Abnormal uterine bleeding and its associated factors among reproductive-age women who visit the gynecology ward in Dilla University General Hospital, Southern Ethiopia, 2022.

BACKGROUND: Abnormal uterine bleeding, a frequent gynecological problem among women of reproductive age, significantly affects their health and quality of life. Despite its problem, research on its extent and contributing factors in Ethiopia is scarce. Hence, this study is designed to determine the magnitude and factors associated with abnormal uterine bleeding among women visiting Dilla University General Hospital, Dilla, Ethiopia. METHODS: A cross-sectional study design was conducted with 380 women of reproductive age at Dilla University General Hospital. A systematic sampling method was employed to select the participants for the study. A structured interview administered questionnaire and checklist were used to collect the data. Stata V.14 software was used for cleaning, coding, ensuring completeness and accuracy, and further analysis. Bivariate and multivariable logistic regression analyses were used. Finally, the variables that have a p-value of < 0.05 were considered statistically significant. RESULTS: In this study, the magnitude of abnormal uterine bleeding was 24.21% (95% CI, 20.14-28.79). History of sexually transmitted disease [AOR = 1.44, 95% CI: (1.33, 4.75)], history of anemia [AOR = 3.92, 95% CI: (1.20, 12.74)]., history of alcohol consumption [AOR = 2.49, 95% CI: (1.22, 5.06)], and perceived stress level [AOR = 1.30, 95% CI: (1.15, 1.69)] were found to be significantly associated with abnormal uterine bleeding. CONCLUSIONS: The magnitude of abnormal uterine bleeding was 24.2% in the study setting. Factors such as a history of sexually transmitted disease, anemia, alcohol consumption, and perceived stress level were identified as significant risk factors for abnormal uterine bleeding. Addressing these factors is crucial for management. Further research and interventions targeting these risks are needed to enhance health outcomes. The study provides valuable insights for future interventions.

Prevalence and associated factors of stress and anxiety among female employees of hawassa industrial park in sidama regional state, Ethiopia.

BACKGROUND: Work-related stress and anxiety are emerging global public health problems causing serious social and economic consequences. Working women bear a heavy burden due to high social disparity, gender inequality, and an important responsibility to balance work and family life in undeveloped society. OBJECTIVE: To assess the prevalence and associated factors of work related stress and anxiety among female employees of Hawassa industrial park in Sidama Region, Ethiopia, 2021. METHODS: Institution-based cross-sectional study design was conducted among 417 female employees using structured interviewer-administered questionnaires and depression, Anxiety, and Stress scale (DASS) 21 items. A simple random sampling technique was used through the computer-generated random method. The outcome variables were work related stress and anxiety. Work related stress and anxiety were ascertained using the DASS 21( stress ≥ 15 &anxiety8 - 14). The associated factors assessed included sociodemographic, behavioral factor, job and organization related factors, past illness and social support related factors. Bivariate and multivariable logistic regression analyses were done. The strength of association was declared by using an adjusted odds ratio (AOR) with a 95% confidence interval and, the statistical significance of P-value < 0.05. RESULT: The prevalence of work-related stress and anxiety were 59.3% [95% CI: (54.7, 63.9)] and 79.8% [95% CI: 75.5, 83.6)] respectively. Respondents with single marital status [AOR = 5.31, 95% CI: (1.68, 16.86)], having chronic illness [AOR = 4:00, 95% CI: (1.24, 12.9)], and current alcohol drinking [AOR = 12.5, 95% CI: (4.56, 34.2)] were significantly associated with stress. Likewise, being single in marital status [AOR = 1.99, 95% CI: (1.15, 3.46)], poor social support [AOR = 3.78, 95% CI: (1.53, 9.35)], overtime work [AOR = 2.31, 95% CI: (1.12, 4.74)], having work experience (3-4 years) [AOR = 4.71, 95% CI: (1.49, 14.84)], and fear of losing job [AOR = 1.72, 95% CI: (1.01, 2.93)] were significantly associated with anxiety. CONCLUSION: The prevalence of work-related stress and anxiety was high in the study area. Marital status, alcohol drinking, and chronic illnesses were factors associated with work-related stress. In contrast the fear of losing a job, work experience, overtime work, and having poor social support were factors associated with anxiety.. The significant factors identified in this study can be targeted to reduce the occurrence of work related stress and anxiety among women through designing preventive programs and strategies which includes acknowledging the importance of mental health services for the welfare of the public, screening for work related stress and anxiety, counselling, and the provision of support for women as well as lifestyle modification.

Magnitude and associated factors of low birth weight among term newborns delivered in Addis Ababa public hospitals, Ethiopia, 2021.

Only 14% of births had information on birth weight available at the time of birth in Ethiopia. Hence, previous studies underestimate the magnitude and associated factors of low birth weight (LBW). As a result, the goal of this study is to fill those gaps in the previous studies. An institution-based cross-sectional study was employed. Binary logistic regression was used to identify the associated factors. In this study, the magnitude of LBW was 13.06%. History of chronic medical illness (AOR = 3; 95% CI: (1.02, 9.17)), haemoglobin level during pregnancy (AOR = 0.23; 95% CI: (0.10, 0.50)), iron/folic acid supplementation (AOR = 0.27; 95% CI: (0.10, 0.72)) and extra meal during pregnancy (AOR = 3.2; 95% CI: (1.52, 7.00)) were significantly associated with LBW. The magnitude of LBW in this study was comparable to the Ethiopian Demographic and Health Survey (EDHS) report from 2016. It is better to intervene in those identified factors in order to reduce LBW.Impact StatementWhat is already known on this subject? Low birth weight (LBW) accounts for 60-80% of all neonatal deaths each year. In developing countries like Ethiopia, LBW is a major public health concern. Almost half of the world's infants are not weighed at birth, a figure that is especially high in sub-Saharan Africa including Ethiopia.What do the results of this study add? Only 14% of births had information on birth weight available at the time of birth in Ethiopia. Hence, previous studies underestimate the magnitude and associated factors of LBW. To meet the Sustainable Development Goals (SDGs)-2030 targets for neonatal and child mortality, sufficient evidence on the magnitude of LBW and associated factors must be important in order to contribute to the development of timely interventions. A history of chronic medical illness, haemoglobin level, iron/folic acid supplementation and extra meal during pregnancy was associated with LBW.What are the implications of these findings for clinical practice and/or further research? The findings of this study will be useful in developing better health policies to prevent LBW as well as interventions that can target the identified factors.

Determinants of induced abortion among women received maternal health care services in public hospitals of Arba Minch and Wolayita Sodo town, southern Ethiopia: unmatched case-control study.

BACKGROUND: About 210 million women become pregnant per year, with one out of every ten pregnancies terminating unsafely worldwide. In developing countries, unsafe induced abortion is a leading cause of maternal mortality and morbidity. In addition, the burden of public health is also greatest in developing regions. In Ethiopia, abortion was responsible for 8.6% of maternal deaths. Despite the problem's significance, little is known about the factors that lead to women terminating their pregnancies. Therefore, this study aims to identify the factors associated with having induced abortion in public hospitals of Arba Minch and Wolayita Sodo town, Southern Ethiopia. METHODS: An institutional-based unmatched case-control study was conducted among 413 women from 15th April to 15th June 2021 in selected public hospitals of Arba Minch and Wolayita Sodo town, Southern Ethiopia. Cases were women who received induced abortion care services or who received post-abortion care services after being presented to the selected public hospital with an attempt of induced abortion whereas controls were women who came for maternal health care (antenatal or postnatal care) services in selected public hospitals and never had history of induced abortion. The data were collected by pretested and structured questionnaires with face-to-face interviews via Kobo Collect v3.1 mobile tools and analyzed by STATA version14. Logistic regression model was used to identify factors associated with induced abortion. In this study P-value less than 0.05 with 95% CI was declared a result as statistically significant. RESULTS: In this study, 103 cases and 309 controls were participated. Urban residence (AOR = 2.33, 95%CI:1.26, 4.32), encountered first sex at age of 20-24 years (AOR = 0.51, 95%CI:0.27,0.97), multiple sexual partner (AOR = 5.47, 95%CI: 2.98,10.03), women who had one child (AOR = 0.32, 95%CI: 0.10, 0.99), and good knowledge of contraceptives (AOR = 0.12, 95%CI: 0.03, 0.46) were identified as determinants of induced abortion. CONCLUSIONS: Interventions focusing on those identified factors could probably reduce the burden and consequences of induced abortion. Sexual and reproductive health education and family planning programs would target urban dwellers, women who start sexual intercourse between the ages of 15 and 19, women with more than one sexual partner, women with a desire to limit childbearing, and women with poor contraceptive knowledge in order to reduce induced abortion.

Obstetric violence and disability overlaps: obstetric violence during child birth among womens with disabilities: a qualitative study.

INTRODUCTION: Obstetric violence is an invisible wound which is being distorting the quality of obstetric care. Obstetric Violence, which is an issue spoken and amplified currently as a type of sexual violence and is of alarming seriousness and is an evolving field of inquiry despite women's experience of institutional childbirth, has garnered unprecedented global attention in recent years. Losing on both counts: obstetric violence is a double burden among disabled women. AIM: To explore the experience of disabled women towards obstetric violence during child birth in Gedio zone, South Ethiopia. METHODS: Twenty-two (22) women with disabilities were interviewed. They were recruited through a nonprobability snowball sampling method. The interviews were conducted using a structured questionnaire in the Gedio zone, south Ethiopia. For coding purposes, NVivo (version 11) software was employed. Using a method known as continuous comparison, we classified the extracted codes based on their similarities and differences. The classes were then arranged in such a way that there was the greatest internal uniformity and the least external mismatch. RESULTS: The profile of the study group is predominantly of women between the ages of 21 and 30. Physical abuse, verbal abuse, stigma and discrimination, neglect and abandonment, and violations of privacy were the five major categories emerged during the thematic analysis describing the experience of obstetric violence. Women also observed these forms of obstetric violence among other disabled women during child birth. In addition to the violations of care, some of the participants described positive aspects of their childbirth experiences in one or more obstetric care settings. CONCLUSION: This study concluded that the quality of service was deplorable, with reports of obstetric violence among this vulnerable group of women imposing a double burden on them. The findings suggest that there is a need to improve maternity care for disabled women by implementing comprehensive, culturally sensitive, client-sensitive special services and providing sensitivity training to healthcare providers, ensuring satisfied, equitable, and quality obstetric care.

Survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia: a retrospective cohort study.

BACKGROUND: Cervical cancer is a cancer of uterine cervix caused mostly by sexually-acquired infection called Human papillomavirus (HPV. In developing region of the globe, fewer than 50% of women with cervical malignancy survive more than 5 years. Therefore, the objective of this study was to assess survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital (TASH), Ethiopia. METHODS: Facility based retrospective cohort study was conducted from March to April 2019 at Tikur Anbesa Specialized Hospital oncology center. Data was collected from patient's chart using pre-tested and structured checklist prepared in English and analyzed using STATA14.2. Cox regression model was used to identify Variables that affected survival. RESULT: The overall survival rate was 38.62% at 5 years. There were a significance differences in survival experience between categories of stage of cervical cancer, age of patients, comorbidity, substance use, base line anemia and treatment modalities. Being stage IV [AHR = 11.76; 95% CI (4.02-34.4)],being advanced age [AHR = 5.99; 95% CI (2.1-17.08)], being comorbid [AHR = 1.58; 95%CI(1.14-2.19)], using substance [AHR = 1.56;95% CI(1.09-2.22)] and being anemic [AHR = 1.6;95% CI(1.11-2.36)] increased the risk of death. CONCLUSION: The overall survival rate was lower than high- and middle-income countries and Significant factors of death after diagnosis of cervical cancer were; advanced FIGO stage, base line anemia, comorbidity, substance use, advanced age and treatment modality. Authors recommend that it is better to expand cervical cancer early screening programs and treatment facilities, strengthen awareness in collaboration with public medias about cervical cancer prevention, screening and treatment options.

Improved malaria case management in formal private sector through public private partnership in Ethiopia: retrospective descriptive study.

BACKGROUND: Malaria is a major public health problem and still reported among the 10 top causes of morbidity and mortality in Ethiopia. More than one-third of the people sought treatment from the private health sector. Evaluating adherences of health care providers to standards are paramount importance to determine the quality and the effectiveness of service delivery. Therefore, the aim of this study was to evaluate the contribution of public private mix (PPM) approach in improving quality of malaria case management among formal private providers. METHODS: A retrospective data analysis was conducted using 2959 facility-months data collected from 110 PPM for malaria care facilities located in Amhara, Dire Dawa, Hareri, Oromia, Southern Nation Nationalities and Peoples and Tigray regions. Data abstraction formats were used to collect and collate the data on quarterly bases. The data were manually cleaned and analysed using Microsoft Office Excel 2010. To claim statistical significance non-parametric McNemar test was done and decision accepted at P < 0.05. RESULTS: From April 2012-September 2015, a total of 873,707 malaria suspected patients were identified, of which one-fourth (25.6 %) were treated as malaria cases. Among malaria suspected cases the proportion of malaria investigation improved from recorded in first quarter 87.7-100.0 % in last quarter (X(2) = 66.84, P < 0.001). The majority (96.0 %) were parasitologically-confirmed cases either by using microscopy or rapid diagnostic tests. The overall slid positivity rate was 25.1 % of which half (50.7 %) were positive for Plasmodium falciparum and slightly lower than half (45.2 %) for Plasmodium vivax; the remaining 8790 (4.1 %) showed mixed infections of P. falciparum and P. vivax. Adherence to appropriate treatment using artemether-lumefantrine (AL) was improved from 47.8 % in the first quarter to 95.7 % in the last quarter (X(2) = 12.89, P < 0.001). Similarly, proper patient management using chloroquine (CQ) was improved from 44.1 % in the first quarter to 98.12 % in the last quarter (X(2) = 11.62, P < 0.001). CONCLUSIONS: This study documented the chronological changes of adherence of health care providers with the national recommended standards to treat malaria. The PPM for malaria care services significantly improved the malaria case management practice of health care providers at the formal private health facilities. Therefore, regional health bureaus and partners shall closely work to scale up the initiated PPM for malaria care service.

A cross sectional study on factors associated with harmful traditional practices among children less than 5 years in Axum town, north Ethiopia, 2013.

BACKGROUND: Every social grouping in the world has its own cultural practices and beliefs which guide its members on how they should live or behave. Harmful traditional practices that affect children are Female genital mutilation, Milk teeth extraction, Food taboo, Uvula cutting, keeping babies out of exposure to sun, and Feeding fresh butter to new born babies. The objective of this study was to assess factors associated with harmful traditional practices among children less than 5 years of age in Axum town, North Ethiopia. METHODS: Community based cross sectional study was conducted in 752 participants who were selected using multi stage sampling; Simple random sampling method was used to select ketenas from all kebelles of Axum town. After proportional allocation of sample size, systematic random sampling method was used to get the study participants. Data was collected using interviewer administered Tigrigna version questionnaire, it was entered and analyzed using SPSS version 16. Descriptive statistics was calculated and logistic regressions were used to analyze the data. RESULTS: Out of the total sample size 50.7% children were females, the mean age of children was 26.28 months and majority of mothers had no formal education. About 87.8% mothers had performed at least one traditional practice to their children; uvula cutting was practiced on 86.9% children followed by milk teeth extraction 12.5% and eye borrows incision 2.4% children. Fear of swelling, pus and rapture of the uvula was the main reason to perform uvula cutting. CONCLUSION: The factors associated with harmful traditional practices were educational status, occupation, religion of mothers and harmful traditional practices performed on the mothers.

Evidence-based intrapartum care practice and associated factors among obstetrics workers in Ethiopia, systematic review and meta-analysis.

Background: Evidence-based practice is defined as using the best available research and clinical evidence by incorporating patients' values and preferences for their health needs. The use of evidence-based intrapartum care practices is an essential tool to improve the quality of obstetrics care. Objective: The primary objective of this study was to determine the prevalence of evidence-based intrapartum care and associated factors among obstetrics care providers in Ethiopia. Method: Important articles were retrieved from universally accepted and used databases, including Cochran, PubMed, HINARI, Google Scholar, Web of Science, African OnLine, and repositories of Ethiopian Universities. We extracted articles by using a standard JOANNA Briggs Institute data extraction sheet. To determine the existence of heterogeneity in studies, I 2 statistics and Cochran Q tests were used. The publication bias of the included studies was checked using Egger's test and a Funnel plot. Result: A total of 2035 obstetrics care providers were involved in this systematic review and meta-analysis. The estimated overall rate of evidence-based intrapartum care practice in Ethiopia was 54.45% (95% CI: 43.06, 65.83); I 2 = 96.6%, p < 0.001). The studies with a sample size greater than 300 count for 47.25% (95% CI: 36.14, 65.83). Whereas obstetrics care providers have a decent knowledge of intrapartum care evidence 3.31 times, a positive attitude toward evidence 3.34 times, training 2.21 times, and work experience ⩾5 years 3.31 times associated with the practice of evidence-based intrapartum care. Conclusion: The overall practice of evidence-based intrapartum care among obstetrics workers in Ethiopia is estimated to be low. Therefore, there should be a focused effort on training and disseminating protocols and guidelines to enhance knowledge and foster a positive attitude among obstetrics care providers. Additionally, the Ethiopian government should prioritize the implementation of the 2021 to 2025 National Health Equity Strategic Plan to achieve its objective of improving the quality of health services.

Risk factors of necrotizing enterocolitis among neonates admitted to the neonatal intensive care unit at the selected public hospitals in southern Ethiopia, 2023.

Introduction: Necrotizing enterocolitis (NEC) is a serious intestinal condition characterized by ischemic necrosis of the intestinal mucosa, inflammation, and invasion by gas-forming organisms, posing a significant threat to neonatal health. Necrotizing enterocolitis remains a significant cause of neonatal morbidity and mortality, particularly in developing countries. Due to limited research conducted in Ethiopia and the study area, there is a lack of information regarding the risk factors associated with necrotizing enterocolitis. Therefore, the goal of this study is to fill the aforementioned gap. Objective: This study aims to identify the risk factors of necrotizing enterocolitis among neonates admitted to the neonatal intensive care unit (NICU) at selected general and referral hospitals in southern Ethiopia in the year 2023. Methods and materials: A facility-based unmatched case-control study was conducted. All neonates admitted to the NICU and diagnosed with necrotizing enterocolitis by the attending physician during the data collection period were considered as cases, whereas neonates admitted to the NICU but not diagnosed with necrotizing enterocolitis during the data collection period were considered as controls. Data were collected through face-to-face interviews and record reviews using the Kobo toolbox platform. The binary logistic regression method was used to determine the relationship between a dependent variable and independent variables. Finally, a p-value of < 0.05 was considered statistically significant. Results: This study included 111 cases and 332 controls. Normal BMI [AOR = 0.11, 95% CI: (0.02, 0.58)], history of khat chewing [AOR = 4.21, 95% CI: (1.96, 9.06)], term gestation [AOR = 0.06, 95% CI: (0.01, 0.18)], history of cigarette smoking [AOR = 2.86, 95% CI: (1.14, 7.14)], length of hospital stay [AOR = 3.3, 95% CI: (1.43, 7.67)], and premature rupture of membrane [AOR = 3.51, 95% CI: (1.77, 6.98)] were significantly associated with NEC. Conclusion: The study identified several risk factors for necrotizing enterocolitis, including body mass index, history of khat chewing, gestational age, history of cigarette smoking, length of hospital stays, and premature rupture of membrane. Therefore, healthcare providers should be aware of these risk factors to identify newborns at high risk and implement preventive measures.

Health-promoting behavior and its determinants towards non-communicable diseases among adult residents of the Gedeo zone, South Ethiopia: the application of the health belief model.

Background: Non-communicable diseases are becoming a challenge for the health care system in Ethiopia, which has suffered a double burden from infectious and rapidly increasing non-communicable diseases. However, there is little information on health-promoting behavior in the study settings. Thus, the purpose of this study was to determine health-promoting behaviors and its associated factors among adult's residents of Gedeo zone. Methods: A cross-sectional study was conducted among 705 adult residents of Gedeo zone, south Ethiopia, selected using a multi-stage sampling technique. Interviews administered through a structured questionnaire were used to collect the data. The data were entered using Kobo Collect and analyzed using Stata version 17. The baseline characteristics of the participants were summarized using descriptive statistics. The independent sample t-test and one-way ANOVA were used to compare two groups and more than two groups, respectively. Stepwise multiple linear regression analysis was used to identify the potential determinants of health-promoting behavior and its components. Statistically significant factors were declared at p-value of less than or equal to 0.05. Results: The overall means score for health-promoting behavior was 73.88 ± 16.79. Physical activity and spiritual growth had the lowest and highest mean scores, respectively. The variables: gender, marital status, education, family history of NCDs, health insurance status, perceived health status, knowledge of NCD risk factors, risk perception of NCDs, expected outcome, cues to action, and self-efficacy showed a statistically significant difference in overall health-promoting behavior. The total health-promoting behavior score was associated with age, gender, perceived health status, marital status, family history of NCDs, health insurance, knowledge of NCD risk factors, perceived threat, expected outcome, self-efficacy, and cues to action. Conclusion and recommendations: In the study, the mean score of health-promoting behaviors was low. Socio-demographic and economic variables, family history of NCD, perceived health status, knowledge of NCD risk factors, perceived threat, expected outcome, self-efficacy, and cues to action affect health-promoting behaviors. Therefore, the study suggests establishing health promotion programs to increase residents' awareness of health-promoting lifestyles, empower them to adopt healthy lifestyles, and improve health outcomes by increasing self-efficacy, providing education, and creating supportive environments.

Obstetric fistula repair failure and its associated factors among women who underwent repair in sub-Saharan Africa. A systematic review and meta-analysis.

BACKGROUND: Obstetric fistula repair failure can result in increased depression, social isolation, financial burden for the woman, and fistula care programs. However, there is limited, comprehensive evidence on obstetric fistula repair failure in Sub-Saharan African countries. This systematic review and meta-analysis aimed to determine the pooled prevalence of obstetric fistula repair failure and associated factors among women who underwent surgical repair in Sub-Saharan African countries. METHODS: To identify potential articles, a systematic search was done utilizing online databases (PubMed, Hinari, and Google Scholar). The Preferred Reporting Items for Systematic Review and Meta-Analysis Statement (PRISMA) guideline was used to report the review's findings. I2 test statistics were employed to examine study heterogeneity. A random-effects model was used to assess the pooled prevalence of obstetric fistula repair failure, and the association was determined using the log odds ratio. Publication bias was investigated using the funnel plot and Egger's statistical test at the 5% level of significance. Meta-regression and subgroup analysis were done to identify potential sources of heterogeneity. The data were analyzed using STATA version 17 statistical software. RESULTS: A total of 24 articles with 9866 study participants from 13 Sub-Saharan African countries were included in this meta-analysis. The pooled prevalence of obstetric fistula repair failure in sub-Saharan Africa was 24.92% [95% CI: 20.34-29.50%]. The sub-group analysis by country revealed that the highest prevalence was in Angola (58%, 95% CI: 53.20-62.80%) and the lowest in Rwanda (13.9, 95% CI: 9.79-18.01%). Total urethral damage [OR = 3.50, 95% CI: 2.09, 4.91], large fistula [OR = 3.09, 95% CI: (2.00, 4.10)], duration of labor [OR = 0.45, 95% CI: 0.27, 0.76], and previous fistula repair [OR = 2.70, 95% CI: 1.94, 3.45] were factors associated with obstetric fistula repair failure. CONCLUSION: Women who received surgical treatment for obstetric fistulas in Sub-Saharan African countries experienced more repair failures than the WHO standards. Obstetric fistula repair failure was affected by urethral damage, fistula size, duration of labor, types of fistula, and history of previous repairs. Therefore, we suggest policy measures specific to each country to provide special attention to the prevention of all risk factors, including poor nutrition, multiparty, obstructed labor, and maternal age, which can result in conditions like large fistulas, urethral damage, and repeat repair, in order to reduce obstetric fistula repair failure.

Fear of childbirth and its associated factors among pregnant women in East Africa: Systematic review and meta-analysis.

BACKGROUND: Tokophobia is a mild to extreme fear of pregnancy and/or childbirth that may cause a woman to avoid giving birth. It is a common obstetrical problem that affects women's health. Some studies have found that fear of childbirth is common in East African countries. However, there was inconsistency across those studies, and no study was undertaken to report the pooled prevalence of fear of childbirth and its associated factors. As a result, the purpose of this systematic review and meta-analysis is to identify the pooled prevalence of fear of childbirth and its associated factors in Eastern Africa. METHODS: We conducted a systematic review and meta-analysis of studies on the prevalence and associated factors of childbirth fear using Pub Med, Hinari, Google Scholar, and East African University archives. Data were extracted using a data extraction format developed in Microsoft Excel, and the analysis was carried out with STATA 14 statistical software. Each article's quality was assessed using the Joanna Briggs Institute's critical appraisal tool for prevalence studies. The Cochrane Q statistics and I2 test were used to examine heterogeneity between studies. Subgroup analysis was done by country and sample size. To assess publication bias, a funnel plot, and Egger's regression test were used. RESULTS: This systematic review and meta-analysis included eleven studies. The pooled prevalence of the fear of childbirth among pregnant women in East Africa was 27.86 %. A history of labor and delivery complications (OR = 5.41, 95 %CI = 2.20, 8.63), poor social support (OR = 4.50, 95 %CI = 1.70, 11.92), primiparity (OR = 1.91, 95 %CI = 1.17, 3.12), no ANC follow-up (AOR=2.65, 95 %CI=1.48, 4.74), and unplanned pregnancy (AOR=4.88, 95 %CI=1.23, 19.31) were statistically associated with the fear of childbirth. CONCLUSION: The pooled prevalence of fear of childbirth was high. Previous labor and delivery complications, poor social support, primiparity, a lack of antenatal care follow-up, and unplanned pregnancy were all statistically associated with fear of childbirth. To address this, healthcare providers should focus on individualized psychological support for pregnant women who experience tokophobia. Furthermore, encouraging comprehensive antenatal care and strengthening social networks can reduce the fear of childbirth and promote maternal well-being.

Hypoxic-ischaemic encephalopathy based on clinical signs and symptoms and associated factors among neonates, Southern Ethiopian public hospitals: a case-control study.

Background: Hypoxic-ischaemic encephalopathy (HIE) is a severe condition that results from reduced oxygen supply and blood flow to the brain, leading to brain injury and potential long-term neurodevelopmental impairments. This study aimed to identify the maternal and neonatal factors associated with hypoxic-ischaemic encephalopathy among Neonates. Methods: The authors conducted a case-control study in 15 public hospitals with 515 neonates and mothers (175 cases and 340 controls). The authors used a questionnaire and clinical records created and managed by Kobo software to collect data. The authors diagnosed hypoxic-ischaemic encephalopathy (HIE) by clinical signs and symptoms. The authors used logistic regression to identify HIE factors. Results: Hypoxic-ischaemic encephalopathy (HIE) was associated with maternal education, ultrasound checkup, gestational age, delivery mode, and labour duration. Illiterate mothers [adjusted odds ratio (AOR)= 1.913, 95% CI: 1.177, 3.109], no ultrasound checkup (AOR= 1.859, 95% CI: 1.073, 3.221), preterm (AOR= 4.467, 95% CI: 1.993, 10.012) or post-term birth (AOR= 2.903, 95% CI: 1.325, 2.903), caesarean section (AOR= 7.569, 95% CI: 4.169, 13.741), and prolonged labour (AOR= 3.591, 95% CI: 2.067, 6.238) increased the incidence of HIE. Conclusion: This study reveals the factors for hypoxic-ischaemic encephalopathy among neonates in Ethiopia. The authors found that neonates born to illiterate women, those who experienced prolonged labour, those whose mothers did not have ultrasound checkups during pregnancy, those delivered by caesarean section, and those born preterm, or post-term were more likely to develop hypoxic-ischaemic encephalopathy. These findings indicate that enhancing maternal education and healthcare services during pregnancy and delivery may positively reduce hypoxic-ischaemic encephalopathy among neonates.

Trends, spatiotemporal variation and decomposition analysis of pregnancy termination among women of reproductive age in Ethiopia: Evidence from the Ethiopian demographic and health survey, from 2000 to 2016.

Background: Pregnancy termination is a major public health problem, and complications of unsafe abortion are among the proximate and major causes of maternal mortality. Mapping the trend and spatiotemporal variation and identifying factors that are responsible for the changes in pregnancy termination help achieve the sustainable development goal of reducing maternal mortality in Ethiopia by understanding the epidemiology and regional variations. Methods: Data from the 2000-2016 Ethiopian Demographic and Health Survey were analyzed with a total weighted sample of 40,983 women of reproductive age. Variables with a p-value <0.05 in a logit multivariable decomposition analysis were considered significant predictors of the decline in pregnancy termination over time. Spatial analysis was used separately for each survey to show the changes in regional disparities in pregnancy termination in Ethiopia. Results: The magnitude of pregnancy termination among women of reproductive age decreased by 39.5 %, from 17.7 % in 2000 to 10.7 % in 2016. The difference in the effects of literacy, working status, marital status, age at first intercourse, age at first cohabitation, knowledge about contraceptives, and knowledge of the ovulatory cycle were the significant predictors that contributed to the change in pregnancy termination over time. Significant clusters of pregnancy terminations were observed in central and northern Ethiopia (Addis Ababa, eastern Amhara, and Tigray regions). Conclusions: Despite the substantial decrease in terminated pregnancies over time in Ethiopia, the magnitude is still high. The government should focus on promoting education for girls and women, providing reproductive health education, including access to contraceptives, and raising the minimum age for girls to engage in sexual activities or marriage by implementing policies.

Determinants of neural tube defect among newborns admitted to neonatal intensive care units of teaching hospitals in Gedeo Zone and Sidama Region, Southern Ethiopia: a case-control study.

BACKGROUND: Neural tube defects are a significant cause of morbidity and mortality that can occur in the early pregnancy periods. Though the burden is high, it gains only limited attention. In Ethiopia, the estimated number of neural tube defect cases was significantly higher. So, identifying factors contributing to it would be significant for planning risk reduction and preventive strategies. Therefore, identifying the possible determinants was aimed at this study. METHODS: A hospital-based, unmatched case-control study was conducted on 104 cases and 208 controls selected from neonatal intensive care units of teaching hospitals in Gedeo Zone and Sidama Region, southern Ethiopia from December 2021 to November 2022. All neural tube defect cases were included consecutively and controls were selected by using a simple random sampling method. Data were collected using interviewer-administered semistructured questionnaires. Data analysis was done by using SPSS V.25. Binary logistic regression was used, and variables with a p value less than 0.25 in bivariate analysis were entered into the multivariable logistic regression model. An adjusted OR with a 95% CI was estimated, and finally, variables that show a level of p value less than 0.05 in multivariable analysis were declared statistically significant. RESULT: After controlling confounders, factors such as unplanned pregnancy 2.20 (95% CI 1.20 to 4.041), history of abortions 2.09 (95% CI 1.19 to 3.67), khat chewing 6.67 (95% CI 2.95 to 15.06), antipyretic and analgesic medications 2.87 (95% CI 1.47 to 5.56) and, being a female neonate 2.11 (95% CI 1.21 to 3.67) were significantly associated with a neural tube defect. CONCLUSION: This study has identified some determinants of neural tube defects. Hence, the behavioural, medical and obstetrical conditions of mothers need serious evaluation in the prepregnancy period. So, improving preconception counselling and prenatal care practices would have a significant role in reducing the risk of neural tube defects.

A multiscale geographically weighted regression analysis of teenage pregnancy and associated factors among adolescents aged 15 to 19 in Ethiopia using the 2019 mini-demographic and health survey.

BACKGROUND: Teenage pregnancy remains one of the major reproductive health problems, especially in sub-Saharan African countries. It can lead to maternal and neonatal complications and social consequences. The proportion of teenage pregnancy differs across regions of Ethiopia. Thus, this study aimed to determine the spatial variation in determinants of teenage pregnancy among adolescents aged 15-19 years in Ethiopia using the 2019 Demographic and Health Survey (DHS). METHODS: This study included a total weighted sample of 2165 teenage girls aged 15 to 19 years. A mixed-effect binary logistic regression model was employed to consider the hierarchical nature of the DHS data using STATA version 17. Adjusted odds ratios with 95% confidence intervals are reported, and a p-value less than 0.05 was used to identify significant predictors. The spatial analysis was conducted with ArcGIS version 10.7 and Python 3. To identify factors associated with the hotspots of teenage pregnancy, a multiscale geographically weighted regression (MGWR) was performed. Spatial regression models were compared using adjusted R2, the corrected Akaike information criterion (AICc), and the residual sum of squares (RSS). RESULTS: The prevalence of teenage pregnancy among adolescents aged 15 to 19 years was 12.98% (95% CI: 11.6%, 14.5%). It was spatially clustered throughout the country with a significant Moran's I value. Significant hotspot areas were detected in central and southern Afar; northern, central, and western Gambela; northeastern and southern central Oromia; and the eastern Somali region. The MGWR analysis revealed that the significant predictors of spatial variations in teenage pregnancy were being illiterate and being married. Based on the multivariable multilevel analysis, age 17 (AOR = 3.54; 95% CI: 1.60, 7.81), 18 (AOR = 8.21; 95% CI: 3.96, 17.0), 19 (AOR = 15.0; 95% CI: 6.84, 32.9), being literate (AOR = 0.57; 95% CI: 0.35, 0.92), being married (AOR = 22.8; 95% CI: 14.1, 37.0), age of household head (AOR = 0.98; 95% CI: 0.98, 0.99) and residing in the Gambela region (AOR = 3.27; 95% CI: 1.21, 8.86) were significantly associated with teenage pregnancy among adolescents aged 15 to 19. CONCLUSION: Teenage pregnancy is a public health problem in Ethiopia. Policymakers should prioritize addressing early marriage and improving teenage literacy rates, with a focus on the Gambela region and other hotspot areas. It is crucial to implement policies aimed at transforming the traditional practice of early marriage and to take measures to enhance literacy levels and promote awareness about sexual and reproductive health at the family and school levels. This will help ensure that young people have the opportunity to pursue education and make informed decisions about their reproductive health.

The Association Between Domestic Violence and Adverse Pregnancy Outcomes in Pregnant Women Seeking Antenatal Care at Public Hospitals in Gedeo Zone: A Prospective Cohort Study.

Background: Domestic violence is any harmful behavior by an intimate partner, such as physical, sexual, or psychological abuse. In Ethiopia, domestic violence is a serious and widespread problem. It affects two-thirds (64.6%) of pregnant women and increases the risk of maternal and perinatal morbidity and mortality. Domestic violence during pregnancy is a growing public health problem that may contribute to maternal and perinatal mortality, especially in low- and middle-income countries. This study aims to assess the association between domestic violence during pregnancy and the risk of adverse pregnancy outcomes in Gedeo Zone Public Hospitals, Southern Ethiopia. Material and Methods: We conducted a prospective cohort study on 142 pregnant women in their third trimester who attended public health institutions in Gedeo Zone for antenatal care. We compared 47 women who were exposed to domestic violence with 95 who were not and followed them until 24 hours after delivery or drop-out. We used SPSS version-24 to analyze data and logistic regression to examine the association between domestic violence and pregnancy outcomes. We reported the results using an adjusted odds ratio with 95% confidence interval and P-value. Results: Out of 142 women, who completed the follow-up, 47 were exposed to domestic violence and 95 were not. We found a strong link between domestic violence and preterm birth. Women exposed to domestic violence had a four-fold higher risk of preterm birth (AOR= 4.392, 95% CI: 1.117, 6.588) than those who were not. They also had a 2.5-fold higher risk of perinatal death (AOR= 2.562, 95% CI: 1.041, 6.308). Conclusion: Domestic violence during pregnancy affects many pregnant women in southern Ethiopia and harms their babies. It leads to preterm birth and perinatal death, which can be prevented. The Ethiopian government and other stakeholders need to protect pregnant women from intimate partner violence urgently.

Factors associated with hypertension among diabetic patients in Gamo Zone, Southern Ethiopia, 2021: case-control study.

The prevalence of hypertension in diabetic patients is nearly twice that of non-diabetic patients. The presence of both hypertension and diabetes accelerates complications and raises the risk of death. Thus, identifying determinants of hypertension in diabetic patients is critical for preventing the development of devastating acute and chronic complications, as well as diabetes-related death. Methods and materials: A case-control study was carried out in public hospitals of Gamo Zone, Southern Ethiopia. To select study participants, a systematic random sampling technique was used. The KOBO toolbox was used to collect data, which was then exported to the IBM SPSS version 25 software package for analysis. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with hypertension in diabetes patients, and variables in the multivariable logistic regression analysis with a P value less than 0.05 were declared significantly associated at a 95% CI. Results: In this study, age greater than or equal to 50 years [adjusted odd ratio (AOR)=4.08, 95% CI (1.41, 11.82)], higher body mass index [AOR=3.23, 95% CI (1.40, 7.66)], and higher waist to hip ratio [AOR=2.15, 95% CI (1.12, 4.13)] were significantly associated with hypertension in diabetic patients. Conclusions: This study found that factors associated with hypertension among diabetic patients included older age (>50 years), a high waait to st#to#hip ratio, and a higher body mass index. The concerned health authorities and healthcare providers in the study area should focus on those identified factors to prevent hypertension among diabetic patients.

Variability and awareness of obstetric fistula among women of reproductive age in sub-Saharan African countries: A systematic review and meta-analysis.

Background: Obstetric fistula among women of reproductive age is a significant public health issue in developing countries, including Sub-Saharan Africa. However, the pooled awareness of obstetric fistula among women of reproductive age in Sub-Saharan Africa and its variation between countries have not yet been studied. Hence, the review aims to assess variability and awareness of obstetric fistula among women of reproductive age in Sub-Saharan African Countries. Method: Articles were searched using different electronic databases, such as PubMed, Web of science, science direct (Scopus), Google scholar, and HINARI and manual search without regard to publication date. A random-effects model was used to ascertain the pooled prevalence of obstetric fistula awareness among women of reproductive age in Sub-Saharan Africa. Publication bias was checked by using funnel plot and Egger's test at a 5% level of significance. I2 test statistics was performed to evaluate heterogeneity among included studies. In addition, to identify the possible reason for the potential heterogeneity between the studies, sub-group and meta-regression analyses were conducted. A sensitivity analysis was performed to determine the impact of individual research on the overall results. The data were extracted by using Microsoft excel and analyzed using statistical software STATA/SE version 17. Result: A total of 22 studies with 79,693 women of reproductive age were included in this systematic review and meta-analyses. In Sub-Saharan Africa, the pooled prevalence of awareness towards obstetric fistula among women of reproductive age was 40.85% (95% CI: 33.48, 48.22%). Analysis of the subgroups by specific countries revealed significant variation. The highest awareness of obstetric fistula was found among Tanzanian women of reproductive age (61.10%, 95% CI: 55.87-66.33%), whereas the lowest awareness was found in research from the Gambia (12.80%, 95% CI: 12.20-13.40%).The likelihood of obstetric fistula awareness were lower by a factor of 0.424 among studies with sample sizes greater than 3542 (ß = -0.424 (95% CI: -0.767 to 0.081), p -value <0.05). Conclusion: According to the current review, there is a low level of awareness about obstetric fistula among women of reproductive age in sub-Saharan Africa, and the results of the sub-group analysis by country showed wide variations. Therefore, we emphasize the need for country-specific public health initiatives to raise awareness about obstetric fistula among women of reproductive age, which could reduce the risk of delayed treatment.