Trend, and multivariate decomposition of perinatal mortality in Ethiopia using further analysis of EDHS 2005-2016.

BACKGROUND: Perinatal mortality is a global health problem, especially in Ethiopia, which has the highest perinatal mortality rate. Studies about perinatal mortality were conducted in Ethiopia, but which factors specifically contribute to the change in perinatal mortality across time is unknown. OBJECTIVES: To assess the trend and multivariate decomposition of perinatal mortality in Ethiopia using EDHS 2005-2016. METHODS: A community-based, cross-sectional study design was used. EDHS 2005-2016 data was used, and weighting has been applied to adjust the difference in the probability of selection. Logit-based multivariate decomposition analysis was used using STATA version 14.1. The best model was selected using the lowest AIC value, and variables were selected with a p-value less than 0.05 at 95% CI. RESULT: The trend of perinatal mortality in Ethiopia decreased from 37 per 1000 births in 2005 to 33 per 1000 births in 2016. About 83.3% of the decrease in perinatal mortality in the survey was attributed to the difference in the endowment (composition) of the women. Among the differences in the endowment, the difference in the composition of ANC visits, taking the TT vaccine, urban residence, occupation, secondary education, and birth attendant significantly decreased perinatal mortality in the last 10 years. Among the differences in coefficients, skilled birth attendants significantly decreased perinatal mortality. CONCLUSION AND RECOMMENDATION: The perinatal mortality rate in Ethiopia has declined over time. Variables like ANC visits, taking the TT vaccine, urban residence, occupation, secondary education, and skilled birth attendants reduce perinatal mortality. To reduce perinatal mortality more, scaling up maternal and newborn health services has a critical role.

HIV1 drug resistance among patients experiencing first-line treatment failure in Ethiopia: protocol for a systematic review and meta-analysis.

BACKGROUND: The emergence of HIV drug resistance presents a substantial challenge. Current antiretroviral treatments, along with current classes, face the danger of becoming partially or entirely inactive. As a result, alternative treatment regimens are limited, and treatment choices are complicated. According to the recommendation of the WHO, nations should consider changing their first-line ART regimen if HIV drug resistance exceeds 10%. In spite of the fact that a number of primary studies have been performed on HIV drug resistance in Ethiopia, their pooled prevalence rate has not been determined in a systematic review and meta-analysis, which may provide stronger evidence. Therefore, the objective of this systematic review and meta-analysis will be to estimate the pooled prevalence rate of HIV1 drug resistance in patients with first-line treatment failure in Ethiopia. METHODS: Primary studies will be identified from PubMed/MEDLINE, Scopus, Embase, Web of Science Core Collection, and Google Scholar. The period of search will be from 01 April to 30 June 2024. Studies identified through the search strategies will first be screened by titles and abstracts. Included studies meeting established criteria will be evaluated for risk of bias using the JBI checklist. Data will be extracted, and the pooled prevalence rate of HIV drug resistance will be computed using STATA 14 software. Random effect models will be used when heterogeneity is suspected. The I2 statistic and its corresponding P value will be checked to distinguish heterogeneity. Additionally, publication bias and heterogeneity will be checked using visual funnel plots, Egger's test, trim-and-fill tests, meta-regression, and subgroup analysis. To present and synthesize the results, narrative synthesis will be performed to describe study characteristics and findings, and forest plots will be used to visually represent effect sizes and confidence intervals from individual studies. DISCUSSION: Estimating the pooled prevalence rate of HIV drug resistance through a systematic review and meta-analysis improves the reliability of the evidence, the availability of effective HIV treatment options, and the ability to assist in making decisions for both clinical practice and public health policy in Ethiopia. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024533975.

Treatment outcomes of obstetrical fistula surgical repair in low- and middle-income countries: A scoping review.

BACKGROUND: Obstetrical fistula is an abnormal opening between the reproductive tract and lower urinary and/or gastrointestinal tract resulting from obstetrical complications, affecting nearly two million women worldwide. It imposes physical, economic, social, and mental consequences on the affected women. Treatment outcomes vary and, mostly, surgical treatment results in improved quality of life and successful subsequent pregnancy for survivors. OBJECTIVES: The review aimed to chart and examine the treatment outcomes of obstetrical fistula surgical repair in low- and middle-income countries. SEARCH STRATEGY: This is a scoping review study to identify treatment outcomes of obstetrical fistula surgical repair in low- and middle-income countries. The search was conducted from databases (PUBMED, Embase, CINAHL, Scopus, and Web of Science), and gray literature (Google Scholar, Google, and conference proceedings). SELECTION CRITERIA: The eligibility criteria were constructed using a participant, concept, and context framework and included study types of primary research, reviews, and reports. Studies without full text and in languages other than English were excluded. DATA COLLECTION AND ANALYSIS: The relevant characteristics of the included studies were extracted on an Excel spreadsheet and analyzed to chart treatment outcomes. MAIN FINDINGS: The review examined the full text of 57 studies on the treatment outcomes of obstetrical fistula. The findings were grouped into two themes: early and late outcomes. The early outcomes included incontinence, surgical-site infection, urine retention, hemorrhage, and retained catheter. The late outcomes included fistula recurrence, residual incontinence, quality of life, reproductive issues, mental health, family and social support, and financial status. CONCLUSION: The treatment outcomes of obstetrical fistula can be grouped into short-term and long-term outcomes. Although this review found adequate studies for the analysis, most study designs were poor. Stronger studies are recommended in the future to guide policy and decision-making. We would like to suggest that researchers conduct systematic reviews and meta-analyses independently for short-term and long-term outcomes.

Effect of women empowerment on treatment seeking practice for sexually transmitted infections among women in Ethiopia.

BACKGROUND: Sexually transmitted infections (STI) are public health problems in Ethiopia. Women have a higher chance of acquiring STI. STI complications are more severe in women compared to men. Despite that, treatment seeking for STI among women is poor. Woman empowerment and gender related factors may be playing a role for treatment seeking practice for STI. However, there are no studies that assess the association between these factors and treatment seeking practice for STI among married reproductive age women in Ethiopia. Therefore, this analysis was designed to explore this association in Ethiopia. METHODS: This analysis used the 2016 Ethiopian demographic and health survey (EDHS) data. The 2016 EDHS collected data about STI treatment seeking practice for STI among other variables. Data was analyzed using STATA 17.0. Sampling weights were applied to improve the representativeness of the samples. Descriptive statistics were computed to describe the characteristics of the women. Binary and multivariable logistic regression models were fitted to identify the association between treatment seeking practice for STI and predictor variables. Multicollinearity was checked using variance inflation factors before running the multivariable logistic regression. RESULTS: In this study, about 28% (95%CI: 20.87, 36.77) married reproductive age women with STI or STI symptoms sought treatment from the formal sector. Women whose husband attended secondary and higher education (AOR, 8.52; 95%CI 1.42, 51.21), and women with higher women empowerment scores (AOR 1.38, 95%CI 1.06, 1.81) had higher odds of treatment seeking for STI or STI symptoms. On the other hand, women who believe wife beating is justified had lower odds (AOR 0.32; 95%CI 0.15, 0.68) of treatment seeking for STI or STI symptoms. CONCLUSIONS: Treatment seeking practice for STI among married reproductive age women in Ethiopia is low. The Ministry of Health and development partners shall conduct further research to identify barriers for treatment seeking practice. Gender variables (women empowerment and belief that wife beating is justified) were significantly associated with STI treatment seeking practice among married reproductive age women. STI prevention and control strategies shall include women empowerment and gender issues as essential component in STI prevention, treatment, and control activities.

Proportions and determinants of successful surgical repair of obstetric fistula in low- and middle-income countries: A systematic review and meta-analysis.

BACKGROUND: Obstetric fistula is a serious and debilitating problem resulting from tissue necrosis on the reproductive and urinary and/or lower gastrointestinal tract organs due to prolonged labor. Primary studies of the treatment of obstetric fistulae report significantly variable treatment outcomes following surgical repair. However, no systematic review and meta-analysis has yet estimated the pooled proportion and identified the determinants of successful obstetric fistula surgical repair. OBJECTIVE: To estimate the proportion and identify the determinants of successful surgical repair of obstetric fistulae in low- and middle-income countries. METHODS: The protocol was developed and registered at the International Prospective Register of Systematic Reviews (ID CRD42022323630). Searches of PubMed, Embase, CINAHL, Scopus databases, and gray literature sources were performed. All the accessed studies were selected with Covidence, and the quality of the studies was examined. Finally, the data were extracted using Excel and analyzed with R software. RESULTS: This review included 79 studies out of 9337 following the screening process. The analysis reveals that 77.85% (95%CI: 75.14%; 80.56%) of surgical repairs in low and middle-income countries are successful. Women who attain primary education and above, are married, and have alive neonatal outcomes are more likely to have successful repair outcomes. In contrast, women with female genital mutilation, primiparity, a large fistula size, a fistula classification of II and above, urethral damage, vaginal scarring, a circumferential defect, multiple fistulae, prior repair and postoperative complications are less likely to have successful repair outcomes. CONCLUSION: The proportion of successful surgical repairs of obstetric fistula in low and middle-income countries remains suboptimal. Hence, stakeholders and policymakers must design and implement policies promoting women's education. In addition, fistula care providers need to reach and manage obstetric fistula cases early before complications, like vaginal fibrosis, occur.

Prevalence of female genital mutilation and associated factors among women and girls in Africa: a systematic review and meta-analysis.

BACKGROUND: Female genital mutilation (FGM) has zero health benefits. It can lead to short- and long-term risks and complications, including physical, sexual, and mental health and well-being of girls and women. It is a worldwide public health issue with more than 80% prevalence in Africa. It is a global imperative to strengthen work for the elimination, and the United Nations Sustainable Development Goal (SDG) strives to eliminate FGM and monitor the progress made. However, one of a challenge in tracking progress is establishing baseline prevalence data within regions and countries. Therefore, this review aimed to pool the prevalence of FGM in Africa and identify the promoting factors among women and girls. METHODS: This review was conducted according to the PRISMA checklist guideline. Both published and unpublished studies conducted from 2012 onwards were eligible. Studies written in non-English languages were excluded. To retrieve relevant studies; PubMed/Medline, Google Scholar, Science Direct, African Journals Online databases, and African Index Medicus (AIM) were searched using a combination of searching terms. The Newcastle-Ottawa Assessment Scale (NOS) tool was used to assess the quality of each included study. The Cochran's Q chi-square and I2 statistical tests were used to evaluate the heterogeneity of the included studies. The Funnel plot and Egger's regression test (p value < 0.05) were used to evaluate meh publication bias. We used STATA for analysis and the overall and subgroup pooled effect size was estimated using the random effect model with DerSimonian and Laired pooled effect method. The overall prevalence of FGM and the adjusted odds ratio (AOR) with 95%CI (confidence interval) for contributing factors were calculated and presented using a forest plot. RESULT: This study included 155 primary studies conducted on the prevalence and/or factors associated with FGM in Africa. The pooled prevalence of FGM was 56.4% (95%CI 49.7-63.6). The primary factors promoting the practice of FGM were family history of circumcision (AOR = 13.71, 95%CI 9.11-20.62), being a Muslim religion follower (AOR = 3.51, 95%CI 2.61-4.71), poor wealth index (AOR = 1.38, 95%CI1.27-1.51), higher age (AOR = 2.95, 95%CI 2.49-3.38), not attending formal education (AOR = 3.28, 95%CI 2.62-4.12), and rural residency (AOR = 2.27, 95%CI 1.84-2.80). CONCLUSION: The prevalence of FGM in Africa was found to be high. This study also observed a variation in FGM prevalence across regions and countries and a slight temporal decline over the study period. As the global community enters the final decade dedicated to eliminating FGM, there remains much to be done to achieve the elimination goal.

Prevalence of female genital mutilation and associated factors among daughters aged 0-14 years in sub-Saharan Africa: a multilevel analysis of recent demographic health surveys.

Background: Female genital mutilation (FGM) is a harmful traditional practice involving the partial or total removal of external genitalia for non-medical reasons. Despite efforts to eliminate it, more than 200 million women and girls have undergone FGM, and 3 million more undergo this practice annually. Tracking the prevalence of FGM and identifying associated factors are crucial to eliminating the practice. This study aimed to determine the prevalence of FGM and associated factors among daughters aged 0-14 years. Methods: The most recent Demographic Health Survey Data (DHS) datasets from sub-Saharan African countries were used for analysis. A multilevel modified Poisson regression analysis model was applied to identify factors associated with FGM. Data management and analysis were performed using STATA-17 software, and the pooled prevalence and adjusted odds ratio (AOR) with a 95% confidence interval (CI) were reported. Statistical significance was set at p ≤ 0.05. Results: The study included a weighted sample of 123,362 participants. The pooled prevalence of FGM among daughters aged 0-14 years in sub-Saharan Africa was found to be 22.9% (95% CI: 16.2-29.6). The daughter's place of birth (AOR = 0.54, 95% CI: 0.48-0.62), mother's age (AOR = 1.72, 95% CI: 1.4-2.11), father's education (AOR = 0.92, 95% CI: 0.87-0.98), mother's perception about FGM (AOR = 0.42, 95% CI: 0.35-0.48), FGM as a religious requirement (AOR = 1.23, 95% CI: 1.12-1.35), mother's age at circumcision (AOR = 1.11, 95% CI: 1.01-1.23), residing in rural areas (AOR = 1.12, 95% CI: 1.05-1.19), and community literacy level (AOR = 0.90, 95% CI: 0.83-0.98) were factors associated with FGM. Conclusion: The high prevalence of FGM among daughters aged 0-14 years in sub-Saharan Africa indicates the need for intensified efforts to curb this practice. Addressing the associated factors identified in this study through targeted interventions and policy implementation is crucial to eradicate FGM and protect the rights and well-being of girls.

Survival and associated factors of mortality of preterm neonates admitted to Felege Hiwot specialized hospital, Bahir Dar, Ethiopia.

BACKGROUND: The complication of prematurity is the second commonest cause of under-five mortality in Ethiopia. Amhara region has the highest neonatal mortality rate in the country. There was no previous study and this study aimed to assess the survival of preterm neonates and its associated factors of preterm neonatal mortality admitted to Felege Hiwot Specialized Hospital, Bahir Dar, Ethiopia, to take necessary action to maximize survival of preterm babies in developing countries. METHODS: A retrospective cross-sectional study was conducted among 686 preterm neonates admitted in Felege Hiwot Specialized Hospital from 1 August 2017 to 30 July 2018. Kaplan-Meier survival curve was used to show the survival rate of preterm neonates and the multivariate Cox proportional hazards model was used to identify covariates of survival of preterm neonates. Those variables having a p-value less than 0.05 were statistically significant for the survival of preterm neonates. RESULT: Out of 686 preterm neonates admitted from 1 August 2017 to 30 July 2018, 49.1% neonates were improved and discharged and 36.1% died. The survival rate was 0%, 19.4%, 46.7% and 75% for gestational age <28 weeks, 28-31 + 6 weeks, 32-33 + 6 weeks and 34-36 + 6 weeks, respectively. In the multivariate Cox regression model, respiratory distress syndrome, necrotizing enterocolitis, asphyxia, hospital-acquired infection, birth weight, gestational age and place of delivery were significantly associated with time to death of preterm neonates at 95% confidence level (p < 0.05). CONCLUSION: The mortality rate (36.1%) of preterm neonates is unacceptably high in Felege Hiwot hospital compared to other similar hospitals in Ethiopia. More than 50% of preterm neonatal deaths can be prevented with available resources. Neonatal units with adequate and committed manpower, using a strict aseptic technique, proper follow-up, early detection and timely management of complications, are recommended to improve the survival of preterm neonates.

Maternal Health Service Uptake Is Associated with a Higher Skin-to-Skin Care Practice in Ethiopia: Result from a National Survey.

BACKGROUND: Though skin-to-skin care (SSC) is becoming an important newborn care package at both facility and community levels in Ethiopia, there is a lack of evidence to monitor the progress at each level. Therefore, this study is aimed at quantifying the proportion of SSC at both national and regional levels and identifying factors that affect SSC uptake in Ethiopia. METHOD: We used the 2016 Ethiopia Demographic and Health Survey data. The survey employed a multistage cluster sampling method. We included 7,488 live births in the analysis. The factors influencing SSC practice were identified using a multivariable logistic regression model. We reported adjusted odds ratios (AORs) with 95% confidence intervals (CIs). RESULTS: In Ethiopia, 24.3% of mothers practiced SSC for their newborns (95% CI = 23.3, 25.2). The highest proportion was in Addis Ababa (63%), and the lowest was in the Somali region (14.5%). Attending 1-4 antenatal care (AOR = 1.51, 95%CI = [1.08, 2.12], giving birth at health facility (AOR = 4.51, 95%CI = [2.16, 9.44], and having female births (AOR = 1.24, 95%CI = [1.01, 1.54]) were associated with more odds of practicing SSC. However, giving birth by the cesarean section had resulted in lower odds of practicing SSC (AOR = 0.37, 95%CI = [0.22, 0.63]). Regions with reduced odds of SSC practice include Amhara (AOR = 0.57, 95%CI = [0.40, 0.82]), Somali (AOR = 0.51, 95%CI = [0.31, 0.83]), and Southern Nations, Nationalities, and People (AOR = 0.64, 95%CI = [0.43, 0.94]). CONCLUSIONS: The SSC practice was low in Ethiopia with a high level of variation between regions. In Ethiopia, maternal health service uptake affects the SSC of the newborns. Well-tailored community-level interventions are needed to increase skin-to-skin care practice among home delivery mothers.

Level of unintended pregnancy among reproductive age women in Bahir Dar city administration, Northwest Ethiopia.

OBJECTIVE: The objective of this study was to determine the prevalence and determinants of unintended pregnancy among reproductive age women in Bahir Dar town, Northwest Ethiopia. RESULT: The prevalence of unintended pregnancy was 15.8% (95% CI 13.8%-17.7%). Single women (AOR 0.18; 95% CI 0.08-0.40), women living away from their husband (AOR 4.18; 95% CI 2.64-6.61) and women with no access/exposure to mass-media (AOR 1.89; 95% CI 1.13-3.15) were more likely to have unintended pregnancy compared to their counter parts.

Iodine content of dietary salt at household level and associated factors using Iodometric titration methods in Dera District, Northwest Ethiopia.

BACKGROUND: In developing countries most of the edible salts have insufficient iodine content; the problem is worse in Africa. Only 15.4% of the Ethiopian population was using adequately iodized salt. Several factors affect iodine content of edible salt including poor handling practices. The existing evidence isn't sufficient to detail the specific factors at the household level. Therefore, the aim of this study was to determine the iodine content of edible salt and identify factors associated with salt iodine content in Dera District, Northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted among 1194 households. A multi-stage sampling technique was used to select the households, and data were collected using the interview. A 50 g salt sample was collected from each selected household and was shipped to the Ethiopian Food, Medicine and Health Care administration and Control Authority (EFMHACA) laboratory center for iodine level analysis. The samples were analyzed using titration method. Data were entered into EPI-INFO and analyzed in SPSS. RESULTS: Out of 1194 salt samples collected, 57.4% had iodine content in the range 15 ppm to 59.42 ppm. Salt stored in closed containers was more likely to have better iodine content compared to salt stored with open containers (AOR = 1.7, 95% CI: 1.24-2.42). Salt samples stored in dry places were 1.5 times more likely to retain iodine compared to samples stored near to heat/fire or in a moist area (AOR = 1.5, 95% CI: 1.03-2.14). Similarly, salt samples stored for less than 2 months were more likely to have adequate iodine level compared to samples stored for over 2 months (AOR = 1.6, 95% CI: 1.12-2.29).Salt samples obtained from household heads attended primary education (AOR = 1.5, 95% CI: 1.05-2.26), high school (AOR = 1.7, 95% CI: 1.05-2.64), and University (AOR = 2.8, 95% CI: 1.06-5.62) were more likely to have adequate iodine content in edible salt compared to whose didn't attend formal education. CONCLUSIONS: Nearly three out of five salt samples had enough iodine content. However, this level is low compared to the WHO recommendation (90%). The age, educational status of head of the household, duration of salt storage, use of cover to store salt and knowledge of household heads were associated with an iodine content of salt. Therefore, use of cover and proper storage of edible salt should be encouraged; improving the educational status of the community is essential the edible salt to retain its iodine content at the household level.

Demand for family planning among HIV positive women on ART: the case of South Gondar and North Wollo Zones Amhara region.

BACKGROUND: Although family planning for human immune deficiency virus positive women has numerous advantages, evidences in different parts of the world showed the existence of persistent unmet need. There were few studies done in Ethiopia on level of unmet need for family planning among women in reproductive age on antiretroviral therapy (ART). This study was therefore done to determine the level of demand and unmet need for family planning among women on ART in South Gondar and North Wollo Zones, Amhara region. METHODS: Institution based cross-sectional study design was used. Data was collected from June 15 to 25, 2013 in South Gondar and North Wollo Zones. Study participants were recruited from six health centers and two hospitals. The study participants were proportionally allocated to the health institutions. Multistage sampling technique was used to recruit study participants. Trained nurses interviewed the respondents using pretested structured Amharic questionnaire. Data was entered, cleaned and analyzed using Statistical Package for Social Science version 16. Ratios and proportions were computed to determine demand and unmet need for family planning. RESULTS: A total of 530 women in reproductive age on ART were interviewed in this study. Two hundred ninety-three women were married. Fourteen (2.6%) women were pregnant at the time of interview. Five of these pregnancies were not planned. In this study, 242 (45.7%) women reported that they were using contraceptives. Most women (74.4%) were using injectable (depo). Among those who were not using contraceptives, 84 (29.2%) reported that they will use in the future. Fifty-two (61.9%) of them said that they will use injectables (depo). In this study, the total demand for family planning among women on ART was 86.7%. From this, 62.1% and 24.6% was met and unmet need respectively. CONCLUSIONS: This study revealed that the level of demand and met need for modern contraceptives among reproductive age women on antiretroviral therapy in South Gondar and North Wollo Zones was higher than that of sexually active married women in Ethiopia. But the level of unmet need is still similar with that of sexually active married women in Ethiopia.

Factors associated with self medication practice among pregnant mothers attending antenatal care at governmental health centers in Bahir Dar city administration, Northwest Ethiopia, a cross sectional study.

INTRODUCTION: Studies in different parts of the world indicate that there is high level use of self medication among pregnant women. But there are no scientific evidences on it and factors associated with it in Bahir Dar city administration. The aim of this study was therefore to assess level of self medication and identify factors associated with it among pregnant women attending ANC service at governmental health centers in Bahir Dar city administration. METHODS: Institution based cross-sectional study was conducted from June 20-July 10, 2013. Data were collected using structured questionnaire and analyzed using SPSS version 16.0. Back ward logistic regression model was used to assess level of association with self medication practice. RESULTS: A total of 510 pregnant women were included in the study. Of these, 25.1% reported self-medication during the current pregnancy. Self medication during pregnancy was significantly associated with gravida (AOR = 2.1, 95% CI: 1.3-3.4), maternal illness on the date of interview (AOR = 4.8, 95% CI: 2.9-8.0) and location of health facility (AOR = 4.6; 95% CI: 2.9-7.4). CONCLUSION: A considerable proportion of pregnant women practiced self-medication during their pregnancy with modern medications or traditional herbs. Mothers who were multi gravida, who had maternal illness on the date of interview and who were attending antenatal care were more likely to practice self medication.

Factors associated with compliance of prenatal iron folate supplementation among women in Mecha district, Western Amhara: a cross-sectional study.

INTRODUCTION: Iron and folate supplementation can effectively control and prevent anaemia in pregnancy. In Ethiopia, all pregnant women are prescribed iron folate during their ANC visit. However, limited adherence is thought to be a major reason for the low effectiveness of iron supplementation programs. Therefore this study was done to investigate factors associated with compliance of prenatal iron folate supplementation among women who gave birth in the last 12 months before the survey in Mecha district. METHODS: Community based cross sectional study design was employed in Mecha district from June 25 - July 15/2013. A sample of 634 women who gave birth 12 months before the survey was included in the study. Study participants were selected by systematic random sampling technique after allocating the total sample to each kebele proportionally. Data were collected using a pre-tested structured Amharic questionnaire. Collected data were edited, coded and entered to Epi info version 3.1 and exported to' SPSS version 16. Bivariate and multivariable analysis was computed. RESULTS: A total of 628 women who gave birth twelve months before the survey were enrolled. In this study only 20.4% of participants were compliant with iron foliate supplementation. In multivariable analysis, age of the mother, educational status of the mother, knowledge of anaemia and iron folate tablets, and history of anaemia during pregnancy were significantly associated with compliance to iron folate supplementation (P<.05). Belief that too many tablets would harm the baby and fear of side effects were the major reasons given for noncompliance. CONCLUSION: Compliance to iron folate supplementation is very low in the study area. Increasing female education and increasing knowledge of women about anaemia and iron folate tablets are recommended to increase compliance to iron folate supplementation.

Determinants of unmet need for family planning among currently married women in Dangila town administration, Awi Zone, Amhara regional state; a cross sectional study.

BACKGROUND: Unmet need for family planning is a major problem of developing countries. Evidences about unmet need for family planning and associated factors are not enough in Dangila town. Therefore, this study was done to assess the magnitude and determinants of unmet need for family planning among currently married women in Dangila town. METHODOLOGY: Community based cross sectional study design was used to collect data from a total of 551 currently married women from February to March 2014. Data were collected using pretested structured interviewer administered questionnaire after written consent was obtained from respondents. Collected data were edited, coded, and entered to SPSS version 16.0. Bivariate and multivariable logistic regression analyses were done to identify determinants of unmet need for family planning. RESULTS: This study revealed that 17.4 % of married women had unmet need for family planning. In this study, women who were housewife/farmers were about 7 [OR = 6.81 (1.91-24.29)] times more likely to have unmet need compared to employed women. Women who were not counseled about family planning by health workers [OR = 6.76 (3.17-14.42)], women whose partner had non-supportive attitude for family planning use [OR = 3.34 (1.26-8.90)] and rural women [OR = 17.65 (4.35-71.67)] were also more likely to have unmet need for family planning. About 33 %, 32 %, 23.5 % and 11.8 % of women mentioned less perceived risk of pregnancy due to breast feeding, fear of side effects, partner opposition and religious prohibition respectively as reasons for not using contraceptives at the time of interview. CONCLUSIONS: The level of unmet need for family planning in the study area is still high compared to the target set (10 %) in the national family planning guide plan of Ethiopia to be achieved by the end of 2015. Therefore, it is important to strengthen counseling and partner involvement in Dangila town to reduce unmet need for family planning.

Hepatitis B vaccine knowledge and vaccination status among health care workers of Bahir Dar City Administration, Northwest Ethiopia: a cross sectional study.

BACKGROUND: Hepatitis B infection is a major public health problem in Ethiopia. Health care workers are at increased risk of acquiring hepatitis B infection due to occupational exposure. There is effective and safe vaccine against hepatitis B infection. But many health care workers in developing countries are not vaccinated. There is no study in Ethiopia that describes hepatitis B vaccine knowledge and vaccination status of health care workers. Therefore, this study was done to assess hepatitis B vaccination status and knowledge among health care workers' of Bahir Dar city administration, Northwest Ethiopia. METHODS: Institution based cross sectional study design was employed from April 1 to 30, 2012. All healthcare workers who were working in Health care facilities of Bahir Dar city administration were the study populations. A total of 374 health care workers were included in the study. Simple random sampling technique was used to select eligible study participants from the list of health care workers. Self administered questionnaire was used to collect data. The completeness of questionnaires was checked every day by facilitators and principal investigators. Data were entered and analyzed with statistical package for social sciences version 16.0 software. RESULT: In this study, 64.7% of respondents perceived their risk of acquiring hepatitis B infection very high or high. Only 52% of the respondents were knowledgeable about hepatitis B infection. In this study, only 62% of health care workers were knowledgeable about hepatitis B vaccine. From the total of 370 respondents, only 20(5.4%) reported that they took three or more doses of hepatitis B vaccine. CONCLUSION: Hepatitis B vaccination status of health care workers in the study area was low. Health care workers' knowledge about hepatitis B infection and hepatitis B vaccine was also low as all health care workers should be knowledgeable.

Determinants of prescribed drug use among pregnant women in Bahir Dar city administration, Northwest Ethiopia: a cross sectional study.

BACKGROUND: Drug use during pregnancy may be dangerous to the fetus. There is high consumption of prescribed drugs among pregnant women. This condition may be much higher in developing countries. There is no sufficient evidence on prescribed drug use among pregnant women in Bahir Dar town. The aim of this study was to assess the level of prescribed drug use and associated factors among pregnant women attending antenatal care (ANC) service at government health centers in Bahir Dar city administration. METHODS: Institution based cross sectional study was used. Data were collected from randomly selected 510 pregnant women. Data were analyzed using SPSS version 16.0. Back ward stepwise logistic regression model was used and p-values <0.05 were considered statistically significant. RESULT: A total of 510 pregnant women were included in the study of which 88.4% were prescribed at least one drug during pregnancy. Nearly 11% of the pregnant women were prescribed with drugs from category D or X of the US-FDA risk classification.Prescribed drug use among pregnant women was more likely when the pregnancy is wanted, (AOR = 2.4, 95% CI: 1.3 - 4.6), if the mother had maternal illness (AOR = 8.5, 95% CI: 5.4-13.4), when the educational level of ANC provider is diploma (AOR = 2.7, 95% CI: 1.5-4.7) and when number of pregnancies is more (AOR =2.1, 95% CI: 1.3-3.3). CONCLUSION: Prescribed drug use including those with potential harm to the fetus during pregnancy was very high in Bahir Dar city administration. Prescribed drug use is more when the woman had illness, when the woman was multi gravida and when the educational level of ANC provider was low (diploma). It is important to upgrade providers' educational level and institute prevention of diseases like malaria to reduce the level of prescribed drug use during pregnancy.

Sex trafficking awareness and associated factors among youth females in Bahir Dar town, North-West Ethiopia: a community based study.

BACKGROUND: Sex trafficking is a contemporary issue in both developed and developing countries. The number of trafficked women and young girls has increased globally. Females aged 18-25 are the most targeted group of trafficking. Although the problem is evident in Ethiopia, there are no studies that explored sex trafficking awareness among females. Therefore, the aim of this study was to assess sex trafficking awareness and associated factors among youth females in Bahir Dar town, North-West Ethiopia. METHODS: A community based cross-sectional study design was employed to collect data from February 1st-30th 2012 from a total of 417 youth females. The participants in the study were selected using systematic random sampling techniques. A structured Amharic questionnaire was used to collect data. Data were entered, cleaned and analyzed using SPSS 16.0. Descriptive statistics were used to describe data. Logistic regression analysis was used to identify factors associated with sex trafficking awareness. RESULT: Two hundred forty-nine (60%) of the participants reported that they had heard or read about sex trafficking. Television (64%), friends (46%) and radio (39%) were the most frequently mentioned sources of information about sex trafficking. About 87% and 74% of the participants mentioned friends and brokers respectively as mediators of sex trafficking. Having TV at home (AOR = 2. 19, 95% CI: 1.31-3.67), completing grade 10 or more (AOR = 2. 22, 95% CI: 1.18-4.17), taking training on gender issues (AOR = 3. 59, 95% CI: 2.11-6.10) and living together with parents (AOR = 3. 65, 95% CI: 1.68-7.93) were factors found associated with sex trafficking awareness. CONCLUSION: In this study, sex trafficking awareness was low among youth females. Having TV at home, living together with someone and being trained on gender issues were predictors of sex trafficking awareness. Therefore, providing education about sex trafficking will help to increase sex trafficking awareness among youth females.

Factors associated with patient's delay in tuberculosis treatment in Bahir Dar City administration, Northwest Ethiopia.

BACKGROUND: Unknown proportions of tuberculosis cases remain undiagnosed and untreated as result of several factors which further increases the number of tuberculosis cases per index case. OBJECTIVE: To identify factors associated with patient's delay in initiating treatment of tuberculosis. Methods. Cross-sectional study was employed from January to April, 2013, in Bahir Dar Ethiopia. A total of 360 patients were included. Data were collected from tuberculosis patients using a semistructured questionnaire. Data were entered and analyzed using SPSS version 16 windows. Multivariate logistic regression analysis was used to identify factors associated with patient delay. RESULTS: Of all patients, 211 (62%) sought medical care after the WHO recommended period (21 days). The median patient delays of smear positive, smear negative, and extrapulmonary patients were 27 (IQR: 10-59), 30 (IQR: 9-65), and 31 (IQR: 10-150) days, respectively, with statistically significant variations among them (ANOVA: F = 5.96; P < 0.003). Place of residence and educational status were the predictors of patient delay. CONCLUSION: Around two-thirds of all patients and more than half of smear positive tuberculosis patients were delayed in seeking medical care within the recommended period. Provision of DOTS service in the vicinity and health education on TB may reduce patient delay and its consequences.

Factors associated with Institutional delivery service utilization among mothers in Bahir Dar City administration, Amhara region: a community based cross sectional study.

BACKGROUND: High maternal mortality is a continued challenge for the achievement of the fifth millennium development goal in Sub-Saharan African countries including Ethiopia. Although institutional delivery service utilization ensures safe birth and a key to reduce maternal mortality, interventions at the community and/or institutions were unsatisfactorily reduced maternal mortality. Institutional delivery service utilization is affected by the interaction of personal, socio-cultural, behavioral and institutional factors. Therefore this study was designed to assess factors associated with institutional delivery service use among mothers in Bahir Dar city administration. METHODS: A community based cross sectional study was conducted in Bahir Dar City administration Northwest of Addis Ababa, Ethiopia. Four hundred eighty four mothers were included in the study. Data were collected by trained female data collectors. Descriptive statistics, binary and multivariable logistic regression analyses were computed. Statistical significance was considered at p < 0.05 and the strength of statistical association was assessed by odds ratios (OR) with 95% confidence intervals. RESULT: In this study, 78.8% of women gave birth to their current child at health institution. The multivariable logistic regression showed that, attending primary education (AOR = 4.7[95% CI:1.3-16.7], secondary education (AOR = 3.5[95% CI:1.1-10.7]), age at first marriage; first time marriage at 15-19 years (AOR = 5.4[95% CI:2.0-15.0]) and first time marriage at 20-24 years (AOR = 5.0[95% CI:1.5-16.8] and gestational age at first ANC visit (first trimester) (AOR = 5.3[1.3-22.2]) and second trimester (AOR = 2.8[95% CI:0.7-11.]) were independent factors affecting institutional delivery service utilization. CONCLUSION: In this study, institutional delivery service utilization is optimal, urban mothers were more likely to practice institutional delivery. This study indicated that age at first marriage, educational status of the women and gestational age at first ANC visit are independent predictors of delivery service utilization. Hence, intensifying education for women and behavior change communication (BCC) interventions to increase early initiation and up-take of ANC service use in the first trimester and delaying marriage are recommended to promote institutional delivery service utilization.