RESUMO
BACKGROUND: Despite tremendous work has been done on demand creation, capacity building and ensuring the logistics of Implanon; its discontinuation rate remained high in Ethiopia; the prevalence is reported to be 31% in Shashemene District. However, the factors contributing to the high prevalence of early Implanon discontinuation were not well understood in our study setting. OBJECTIVE: This study aimed to identify the determinants of implanon discontinuation among women who had ever used Implanon in Shashemene District, Southern Ethiopia. METHODS: A community-based unmatched case-control study was conducted among randomly selected 264 women (88 cases and 176 controls) in Shashemene District, Southern Ethiopia, from April 12 to May 18, 2021. A systematic random sampling technique was used to select the respondents. Cases were women who discontinued Implanon before 3 years and controls were those who used implanon for 3 full years. A pre-tested, interviewer-administered structured questionnaire was used to collect data. Bivariable and multivariable binary logistic regression analyses were performed to identify determinants of Implanon discontinuation. An odds ratio (OR) with a 95% confidence interval (CI) was used to estimate the strength of the association, and significance was declared at a P value of less than 0.05. RESULT: The mean age of the respondents was 28.23 (± 5.46) years: 27.27 (± 5.38) years for cases and 28.70 (± 5.5) years for controls. Women with no formal education [AOR = 3.09, 95% CI: (1.20, 8.00)], fewer than four children [AOR = 2.47, 95% CI: (1.20, 5.08)], no history of abortion [AOR = 2.84, 95% CI: (1.25, 6.46)], being new acceptors [AOR = 2.14, 95% CI: (1.02, 4. 49)], being counseled for less than fifteen minutes [AOR = 2.47, 95% CI: (1.29, 4.70)], not discussing it with a partner [AOR = 2.88, 95% CI: (1.42, 5.84)] and experiencing side effects [AOR = 0.35, 95% CI: (0.17, 0.71)] were significantly associated with discontinuation of implanon. CONCLUSION: Women with no formal education, having less than four children, history of abortion, new acceptors, duration of counseling, discussion with partner, and side effects were determinants of Implanon discontinuation among women. There is a need to ensure adequate pre-implantation counseling and appropriate management of side effects. Furthermore, interventions should target new acceptors and those without formal education.
RESUMO
Introduction: Appropriate infant feeding practices are critical to a child's growth, health, and development during the first 1000 days of life. One in every six children worldwide receives a minimum acceptable diet. According to the EDHS 2016, the status of the minimum acceptable diet was 7 percent among children aged 6-23 months in Ethiopia. The study sought to ascertain the relationship between complementary feeding (CF) indicators and household food insecurity in children aged 6-23 months. Methods: A systematic sampling method was used to conduct a cross-sectional study of 536 mother-child pairs aged 6-23 months. The 24-hour dietary recall was used to collect data on CF practices using face-to-face interviews with socioeconomic and food security questionnaires. The relationship between complementary feeding indicators and household food insecurity was investigated using logistic regression analysis. The relationship between independent variables and complementary feeding indicators was determined using multivariate logistic regression. Results: Overall, a total of 67.9% of children received timely introduction of CF and Minimum Meal Frequency (MMF), Minimum Dietary Diversity (MDD), and Minimum Acceptable Diet were met by 61.7%, 42.5%, and 41.7%, respectively. Result of multivariate logistic regression showed there is significant association between household food security with MMF, MDD, and MAD [AOR: 2.02, 95% CI: (1.25-3.24); AOR: 1.55, 95% CI: (1.02-2.36); and AOR: 1.62, 9595% CI: (1.06-2.47)], respectively, while there was no association with introduction of CF [AOR = 0.87, 95% CI: (0.55-1.39)]. Conclusion: This study revealed that the rates of MMF, MDD, and MAD remained low in this study setting. Household socioeconomic status (wealth index, food security status, household income) and child age were found to be among the factors statistically significantly associated with complementary feeding practices indicators.
RESUMO
BACKGROUND: Inadequate complementary feeding is a major cause of childhood malnutrition. Malnutrition caused by insufficient complementary feeding accounts for more than one-third of all under-five mortality whereas appropriate feeding practices are critical for improving nutritional status and ensuring child survival. Thus, the objective of this study was to assess the prevalence of appropriate complementary feeding practices among mothers having 6-23 months children, from Feb.-march 2020 and associated factors in Shashemene Town, Oromia, Ethiopia. METHODS: From February to March of 2020, a community-based cross-sectional survey was conducted. 536 mothers with children aged 6 to 23 months were chosen for the study using a two-stage sampling procedure. Data was collected by Face-to-face interviews during home-to-home visits with mothers who had children aged 6-23 months, using a structured questionnaire on the main complementary feeding indicators. The Statistical Package for the Social Sciences (SPSS) software was used to analyze the data. Logistic regression was used to identify factors associated with appropriate complementary feeding practice, with statistical significance set at probability value < 0.05. RESULTS: The proportion of children aged 6-23 months who met the criteria for complementary food introduction, minimum meal frequency, minimum dietary diversity, minimum acceptable diet, and appropriate complementary feeding practices was 67.9 percent, 61.7 percent, 42.5 percent, 41.7 percent, and 30 percent, respectively. Child age 12-17 and 18-23 months were the independent factors associated with appropriate complementary feed practice [adjusted odd ratio (AOR): 2.32, 95 percent confidence interval (CI): (1.40-3.82)]. ** 1.91 (1.10-3.32) **. Socioeconomic status: mothers in the wealth index of the household, second, third, and fourth, [AOR: 4.27,95 percent, CI (1.8-10.22) ** 4.02(2.23-9.94) ** 7.02(3.27-15.1) **], number of antenatal care visits greater than or equal to four [AOR: 2.57,95 percent, CI: (1.3-5.05)] **, information sources [AOR: 3.5,95 percent, CI: (1.45-8.26) **]. CONCLUSION: This study found that children aged 6-23 months had a low level of appropriate complementary feeding practice. Mothers with children aged 6-11 months, the number of antenatal care (ANC) visits, socioeconomic status, sources of information, mothers' knowledge, and positive attitude were all associated with appropriate feeding practices. As a result, nutritional education/counseling intervention on child feeding practices was suggested.