The association between male involvement in institutional delivery and women's use of institutional delivery in Debre Tabor town, North West Ethiopia: Community based survey.

BACKGROUND: Maternal deaths remain high in Ethiopia mainly due to poor maternal health service utilization. Despite men are the chief decision-makers and economically dominant in Ethiopia, the impact of their involvement on maternal health services utilization is not clear. This study aimed to assess the association between male involvement and women's use of institutional delivery, and factors influencing male partners' involvement in institutional delivery. METHODS: A community based cross-sectional study was conducted between March and May, 2019. A total of 477 married men who have children less than one year of age were interviewed. Face-to-face interviews using a pre-tested and structured questionnaire were used for data collection. Bivariate and multiple logistic regressions were carried out. SPSS version 23 was used for data analysis. RESULTS: Overall 181 (37.9%) husbands/partners were involved in institutional delivery for the most recent child birth. Male partners involvement in institutional delivery was strongly associated with an increased odds of attending institutional delivery by spouse [AOR: 66.2, 95% CI: 24.8, 177.0]. Education [AOR: 0.33, 95% CI: 0.18-0.59], knowledge on maternal health [AOR: 1.67, 95% CI: 1.11-2.50], favourable attitude towards institutional delivery [AOR: 1.83, 95% CI: 1.23-2.71], and no fear while supporting spouse [AOR: 2.65, 95% CI: 1.28-5.50] were positively associated with male partners involvement in institutional delivery. CONCLUSION: Male partner's involvement in institutional delivery was inadequate. This study reported a significant beneficial impact of male involvement on maternal health through improved utilisation of institutional delivery. Therefore, maternal health interventions should target husbands as consumers of maternal health services, and healthcare/government policies that isolate or discourage men from having active engagement in maternal health should be improved.

The association between unmet need for contraception and unintended pregnancy among reproductive-age women in Ethiopia.

Objectives: An unintended pregnancy and unmet need for contraception remains a serious public health issues both in developed and developing countries. This study aimed to investigate the relation between unmet needs for contraception and unintended pregnancy, and identify other factors contributing for unintended pregnancy in Ethiopia. Methods: Data were obtained from the 2016 Ethiopian Demographic and Health Survey. A total of 7590 mothers were included. The planning status of the last pregnancy was the main outcome variable, and the unmet need for contraception was the primary explanatory variable. Bivariate and multiple logistic regressions were carried out. SPSS version 20.0 was used for data analysis. Statistical significance was declared at p < 0.05. Results: More than one-fourth of mothers (26.6%) gave either mistimed or unwanted birth. The rate of unmet need for contraception was 26.5%. Women with unmet need for contraception had (adjusted odds ratio (AOR) = 10.29, 95% confidence interval (CI) = 8.70-12.10) higher odds of experiencing unintended pregnancy than those who met their contraception need. Age, history of pregnancy termination, parity, women's autonomy, and fertility preference were factors associated with unintended pregnancy. Conclusion: An unintended pregnancy and the unmet need for contraception remain a major public health issue in Ethiopia. A strong positive association between the unmet need for contraception and unintended pregnancy suggests that interventions targeting the unmet need for contraception could reduce unintended pregnancy. Furthermore, empowering women, promoting a clear fertility goal, and improving men's involvement would reduce unintended pregnancy.

Cesarean delivery among women who gave birth in Dessie town hospitals, Northeast Ethiopia.

BACKGROUND: One of the key strategies for reducing maternal and perinatal morbidities and mortalities is the provision of skilled intrapartum care. While cesarean section is an important emergency obstetric intervention for saving the lives of mothers and newborns, a study comparing the prevalence of cesarean delivery is not sufficiently available in Ethiopia. This study aimed at assessing the prevalence and associated factors of cesarean delivery among women who gave birth at hospitals in Dessie town, Northeast Ethiopia. METHODS: A facility based cross-sectional study was conducted between July and October 2013. A total of 520 women who gave birth in four hospitals (public = 1, private = 3) were interviewed. Face-to-face interviews using a pre-tested and structured questionnaire were conducted for primary data collection. Additionally, patients' charts were reviewed to collect mothers' clinical data. Bivariate and multiple logistic regressions analyses were conducted. Odds ratios and 95% confidence intervals were computed and a P-value of less than 0.05 was taken to declare the level of significance. RESULTS: A total of 512 mothers were included in the final analysis (response rate = 98.4%), the prevalence of cesarean delivery was found to be 47.6% (95% CI: 44.3, 51.1), While 46 (18.2%) of the procedure conducted in public and 198 (76.1%) were in private hospitals. Partograph monitoring [AOR = 3.84 95%CI: 2.24, 6.59], oxytocin administration [AOR = 4. 80 95%CI: 2.87-8.02], previous cesarean delivery [AOR = 2. 86 95%CI: 1.64-5.01] and place of delivery being a private hospital [AOR = 6. 79 95%CI: 4.18-11.01)] were associated with cesarean delivery. CONCLUSION: The prevalence of cesarean delivery was found to be high, and was significantly higher in private hospitals than a public facility. There is a need to conduct cesarean delivery audits to appropriately utilize scarce resources. Further an in-depth exploration of the experiences of women with cesarean delivery is necessary.