Prevalence and associated factors of caesarean section among mothers who gave birth across Eastern Africa countries: Systematic review and meta-analysis study.

Background: Caesarean section (CS) rate increased dramatically worldwide, exceeding the World Health Organization's benchmark (10-15 %) in many countries. This rate varies in different regions of the continent. Using various study designs, researchers from across East African countries investigated the prevalence of caesarean section and the factor associated with it but no study shows a pooled prevalence of caesarean section in the Eastern African region. Therefore, this review aimed to systematically summarize and estimate the pooled prevalence of caesarean section and its associated factors in Eastern Africa, 2023. Methods: PubMed, Web of Science, EMBASE, Scopus and CINAHL were rigorously searched to find relevant studies. All identified observational studies reporting the prevalence of CS and its associated factors in East Africa published till August 2023 were considered. Heterogeneity across the studies was evaluated using the I2 test. Publication bias was assessed by funnel plot and Egger's regression test. Finally, a random effect meta-analysis model was computed to estimate the pooled prevalence of CS and qualitative analysis was employed for associated factors. The study protocol was registered in PROSPERO. Results: This review was assessed using twenty-six eligible studies from a total of 2223 articles with a total of 600,431 participants. In this meta-analysis, the pooled prevalence of caesarean section in Eastern Africa was 24.0 % (95%CI: 22-27 %). The highest pooled prevalence of caesarean section was in Ethiopia, 28.30 % (95%CI; 21.3-35.2 %), and the lowest was seen in Uganda, 11.9 % (95%CI; 7.9-15.9 %). Urban residency, having high level of wealth asset, education level college and above, advanced maternal age, big birth weight, history of previous caesarean section, private institution delivery, multiple pregnancies, pregnancy-induced hypertension, antepartum haemorrhage and fetal malpresentation were linked with a greater likelihood of having CS. Conclusions: and recommendation: The overall pooled prevalence of CS in Eastern Africa was high compared to the WHO proposed recommended range. Therefore, the finding implies that each East African countries Ministry of Health and health care professionals shall be given particular emphasis made on strengthening antenatal care services and ensure more women have access to skilled healthcare professionals during childbirth. This can help in providing appropriate interventions, support to women and reducing the need for emergency and unnecessary CSs. The result of this research are a baseline data for future researchers to conduct further studies to better understand the reasons behind the high rates and identify potential interventions and solutions specific to the African context.PROSPERO protocol number: CRD42023440131.

Prevalence of modern contraceptive discontinuation and associated factors among married reproductive age group women in Debre Berhan town, Ethiopia: a community-based cross-sectional study.

OBJECTIVE: To assess the prevalence of modern contraceptive discontinuation and associated factors among married reproductive age (15-49 years) group women. STUDY DESIGN, SETTING AND PARTICIPANTS: A community-based cross-sectional study was conducted in Debre Berhan town among 500 reproductive age group women. Study participants were selected using two-stage sampling procedures. Data were collected using a semistructured face-to-face interview questionnaire. The data were entered in EpiData V.4.2.0 and then exported to SPSS V.25 software for data analysis. Descriptive statistics such as mean, per cent and frequency were used to summarise women's characteristics. Binary logistic regression analysis was used to identify predictors' variables with modern contraceptive discontinuation and p<0.05 was used to declare association. RESULTS: The prevalence of modern contraceptive discontinuation among married reproductive age group women was 35.2% with a mean duration of use of 2.6±2.1 months. This study also revealed that the discontinuation rate was 12.6% within the first year of use. In the current study, those living with their husband (adjusted OR (AOR)=3.81, p<0.001), experiencing side effects while using modern contraceptives (AOR=2.45, p=0.02), getting counselling service (AOR=5.51, p<0.001) and respondent husband acceptance of her modern contraceptive use (AOR=3.85, p=0.01) were significantly associated with modern contraceptive discontinuation. CONCLUSION: The findings of this study showed that the prevalence of modern contraceptive discontinuation rate of all methods among married reproductive age group women was 35.2%. To reduce modern contraceptive discontinuation, mutually, it is important to create community awareness about the importance of the continued use of modern contraceptives, improve the quality of family planning service in the health institution, strengthen family planning counselling service and give adequate counselling on details of effectiveness and side effects.

Uncertainty associated with parents of preterm infants hospitalised in neonatal intensive care unit among selected governmental hospitals in Addis Ababa, Ethiopia, 2022: an institution-based cross-sectional study.

OBJECTIVE: To assess the uncertainty associated with parents of preterm infants hospitalised in neonatal intensive care units of selected governmental hospitals in Addis Ababa, Ethiopia, 2022. DESIGN: A cross-sectional study conducted from 3 March 2022 to 30 March 2022. SETTING: The research was conducted at a government hospital in Addis Ababa, Ethiopia. PARTICIPANTS: Out of 305 eligible participants, 303 were parents of preterm infants' participants with complete data. PRIMARY OUTCOME MEASURE: Levels of parental uncertainty, assessed by using the Mishel scale of uncertainty. Simple and multivariable linear regression analyses were conducted to assess associations between variables. RESULTS: The mean uncertainty expressed by parents was 101.3 (SD=21.12). There were significant associations found with various factors. The sex of the respondent fathers (ß=-4.65, 95% CI -9.32 to -0.025), length of neonatal intensive care unit (NICU) stay >10 days (ß=14.64, 95% CI 8.71 to 20.56), gestational week between 34 and 37 weeks (ß=-7.47, 95% CI -11.42 to -3.52), parents with college degrees and above (ß=-14.15, 95% CI -22.94 to -5.34), parents with neonates who were preterm and had neonatal sepsis (ß=10.42, 95% CI -17.57 to -3.27), parents without a history of neonatal NICU admission (ß=-6.16, 95% CI -11.69 to -0.63) and parents who were housewives (ß=6.51, 95% CI 1.83 to 12.19) all showed significant associations. CONCLUSION: Factors like educational status, gestational week, neonatal admission history and NICU stay length contribute to parental uncertainty. Promoting empathy and clear communication is crucial. Hospitals should develop compassionate protocols for information delivery, including regular updates and effective addressing of concerns. Fostering a supportive environment helps parents express emotions and seek support.

Level of Family centered care and associated factors among parents of children with cancer at tertiary level hospital, Ethiopia.

OBJECTIVE: To determining level and factors affecting Family Centered Care (FCC) in pediatric oncology unit of Tikur Anbessa Specialized hospital (TASH), Ethiopia. METHOD: A cross sectional study was conducted from June to December 2022. Three hundred ninety-three parents of children with cancer were consecutively interviewed using Measure of Processes of Care (MPOC-20). Multivariable linear regression was used to identify independent predictors of FCC. RESULT: The total MPOC 20 means was 3.71(SD = 1.04). The mean score for respectful and supportive care, coordinated and comprehensive care, enabling and partnership, providing specific information and providing general information were found to be 4.8, 4.6, 3.7, 2.3 and 2.6, respectively. Family employment (-0.33(95% CI = -0.63, -0.03; P = .029)), low family education (-0.40 (95% CI = -0.70, -0.11; P = .008)), referral cases (-0.37(95% CI = -0.59, -0.14; P = .001)), shorter time spent in hospital (-0.49(95% CI = -0.85, -0.12; P = .010)) and psychological distress (-0.01(95% CI = -0.026, -0.001; P = .028)) were associated with lower mean score of FCC. CONCLUSION: The total FCC mean score was found to be low. From the five FCC components providing general and specific information scored the lowest mean level. PRACTICE IMPLICATIONS: Mechanism to improve information delivery that address parents from different background and referred from other health facility should be in place in order to improve FCC level. In addition, the FCC should be designed to address parents of children with different lengths of stay.

Health providers readiness in managing intimate partner violence in public health institutions, Ethiopia.

INTRODUCTION: Intimate Partner Violence (IPV) is a worldwide public health problem and major human and legal rights abuses of women. It affects the physical, sexual, and psychological aspects of the victims therefore, it requires complex and multifaceted interventions. Health providers are responsible for providing essential healthcare services for IPV victims. However, there is a lack of detailed information on whether or not health providers are ready to identify and manage IPV. Therefore, this study aimed to assess health providers' readiness and associated factors in managing IPV in public health institutions at Hawassa, Ethiopia. METHOD: Institutional based cross-sectional study was conducted through a simple random sample of 424 health providers. Data was collected with an anonymous questioners using physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool. Linear regression analysis was used to examine relationships among variables. The strength of association was assessed by using unstandardized ß with 95% CI. RESULTS: The mean score of perceived provider's readiness in managing IPV was 26.18± 6.69. Higher providers age and providers perceived knowledge had positive association with provider perceived readiness in managing IPV. Whereas not had IPV training, absence of a protocol for dealing with IPV management, and provider attitude had a negative association with provider perceived readiness in managing IPV. CONCLUSION AND RECOMMENDATION: This study reviled that health providers had limited perceived readiness to manage IPV. Provision of training for providers and develop protocol for IPV managements have an important role to improve providers readiness in the managements of IPV.

Predictors of Depressive Symptoms Among Parents of Children With Cancer in Ethiopia.

Background: The severity of the psychological impact on parents of children with cancer, often depressive symptoms due to mild-to-severe stress, is well documented. The causes are primarily related to their child's cancer diagnosis and treatment, side effects, lack of social support, missing information about their child's disease, and understanding of how to care for their child during treatment. This study assessed predictors of depressive symptoms among parents of children with cancer in one hospital in Ethiopia. Method: The institution-based, cross-sectional design was employed. Parents (n = 126) whose child was admitted at Jimma University Medical Center between February 25 and April 25, 2020, and met inclusion criteria were invited to participate. Results: Questionnaires from 122 parents of children with cancer were included (four had missing data). The prevalence of depressive symptoms was 60.7%. Multivariate regression analysis revealed gender (B = 1.207, p = .033) and higher levels of education (B = 1.019, p < .001) were associated with depressive symptoms in mothers. Receiving information about the child's treatment, however, was negatively associated with depressive symptoms (B = -1.490, p = .031). Monthly income and contact with religious leaders were not significant predictors. Discussion: Mothers of children hospitalized for initial cancer treatment in Jimma, Ethiopia, are at risk for depressive symptoms. It is possible that mothers with higher education are in occupations demanding their time, not allowing them to fulfill responsibilities felt to be essential in the child's treatment journey. Information on the child's treatment nurses have an important role in identifying depressive symptoms in parents but require training to do so.

Stress and coping strategies among parents of children with cancer at Tikur Anbessa Specialized Hospital paediatric oncology unit, Ethiopia: a phenomenological study.

OBJECTIVE: This study explores sources of stress, conditions that help reduce stress levels and coping strategies among parents of children with cancer receiving chemotherapy at Tikur Anbessa Specialized Hospital (TASH) in Ethiopia. DESIGN: A qualitative phenomenological approach was used. SETTING: Parents of children receiving chemotherapy at the TASH paediatric oncology unit. PARTICIPANTS: Fifteen semistructured in-depth interviews were conducted with nine mothers and six fathers of children with cancer from November 2020 to January 2021. RESULTS: Sources of stress related to child's health condition as the severity of the child's illness, fear of treatment side effects and loss of body parts were identified. Parents mentioned experiencing stress arising from limited access to health facilities, long waiting times, prolonged hospital stays, lack of chemotherapy drugs, and limited or inadequate information about their child's disease condition and treatment. Other sources of stress were insufficient social support, stigmatisation of cancer and financial problems. Conditions decreasing parents' stress included positive changes in the child's health, receiving cancer treatment and access to drugs. Receiving counselling from healthcare providers, getting social support and knowing someone who had a positive treatment outcome also helped reduce stress. Coping strategies used by parents were religious practices including prayer, crying, accepting the child's condition, denial and communication with health providers. CONCLUSION: The main causes of stress identified by parents of children with cancer in Ethiopia were the severity of their child's illness, expectations of poor treatment outcomes, unavailability of cancer treatment services and lack of social/financial support. Measures that should be considered to reduce parents' stress include providing psycho-oncological care for parents and improving the counselling available to parents concerning the nature of the child's illness, its treatment, diagnostic procedures and treatment side effects. It may also be helpful to establish and strengthen family support groups and parent-to-parent communication, improve the availability of chemotherapy drugs and offer more education on coping strategies.

HIV/AIDS Related Knowledge of University Students in Southeast Ethiopia: A Cross-Sectional Survey.

PURPOSE: University students are often a sexually active group that is at risk of acquiring and transmitting HIV. This risk depends on their level of knowledge towards the disease. Hence, HIV/AIDS related knowledge represents the acquisition of scientific facts and information regarding the symptoms, way of transmission, adverse consequences, and prevention strategies of the disease. Therefore, this study aimed to assess level of HIV/AIDS related knowledge among regular undergraduate students of Madda Walabu University, Southeast Ethiopia. METHODS: A cross-sectional study was conducted from February 10-25, 2020. A simple random sampling technique was employed to select the study participants. Data were entered to Epi Data version 4.6.0.2 and analyzed using SPSS version 26 software. A bivariate and multivariable binary logistic regression model was used to identify factors associated with level of HIV/AIDS knowledge. Odds ratio with 95% confidence interval and p-value<0.05 was used to declare statistical significance. RESULTS: A total of 442 study participants were included in the study. The level of HIV/AIDS knowledge among study participants was found to be 51.4%. Health science students [AOR=16.28 (8.21-32.28)], being in year III and above [AOR=5.34 (2.92-9.76)] and having monthly stipend >300 birr from parents and relatives [AOR=2.70 (1.34-5.48)] had a higher odds of a good level of HIV/AIDS knowledge. CONCLUSION: Nearly half of the students had a poor level of HIV/AIDS knowledge. Field of study, year of the study, and monthly income were significantly associated with level of HIV/AIDS related knowledge. University-based HIV/AIDS education considering year of study has to be given, and risk reduction on focusing on behavioral change intervention are recommended.

Predictors of Resilience Among Parents of Children with Cancer: Cross-Sectional Study.

PURPOSE: Resilience is an ability to overcome adversities in response to a potentially traumatic event. It relieves parents' discomfort and builds personal capacity when facing a stressful situation like childhood cancer. Therefore, the study's objective is to assess the magnitude of resilience and its predictors among the parents of children with cancer at Jimma medical center, Ethiopia, 2020. METHODS: The institutional-based cross-sectional design was employed on 126 parents of children with cancer at Jimma Medical Center. All study populations who attend the hospital from February 25 to April 25, 2020, and fulfill the inclusion criteria were included. Data were entered into Epi data version 4.6.0.2 and analyzed by SPSS version 25. Descriptive analysis was used to describe the study variables. Furthermore, linear regression analysis was calculated to assess predictors of resilience. RESULTS: The level of resilience among parents' children with cancer were a mean scored 51.41±12.02. In this study, factors associated with resilience were receiving support from friends (ß=5.67, 95% CI=1.58, 9.77; P=0.007), attend recreational activities (ß=13.8, 95% CI=5.32, 22.37; P=0.03) and receiving health information from health care professionals (ß=6.37; 95% CI= (1.75, 11.00), P=0.007), parents depression (ß= -0.827, 95% CI= (-1.619,-0.034), P=0.041) and parents stress (ß =-0.88,95% CI (-1.54,-0.23), P=0.031). CONCLUSION: The magnitude of resilience among parents of children with cancer was low relative to other studies. Support from friends, attending recreational activities, and receiving health information from health care professionals were positively associated with resilience. In contrast, parents' depression and stress were negatively associated with resilience.

Prevalence and Factors Associated with Postpartum Depression Among Mothers Attending Public Health Centers of Addis Ababa, Ethiopia, 2016.

OBJECTIVES: Postpartum Depression (PPD) is a serious public health problem that leads to high maternal morbidity and mortality, enormously affecting the infant, family and society. Thus, the aim of this study was to assess the prevalence and factors associated with postpartum depression among postpartum mothers attending public health centers in Addis Ababa, Ethiopia, 2016. METHODS: Facility-based cross-sectional study was conducted from March 2016-April 2016 among 633 postpartum women. Four sub cities were identified through simple random sampling technique among 10 sub cities in Addis Ababa, Ethiopia. Furthermore, the study participants were determined by systematic random sampling after 10 health centers were selected by lottery method and the number of participants in each health center was proportionally allocated. In order to determine postpartum depression, participants were rated using the Edinburgh Postnatal Depression Scale (EPDS) and the findings were analyzed using bivariate and multivariate logistic regression. P-value less than 0.05 with 95% confidence interval was used to state the association. RESULTS: The study revealed prevalence of postpartum depression among mothers was 23.3%. Moreover, women who were unmarried, had unplanned pregnancy, delivered without presence of any relatives in health institutions, had previous history of child health, had history of substance use and had low income were found to more often display postpartum depression. CONCLUSION: For optimal maternal health care provision in regards to postpartum depression, integration of mental health service in addition to inter sectoral collaboration of women's affair with health institutions is crucial.

Prevalence of disrespect and abuse of women during child birth and associated factors in Bahir Dar town, Ethiopia.

OBJECTIVES: Disrespect and abuse are an often-unacknowledged cause of maternal mortality and morbidity globally. The objective of this study was to assess the prevalence and associated factors of disrespect and abuse of women during childbirth at a health facility in the town of Bahir Dar, Ethiopia. METHODS: In this community-based cross-sectional study, 422 mothers were interviewed from March 1 to 30, 2017 using a systematic random sampling technique with the kth value of 23 calculated based on the number of households in each sub-city and the expected sample size from sub-cities. Data were collected using a structured face-to-face interview questionnaire. EpiData version 3.1 was used to code and enter data, which were analyzed using SPSS version 22. Descriptive statistics were calculated for each variable, and binary logistic regression analysis with 95% confidence intervals (CIs) was carried out to determine the associations between predictor variables and outcome variables. RESULTS: A total of 410 women participated in the study, with a response rate of 97.2%. The overall prevalence of disrespect and abuse was 67.1% (95% CI, 63.0 to 72.0). Disrespect and abuse were more prevalent in women with a monthly income less than 2,000 Ethiopian birr (adjusted odds ratio [aOR], 1.74; 95% CI, 1.08 to 2.80), mothers who stayed in a health facility after delivery (aOR, 5.14; 95% CI, 2.23 to 11.82), those who received care at a governmental hospital (aOR, 2.49; 95% CI, 1.15 to 5.40), and those who attended fewer than 4 antenatal care visits (aOR, 1.97; 95% CI, 1.15 to 3.40). CONCLUSIONS: The prevalence of disrespect and abuse was high in this study setting. To decrease the prevalence of this phenomenon, appropriate interventions should be designed, focusing on increasing the number of antenatal care visits, increasing the incomes of mothers, and improving the relationship between health workers and mothers during mothers' stay at health facilities.

Levels of adherence and factors associated with adherence to option B+ prevention of mother-to-child transmission among pregnant and lactating mothers in selected government health facilities of South Wollo Zone, Amhara Region, northeast Ethiopia, 2016.

OBJECTIVES: The aim of this study was to measure the levels of adherence and to identify factors associated with adherence to option B+ prevention of mother-to-child transmission (PMTCT) among pregnant and lactating mothers in selected government health facilities of South Wollo Zone, Amhara Region, northeast Ethiopia. METHODS: An institution-based cross-sectional quantitative study design was employed from March 1, 2016 to April 14, 2016, using a standard structured data collection instrument. A sample of 191 human immunodeficiency virus (HIV)-positive pregnant and lactating mothers who were receiving PMTCT follow-up in the selected health facilities participated in the study. The data were entered using EpiData 3.1 and analyzed using SPSS version 21. Bivariate and multivariate logistic regression analyses were employed to identify factors associated with adherence. The p-values <0.05 and 95% confidence intervals (CIs) were used to identify associations between independent predictors and the outcome variable. RESULTS: The level of adherence to option B+ PMTCT drugs was 87.9%. Women who received in-hospital treatment, who lived in rural areas, and faced challenges in initiating lifelong option B+ treatment on the same-day that they were diagnosed with HIV were less likely to adhere to the treatment (adjusted odds ratios [95% CI] of 0.3 [0.11 to 0.82], 0.26 [0.1 to 0.73], and 0.08 [0.02 to 0.37], respectively). CONCLUSIONS: Collaborative efforts of zonal health departments with health facility administrators and counselors are recommended for effective and efficient interventions focusing on hospitals, rural areas, and patients who face challenges on the day of their diagnosis.