopia. METHODS: This is a community based cross sectional survey conducted in Dabat Demographic and health survey from December 10/2020 to January 10/2021 among women who gave birth within two years before the survey. This study applied a census method to identify and select eligible pregnant women. A structured and pretested questionnaire was used to collect the data. The data was entered into Epi-data version 3.1 and exported to STATA version 14 for analysis purpose. Adjusted Odds Ratio at 95% confidence interval was used to show the association between dependent and independent variables. Statistical significance was declared at a P value less than 0.05. RESULTS: A total of 871 pregnant women were identified from the survey and included in this study. Overall, 96.67% (95% CI: 95.24, 97.67) had not get adequate (all components) ANC. The components of ANC services were increased from 3.35 to 32.34%, 2.52 to 46.33% 1.96 to 55.8%, 2.31 to 46.53%, 3.54 to 55.75%, 2.46 to 44.62%, 1.18 to 45.96%, and 2.45 to 54.6% for tetanus toxoid Vaccine, HIV/AIDS testing and counseling, danger sign, place of delivery, deworming, iron folic acid, family planning, and breast feeding counseling, from first ANC visit to fourth ANC visit, respectively. Rural residence (AOR = 4.89, 95% CI: 1.21, 19.86), and less than four number of ANC visit (AOR = 5.15, 95% CI: 2.06, 12.86) were significantly associated with inadequate uptake of ANC components. CONCLUSION: Only three in hundred pregnant women were received adequate ANC components in the study area. Rural residence and less than four number of ANC visit were factors significantly associated with inadequate ANC uptake. Therefore, the district health department managers and program implementers need to train the health care providers about the components of ANC. As well, increasing community and facility awareness of WHO recommendations on ANC visits focusing on rural women is needed.

Incidence, time to recovery and predictors among neonates admitted with respiratory distress to the neonatal intensive care unit at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2021.

BACKGROUND: One of the major factors contributing to newborn morbidity and mortality across the globe is respiratory distress. In resource-constrained developing nations like Ethiopia, it is a significant issue. Depending on the quality of the care provided, the incidence and time to recovery may differ amongst medical facilities. However, Ethiopia still lacks appropriate data on the incidence and time to recovery from respiratory distress. OBJECTIVE: The aim of the study was to assess the incidence, time to recovery, and predictors among neonates admitted with respiratory distress in the neonatal intensive care unit at the University of Gondar Comprehensive Specialized Hospital. METHODS: An institution-based retrospective follow-up study design was conducted among 452 neonates with respiratory distress. Data were collected using a data extraction checklist from the medical registry. The extracted data were entered into EPI INFO version 7.2.1.0 and then exported to STATA version 14 for analysis. The median time to recovery, the Kaplan Meier curve, and the log-rank test was computed. Both bi-variable and multivariable Cox regression models were applied to analyze the data. p-value ≤ 0.05 was considered statistically significant. RESULTS: Of all respiratory distressed neonate,311 were recovered. The overall incidence rate of neonates admitted with from respiratory distress was 11.5 per 100-neonate day (95% CI: 10.30-12. 87) with 2,703-person day observation and the median time to recovery from respiratory distress was 7 days with (IQR = 3-13 days). Predictors of time to recovery from respiratory distress were very low birth weight (AHR = 0.17, 95% CI: 0.08-0.41), low birth weight (AHR = 0.50, 95% CI: 0.31-0.81), very preterm (AHR = 0.42,95% CI:0.20-0.89), sepsis (AHR = 0.50 95% CI: 0.38-0.65), hypothermia (AHR = 0.61, 95% CI: 0.39-0.81), and Apgar scores less than seven at first (AHR = 0.35, 95% CI: 0.15-0.79) and fifth minute (AHR = 0.45, 95% CI: 0.20-0.97). CONCLUSION: The incidence and time to recovery in this study were discreetly acceptable as compared to previous study. The aforementioned predictors could be used to identify neonates with respiratory distress who are at risk of developing a long-term illness and guide prompt referral to hospitals. This will also provide clinicians with prognostic information, as longer recovery times have economic and social implications in resource limited countries like Ethiopia.

Predictors of time to recovery of preterm neonates with respiratory distress syndrome admitted in University of Gondar comprehensive specialized hospital neonatal intensive care unit North West Ethiopia.

BACKGROUND: Respiratory distress syndrome (RDS) is caused by a deficiency of a molecule called surfactant. It occurs in newborns born before 37 weeks of gestation. It is a main cause of morbidity and mortality in the early neonatal period. Therefore, this study aims to assess median time to recovery and predictors of preterm neonates with respiratory distress syndrome admitted in University of Gondar comprehensive specialized hospital Northwest Ethiopia 2020. METHODS: Institution based retrospective follow up study was conducted on 386 preterm neonates with hyaline membrane disease who were admitted in the neonatal intensive care unit from January, 2016 to December 2018. The data were entered in to EPI info version 7.0 and transferred to Stata version 14.0 for analysis. Both bi-variable and multi variable Weibull parametric model were fitted to identify predictors with 95% confidence interval of hazard ratio (HR) and p-value. P-value less than 0.05 in the multivariable model showed the presence of significant association between covariates and the dependent variable. RESULTS: The overall median length of recovery were 11 day with an interquartile range of (7, 16) neonate-days. Being a product of multiple pregnancy (AHR 1.67; 95%CI (1.25, 2.23)), vaginal mode of delivery (AHR 1.6; 95%CI (1.13, 2.26)), and neonatal hypothermia at admission (AHR 1.6; 95%CI (1.13, 2.26)) were found to be significant predictors of time to recovery. CONCLUSION: In this study the median time to recovery of preterm neonates with respiratory distress syndrome was slower than the clinical recommendations. Receiving bag and mask ventilation and hypothermia decreased the recovery whereas, vaginal delivery gestational age at birth, being multiple pregnancy, birth weight ≥2000grams were enhance the recovery of preterm neonates with RDS.

Prevalence of violence and associated factors among youth in Northwest Ethiopia: Community-based cross-sectional study.

BACKGROUND: Violence as a known serious public health problem affects people in all stages of life, from childhood to the elderly. In society, one of the most visible forms of violence is young people violence, whereas they, adolescents and young adults, are the main victims of such violence. There was limited information on the burden of violence and factors among this age group. Therefore, this study aimed to determine the prevalence of violence and its associated factors among youth in Northwest, Ethiopia. METHODS: A community-based cross-sectional study design was conducted to estimate the magnitude of violence among youth in Northwest, Ethiopia. Data were taken from the mega project entitled assessment of common health problem and risky health behavior among youth. Youth violence was the dependent variable whereas the socio-demographic variables and substance use were the independent-variables. The bivariate logistic regression model was employed to identify associated factors. An adjusted odds ratio with a 95% confidence interval was used to determine factors associated with violence. RESULTS: From the total 1765 representatives of the youth population,1597 (90.5%) youth participated in the study. Overall, the prevalence of violence among youth aged 15-24 years for the last 12 months was 21.5%. In the multivariable logistic regression model, factors significantly associated with violence were being married and divorced (AOR = 1.77, 95%CI: 1.13, 2.79) and (AOR = 5.67, 95%CI: 2.93, 10.99), respectively, living with mother's only (AOR = 1.85,95%CI: 1.28, 2.66) and father's only (AOR = 2.45, 95% CI: 1.30, 4.63), and substance use (AOR = 2.38,95% CI: 1.56, 3.66). CONCLUSIONS: The prevalence of violence among youth was high compared to other studies. Special emphasis Should be given for youth violence in order to manage the victims as well as for preventing and controlling the identified factors through strengthening policies and strategies.

Neonatal mortality and associated factors among neonates admitted to neonatal intensive care unit of Gandhi memorial hospital in Addis Ababa, Ethiopia, 2019.

BACKGROUND: Ethiopia witnessed an unprecedented decline in under-5 and neonatal mortalities since 2000. But, neonatal mortality still accounts for the largest proportion of under-five child mortality. Quality of service at hospitals may vary and determine the magnitude of neonatal mortality. OBJECTIVE: To assess the prevalence and associated factors of neonatal mortality among newborns Admitted to the Neonatal intensive care unit of Gandhi Memorial Hospital Addis Ababa, Ethiopia, 2019. METHODS: Institution-based cross-sectional study was conducted from November 1 to December 31, 2019. A sample of one in every 2 admitted patients was included in the study. our exclusion criterion was neonates who had no mothers or guardians and/or neonatal medical records incomplete for status at discharge. We used the Systematic random sampling technique to select the study participants. A pretested structured interviewer-administered questionnaire and a preliminary tested checklist were used to collect primary and secondary data respectively. Descriptive and summary statistics were performed. A binary logistic regression model was fitted and variables that had a P-value of < 0.05 in the multivariable model were considered statistically significant. RESULTS: A total of 570 neonates who have mothers were involved in the study giving a response rate of 98.8%. The prevalence of neonatal mortality was 7.7% (95% CI: 5.7, 9.8). Mothers' educational status (No education (AOR 3.37, CI 95%, 1.02-11.20), premature rupture of membrane (prolonged PROM) (AOR 5.59, CI 95%, 1.05-29.76), and birth weight less than 2500gm (AOR 3.23, CI 95%, 1.17-8.90) are the significant factors associated with neonatal mortality. CONCLUSION: The prevalence of neonatal mortality at Gandhi memorial hospital was generally high. As our finding revealed, neonates who are underweight and whose mothers have no formal education as well as have prolonged PROM have higher odds of neonatal mortality. Thus, clinicians, policymakers, and program managers should give special attention to neonates of none educated mothers, mothers with prolonged PROM, and neonates with low birth weight.

Prevalence and risk factor for mistreatment in childbirth: In health facilities of Gondar city, Ethiopia.

BACKGROUND: Providing compassionate and respectful maternity care to mothers is a vital intervention to improve health outcomes of women and newborns. However, there is less data of compassionate and respectful maternity care in Gondar city. Therefore, this study aimed to assess the magnitude of mistreatment and associated factors among mothers who gave birth at the public health facilities in Gondar city, northwest Ethiopia. METHODS: Institutional based cross-sectional study was conducted from March to April 2019 in Gondar city public nine health facilities. A total of 584 randomly selected women in the postpartum period were recruited in this study. A binary logistic regression analysis was done to see whether there was an association between mistreatment and independent variables. Finally, the logistic regression analysis was done by stratifying type of parity and mode of delivery. RESULTS: Overall, 73.2% (95% CI: 69.7-76.7%) of the women were mistreated during their childbirth care. Non-consented care was the most commonly experienced form of mistreatment (63.6%, 95% CI: 59.6-67.6%). Having less than four antenatal care follow-up visits (AOR = 3.58, 95% CI: 2.04-6.29), giving birth in the hospital (AOR = 2.83, 95% CI: 1.52-5.27), and facing complications during delivery (AOR = 2.06, 95% CI: 1.52-3.98) were significantly associated with mistreatment among postpartum mothers. CONCLUSIONS: This study showed a lower proportion of mistreatment than other studies in Ethiopia. Having less than four ANC follow up, place of current delivery, and facing complication during delivery were identified as the determinants of mistreatment. Therefore, this calls for strengthening actions, like providing maternity education during antenatal care and appropriate management of complications to improve the quality of maternity care at health facilities, and enhancing hospital working health workers capacity on compassionate and respectful maternity care.

Factors associated with decision-making power of married women to use family planning in sub-Saharan Africa: a multilevel analysis of demographic health surveys.

BACKGROUND: In sub-Saharan Africa, there are several socio-economic and cultural factors which affect women's ability to make decision regarding their own health including the use of contraceptives. Therefore, the main aim of this study was to determine factors associated with decision-making power of married women to use family planning service (contraceptives) in sub-Saharan Africa. METHODS: The appended, most recent demographic and health survey datasets of 35 sub-Saharan countries were used. A total weighted sample of 83,882 women were included in the study. Both bivariable and multivariable multilevel logistic regression were done to determine the associated factors of decision-making power of married women to use family planning service in sub-Saharan countries. The Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated for those potential variables included in the final model. RESULTS: Married women with primary education (AOR = 1.24; CI:1.16,1.32), secondary education (AOR = 1.31; CI:1.22,1.41), higher education (AOR = 1.36; CI:1.20,1.53), media exposure (AOR = 1.08; CI: 1.03, 1.13), currently working (AOR = 1.27; CI: 1.20, 1.33), 1-3 antenatal care visits (AOR = 1.12; CI:1.05,1.20), ≥ 4 ANC visits (AOR = 1.14;CI:1.07,1.21), informed about family planning (AOR = 1.09; CI: 1.04, 1.15), having less than 3 children (AOR = 1.12; CI: 1.02, 1.23) and 3-5 children (AOR = 1.08; CI: 1.01, 1.16) had higher odds of decision-making power to use family planning. Mothers who are 15-19 (AOR = 0.61; CI: 0.52, 0.72), 20-24 (AOR = 0.69; CI: 0.60, 0.79), 25-29 (AOR = 0.74; CI: 0.66, 0.84), and 30-34 years of age (AOR = 0.82; CI: 0.73, 0.92) had reduced odds off decision-making power to use family planning as compared to their counterparts. CONCLUSION: Age, women's level of education, occupation of women and their husbands, wealth index, media exposure, ANC visit, fertility preference, husband's desire in terms of number of children, region and information about family planning were factors associated with decision-making power to use family planning among married women.

Youth Risky Sexual Behavior: Prevalence and Socio-Demographic Factors in North-West Ethiopia: A Community-Based Cross-Sectional Study.

INTRODUCTION: Despite, risky sexual behavior behaviors adversely affect the health of youth people, youth has been start sexual lives during teenager is increasing, thus youth has been engaged in risky sexual behaviors. However, almost all the previous studies are institutional based and did not considered out school youth. Therefore, this community based study among youth was implemented to identify sociodemographic determinants of risky sexual behaviors among youth. METHODS: The community based cross-sectional study design was conducted from March 15 to April 15, 2019, among youths. Data were extracted from data collected for project on assessments of common health problem and risky behaviors in central, north and west Gondar zone, Northwest Ethiopia. A bivariable and multivariable logistic regression model was fitted. Adjusted odds ratio with 95% confidence interval were used to determine the presence of an association between independent variables and risky sexual behavior. RESULTS: The overall prevalence of risky sexual behavior was 27.5%, 95%CI: (25-29). Age 20-24 years (AOR = 1.8,95% CI:1.3-2.5), female (AOR = 1.6,95%CI: 1.2-2.1), had no formal education (AOR = 1.9,95% CI:1.1-3.4), not schooling during data collection year (AOR = 1.8,95%CI:1.3-2.6), family wealth index status; lowest (AOR = 2.3,95%CI:1.3-3.9), low (AOR = 2.1,95%CI:1.2-3.5), medium (AOR = 1.9,95%CI:1.2-3.0) and high (AOR = 1.8, 95%CI:1.1-3.0), having common mental disorder (AOR = 2.0,95% CI: 1.4-2.7), and watching pornography materials (AOR = 1.6, 95%CI: 1.2-2.1) were factors associated with risky sexual behaviors. CONCLUSIONS: Findings of this study revealed that one every four youths aged 15-24 years old had risky sexual behaviors. Hence, working on economic development of the family and prevention of violence can contribute to reducing risky sexual behavior among youths.

Suicide attempt and its determinants among youth in central, north, and west Gondar zones, northwest Ethiopia: Findings from the youth health project.

Introduction: Suicide is a deliberate attempt to take one's own life. Suicidal behavior among adolescents and young people, a significant global public health issue, is under-researched, particularly in developing nations like Ethiopia. Therefore, this study aimed to assess the prevalence of suicide attempts and their determinants among school-aged and out-of-school youth in the central, north, and west Gondar zones of Ethiopia. Methods: A community-based cross-sectional study was conducted from 15 March to 15 April 2019, among youth in the central, north, and west Gondar zones. The data for this study were extracted from information collected for the assessment of common health problems and risky behaviors among youth. A multistage cluster sampling technique was used to collect the data using face-to-face interviewer-administered questionnaires. Bivariable and multivariable logistic regression analyses were done to identify the independent determinants of suicide attempts. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to identify the presence and direction of the association between the dependent and independent variables. Results: A total of 1,597 youth participated in this study, and the mean age of the participants was 19.1 ± 2.8 standard deviations (SDs). The lifetime prevalence of suicide attempts in the study participants was 5.5% (95% CI: 4.4, 6.8%). Risky sexual practices (AOR = 1.89, 95%CI: 1.19-2.99), the presence of common mental health problems (AOR = 6.31, 95% CI: 3.78-10.88), having a personal income (AOR = 1.68, 95% CI: 1.05-2.71), and a history of violence (AOR = 2.81, 95% CI 1.76-4.49) were significantly associated with a suicide attempt. Conclusion: In this study, the prevalence of lifetime suicide attempts among youth is high. The presence of common mental health problems, having a personal income, risky sexual practices, and a history of violence increase the likelihood of suicide attempts. Working on the reduction of risky sexual practices, ensuring the integration of psychological treatment into medical treatment programs for victims of violence, psychosocial support for young people, and integrating youth-friendly health services to promote mental health would help to reduce suicide attempts among youth.

Time to first birth and its determinants among married female youths in Ethiopia, 2020: survival analysis based on EDHS 2016.

INTRODUCTION: The first birth is the most significant events in a woman's life that indicates the beginning of undertaking the intensive responsibilities of motherhood and childcare. Age at first birth has health, economic and social consequences and implications. But little has been known on the time to first birth and its determinants in Ethiopia. Therefore, this research is planned to address this issue. OBJECTIVES OF THE STUDY: To assess the time to first birth and its determinants among married female youths in Ethiopia, 2020. METHODS: The data was accessed freely through ( https://www.dhsprogram.com ). Survival analysis of time to first birth was done based on EDHS 2016 data among 2597 weighted study subjects. The data was extracted using STATA version 14.0. Kaplan Meier's survival and Log rank test were used to compare survival experiences of respondents using categorical variables. Proportional hazard assumption was checked and was not violated. Cox proportional hazard model was applied, hazard ratio with 95% CI was computed and variables with p value < 0.05 in the multivariable analysis were taken as significant determinants. RESULTS: Overall median survival time was 18 years (IQR = 17-20). The significant determinants of time to first birth are place of residence (being rural (AHR = 1.49, 95% CI 1.13, 1.97),Religion (being Muslim [AHR = 1.57, 95% CI 1.22, 2.02),being protestant (AHR = 1.73, 95% CI 1.34, 2.24)], age at first sex [first sex < 15 years (AHR = 1.68, 95% CI 1.23, 2.29)] and first sex between 15 and 17 years (AHR = 1.54, 95% CI 1.29, 1.85), age at first marriage (marriage < 15 years (AHR = 6.52, 95% CI 4.91, 8.64), marriage between 15 and 17 (AHR = 2.63, 95% CI 2.20, 3.14), unmet need for family planning (AHR = 1.23, 95% CI 1.00, 1.52) CONCLUSION: In this study, the median age at first birth was 18 years. This show, about 50% of study participants give birth for the first time before their 18th birth day. This age is the ideal age for schooling and to do other personal development activities. Therefore giving birth before 18 year will limit female youths from attending school and performing personal development activities in addition to health and demographic consequences of early child bearing.

Effect of Community-Based Health Insurance on Healthcare-Seeking Behavior for Childhood Illnesses Among Rural Mothers in Aneded District, East Gojjam Zone, Amhara Region, Northwest Ethiopia.

BACKGROUND: Community-based health insurance (CBHI) schemes have been implemented in developing countries to facilitate modern medical care access. However, studies conducted on the effect of CBHI on healthcare-seeking behavior (HSB) have been limited and revealed inconsistent results. Therefore, this study aimed to assess the effect of CBHI on mothers' HSB for common under-five childhood illnesses. METHODS: A community-based comparative cross-sectional study was conducted among 410 rural mothers (205 insured and 205 non-insured), and a multistage random sampling technique was used to select the study participants. Binary logistic regression and propensity score matching were used to identify factors associated with the mothers' HSB, and estimate the effect of CBHI on mothers' HSB, respectively. RESULTS: The overall mother's HSB for childhood illnesses was 48.8% (200/410). From those mothers who visited healthcare, 92.0% were married, 86.0% were unable to read and write, 94.5% were farmers, and 54.5% were from low wealth status, 58.50% had a family size of ≤5, 54.0% had children less than 24 months of age. Besides, 63.0% were members of CBHI, 37.0% perceived their child's illness as severe, 78.0% made a shared decision to visit a health facility, and 67.5% lived within less than five Kms from the nearby health facilities. Being a member of CBHI, the child's age, decision to visit a health facility, and perceived disease severity were predictors of HSB. The CBHI had a significant effect on the HSB for childhood illnesses with ATT of 28.7% (t = 3.959). CONCLUSION: The overall mothers' HSB for common childhood illnesses was low though the CBHI has a significant effect. CBHI should be strengthened to improve the mothers' HSB. It is also crucial to strengthen awareness creation regarding joint decision-making and educate mothers to visit the health facilities regardless of children's age and disease severity.

Knowledge and Associated Factors of Postpartum Contraceptive Use Among Women in the Extended Postpartum Period in Gondar City, Northwest Ethiopia.

BACKGROUND: The choice of a postpartum contraceptive method and the timing of its initiation depend on the woman's knowledge regarding postpartum contraceptives use. Also, women's perception towards family planning is reliant on good knowledge and has a great influence on their attitudes and practices. There is limited information on the knowledge and associated factors of postpartum contraceptive use among women. Therefore, the aim of this study was to assess the knowledge and associated factors of postpartum contraceptive use among women in the extended postpartum period. METHODS: An institutional-based cross-sectional study was conducted from November 5, 2018 to December 5, 2018 among postpartum women in six health institutions in Gondar city, northwest Ethiopia. A systematic random sampling technique was used to select the study participants. Data were analyzed using SPSS version 20. Bivariable and multivariable logistic regression models were fitted to identify the determinants of knowledge of postpartum contraceptive use. Adjusted odds ratio (AOR) with their 95% confidence intervals (CI) were calculated. P-values less than 0.05 were considered to indicate statistical significance. RESULTS: Out of 403 participants, 299 (74.2%) had good knowledge on postpartum contraceptive use. Being urban residents (AOR=2.95, 95% CI=1.34-6.48), previous modern contraceptives use (AOR=5.15, 95% CI=1.16-22.88), health facility delivery (AOR=4.10, 95% CI=1.20-13.98), and counseling about family planning during PNC (AOR=3.80; 95% CI=1.52-9.51) were significantly associated with good knowledge. CONCLUSION: This study showed that the knowledge of women regarding postpartum contraceptives was relatively low. Therefore, increasing institutional delivery service and counseling about family planning during the postpartum period should get more focus to address the knowledge gap of postpartum mothers.

Early marriage and women's empowerment: the case of child-brides in Amhara National Regional State, Ethiopia.

BACKGROUND: Women, especially those who marry as children, experience various forms and degrees of exclusion and discrimination. Early marriage is a harmful traditional practice that continues to affect millions around the world. Though it has declined over the years, it is still pervasive in developing countries. In Ethiopia, Amhara National Regional State (or alternatively Amhara region) hosts the largest share of child-brides in the country. This study aimed at assessing the effects of early marriage on its survivors' life conditions - specifically, empowerment and household decision-making - in western Amhara. METHODS: This study employed community-based cross-sectional study design. It adopted mixed method approach - survey, in-depth interview and focus group discussion (FGD) - to collect, analyse and interpret data on early marriage and its effects on household decision-making processes. The survey covered 1278 randomly selected respondents, and 14FGDs and 6 in-depth interviews were conducted. Statistical procedures - frequency distribution, Chi-square, logistic regression - were used to test, compare and establish associations between survey results on women empowerment for two groups of married women based on age at first marriage i.e., below 18 and at/after 18. Narratives and analytical descriptions were integrated to substantiate and/or explain observed quantitative results, or generate contextual themes. RESULTS: This study reported that women married at/after 18 were more involved in household decision-making processes than child-brides. Child-brides were more likely to experience various forms of spousal abuse and violence in married life. The study results illustrated how individual-level changes, mainly driven by age at first marriage, interplay with structural factors to define the changing status and roles of married women in the household and community. CONCLUSION: Age at first marriage significantly affected empowerment at household level, and women benefited significantly from delaying marriage. Increase in age did not automatically and unilaterally empowered women in marriage, however, since age entails a cultural definition of one's position in society and its institutions. We recommend further research to focus on the nexus between the household and the social-structural forms that manifest at individual and community levels, and draw insights to promote women's wellbeing and emancipation.

Determinants of Under-Five Child Mortality in Ethiopia: Analysis Using Ethiopian Demographic Health Survey, 2016.

BACKGROUND: Under-five mortality rate is a leading indicator of the level of child health and the overall development in countries which indicate the quality of life of a given population, as measured by life expectancy. OBJECTIVES: To identify and analyze factors that may have a significant influence on under-five mortality in Ethiopia. METHODS: A national representative cross-sectional study and a quantitative study were conducted among 18,008 households selected based on 2016 EDHS data. The analysis was done using SPSS version 20 statistical software. Both bivariate and multivariable analyses were employed. In multivariable analysis, p value less than 0.05 was considered statistically significant and odds ratio with 95% CI (confidence interval) was used to assess the determinants of under-five child mortality. RESULTS: A total of 10,641 children were included in the study with a 99.0% response rate. The U5CM for being a rural resident (AOR = 1.802, 95% CI: 1.251, 2.595), not breastfeeding (AOR = 2.956, 95% CI: 2.490, 3.511), having multiple birth (AOR = 4.755, 95% CI: 3.440, 6.572), male gender (AOR = 1.363, 95% CI: 1.153, 1.612), having first birth order (AOR = 1.592, 95% CI: 1.275, 1.992), and having family size six and above (AOR = 2.187, 95% CI: 1.769, 2.707). The increment of family size increases the risk of U5CM. CONCLUSION: Multivariate logistic analysis reflected that place of residence, mothers' educational level, religion, current breastfeeding status, type of birth, sex of child, birth order, and family size were found to be significant predictors of under-five child mortality. So, government policy, nongovernmental organizations, and all concerned bodies should be focused on the major determinants of under-five child mortality and put in a lot more effort to reduce under-five child mortality, and health intervention policies should be revised.

Parent-Adolescent Communication on Sexual and Reproductive Health Issues and Associated Factors among Preparatory and Secondary School Students of Dabat Town, Northwest Ethiopia.

Background: A significant number of adolescents as well as young men and women aged 10 to 24 years die each year in the world due to avoidable sexual and reproductive health problems such as unwanted pregnancy, unsafe abortion, and sexually transmitted infections, including HIV/AIDS. This is attributed to low access to and/or uptake of sexual and reproductive health services. Objective: To assess parent-adolescent communication on sexual and reproductive health issues and associated factors among secondary and preparatory school students in Dabat town, northwest Ethiopia, 2018. Methods: An institution-based cross-sectional study was conducted from April 1 to 10, 2018, using multistage sampling technique. Data were collected from 550 participants using structured, pretested, and self-administered questionnaire; entered into Epi Info version 7; and analyzed using SPSS version 20. Both bivariate and multivariable logistic regression analyses were employed, and variables with less than 0.05 P value in the multivariable regression were considered as statistically significant. Adjusted odds ratio with 95% CI was used to determine the strengths and directions of associations. Result: This study revealed that 48.5% of the participants discussed sexual and reproductive health issues with parents. Male sex (AOR = 1.6; 95% CI: 1.1-2.25), family income greater than ETB 1,000 (AOR = 1.6; 95% CI: 1.02-2.57), good knowledge of sexual and reproductive health (AOR = 1.5; 95% CI: 1.03-2.09), and favorable attitude to sexual and reproductive health issues (AOR = 1.9; 95% CI: 1.29-2.67) were factors significantly associated with parent-adolescent communication on the issues. Conclusion: This study showed that the proportion of parent-adolescent communication on sexual and reproductive health issues was low. Male sex, family income greater than ETB 1,000, and good knowledge and favorable attitude of adolescents had significant association with the communication.

Early Resumption of Sexual Intercourse and Its Associated Factors Among Postpartum Women in Western Ethiopia: A Cross-Sectional Study.

BACKGROUND: Women are often forced to recommence sexual intercourse after childbirth to maintain intimacy and fulfill their partners' desires. Early resumption of postpartum sexual intercourse leads to sexual health problems and unwanted pregnancy if not complemented with appropriate contraceptive use. However, sexual practice during the early postpartum period has received little attention in clinical and research settings. The aim of this study was therefore to assess the early resumption of sexual intercourse and its associated factors among postpartum women attending public health institutions in Nekemte town, Western Ethiopia. METHODS: An institution-based cross-sectional study was carried out from March to April 2019. A systematic random sampling technique was used to select 528 postpartum women. An interviewer-administered, pretested, and structured questionnaire was used to collect data. Data were coded and entered into Epi Info 7.2.1, and exported to SPSS version 20.0 to run bivariable and multivariable logistic regressions. RESULTS: One in five postpartum women (20.2%, 95% CI: 17.1-23.6) practiced an early resumption of sexual intercourse, of whom three-fifths (58%) did not use any contraceptives. Women's secondary education (AOR=0.22, 95% CI: 0.07-0.71), husband's elementary (AOR=0.23, 95% CI: 0.06-0.87) and secondary education (AOR=0.25, 95% CI: 0.07-0.88), as well as women's fertility status (parity of one) (AOR=3.52, 95% CI: 1.24-10.01), normal vaginal delivery (AOR=5.44, 95% CI: 1.84-16.12), giving birth to a male child (AOR=1.94, 95% CI: 1.05-3.60), desire for another child (AOR=5.71, 95% CI: 1.89-17.25), and pressure from the husband to initiate intercourse (AOR=9.89, 95% CI: 4.99-19.58) were significantly associated with early resumption of sexual intercourse. CONCLUSION: A significant proportion of postpartum women who resume early sexual intercourse do not use any contraceptives. Interventions that focus on strengthening the integration of postpartum sexual health education and service use are warranted.

Willingness to Use Mobile based e-Partograph and Associated Factors among Care Providers in North Gondar Zone, Northwest Ethiopia.

BACKGROUND: The proper use of Partograph supports to capture key maternal and fetal data. Paper-based Partograph are prone to error, incompleteness, delayed decisions and loss of clients' information. Electronic (e-Partograph) enables to easily retain and retrieve client data to ensure quality of care. Mobile technologies found an opportunity for resource-limited countries to improve access and quality of health care. Evidences were lacking on end users' acceptance to e-Partograph. OBJECTIVE: This study aimed to assess obstetric care providers' willingness to use mobile based e-Partograph and its associated factors. METHODS: Institutional based cross-sectional study was conducted from December 30, 2016 to January 21, 2017. A total 466 obstetric care providers were selected using multistage sampling technique in North Gondar Zone, Northwest Ethiopia. A structured self-administered questionnaire was used to collect the data. The data were entered in to Epi info version 7 and analyzed by using SPSS version 20. Cronbach's Alpha test was calculated to evaluate the reliability of data. A multivariable logistic regression analysis were used to identify factors associated with dependent variable. Adjusted odds ratio with 95%CI was used to determine the presence of association. RESULTS: The study found that 460(99.6%) of care providers owned mobile phone. Smartphone owners accounted only 102(22%). Of them, 205(46%) were willing to use mobile-phone for e-Partograph. Care providers aged >30 years (AOR=2.85, 95% C.I: 1.34-6.05), medical doctors and higher level clinicians (AOR=8.35, 95% C.I: 2.07-33.63), Health Center (AOR=4.41, 95% C.I:0.10-9.26), favorable attitude towards Partograph (AOR=2.76, 95% C.I: 1.49-5.09) and related in-service trainings (AOR=7.63, 95% C.I: 3.96-14.69) were enabling factors for willingness to use mobile phone. CONCLUSIONS: Almost all obstetric care providers had access to mobile phone, however; smartphone ownership is still low. Willingness to use mobile-phone for e-Partograph was low. Younger aged, lower level clinicians, Hospital based workers, unfavorable attitude on Partograph and lack of in-service trainings were main factors for non-willingness. Hence awareness creation on partograph use and digital capacity building are crucial for effective e-partograph management.