Effective breastfeeding techniques and associated factors among lactating women in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Effective breastfeeding is crucial for maternal and child health, particularly in low-resource settings like Ethiopia. It encompasses a range of skills and strategies, including proper latch, positioning, and frequency of feeding. These techniques not only ensure sufficient milk transfer but also foster bonding between mother and child, enhancing the breastfeeding experience. To effectively prioritize maternal and child health, it is crucial to comprehensively understand the prevalence and factors influencing effective breastfeeding nationwide. Therefore, this study aimed to provide a pooled prevalence of effective breastfeeding techniques and associated factors among lactating mothers in Ethiopia. METHODS: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist, focusing on studies conducted in Ethiopia. We identified eight relevant studies through Google Scholar, Medline, PubMed, Scopus, and the Cochrane Library. Analysis was conducted using STATA version 11, and systematic data extraction employed a checklist to extract relevant data. I2 tests and the Cochrane Q test statistic were used to evaluate heterogeneity. To explore potential publication bias, Egger's weighted regression, Begg's test, and a funnel plot were utilized. RESULTS: We identified a total of 955 research articles. Eight studies meeting the eligibility criteria were incorporated into this meta-analysis and systematic review. The pooled prevalence of effective breastfeeding techniques was 41.99% [95% CI 32.16-51.81]. According to the results of the current meta-analysis, effective breastfeeding techniques were significantly associated with antenatal care follow-up [OR = 1.75, 95% CI 1.10-2.78], maternal educational status [OR = 2.70, 95% CI 1.55-4.71], breastfeeding technique counseling [OR = 2.02, 95% CI 1.41-2.90], the absence of breast problems [OR = 2.26, 95% CI 1.49-3.43], breastfeeding experience [OR = 1.98, 95% CI 1.14-3.46], and immediate skin-to-skin contact [OR = 2.32, 95% CI 1.56-3.44]. CONCLUSION: Our findings highlight the vital role of various factors in shaping effective breastfeeding. IMPLICATIONS: To improve practices and health outcomes, we recommend targeted interventions, such as strengthening antenatal care, implementing maternal education, and providing comprehensive breastfeeding counseling. Proactively addressing breast problems and prioritizing immediate skin-to-skin contact is crucial for successful breastfeeding.

Urinary incontinence following successful closure of obstetric vesicovaginal fistula repair in Southern Ethiopia.

BACKGROUND: Urinary incontinence (UI) after successful closure of obstetric vesicovaginal fistula (VVF) repair is a widely recognized public health problem. However, there is insufficient research evaluating the factors associated with UI after successful obstetric VVF repair in Ethiopia. OBJECTIVES: The main aim of this study was to assess the magnitude and associated factors of UI following the successful closure of obstetric VVF repair at the Yirgalem Hamlin Fistula Center in the Sidama region of southern Ethiopia. METHODS: A retrospective cross-sectional analytical study was performed on patients who underwent obstetric VVF repair at the Yirgalem Hamlin Fistula Center between 2016 and 2020. The data were collected from September to October 2021. EPI Data Version 3.1 and SPSS Version 25.0 were used for data entry and analysis. A multivariable binary logistic regression model was used for all variables significant in the bivariate binary logistic analysis to determine the association between the independent variables and outcome variables. The data are presented in tables and figures. Variables with a p-value < 0.05 were considered to be statistically associated with the study outcome. RESULTS: In total, 499 study subjects were included. The magnitude of UI after successful closure of obstetric VVF repair was 23.25%. A Goh type 4 fistula (AOR = 4.289; 95% CI 1.431, 12.852), a fistula size > 3 cm (AOR = 8.855; 95% CI 4.786, 16.382), a partially damaged urethra (AOR = 2.810; 95% CI 1.441, 5.479), and a completely destroyed urethra (AOR = 5.829; 95% CI 2.094, 16.228) were found to be significantly associated factors with the outcome variable. CONCLUSIONS: Nearly one in four patients who had successful closure of obstetric VVF repair at the Yirgalem Hamlin fistula center had UI, which is above the WHO recommendations. The presence of a Goh type 4 fistula, large fistula size, and damaged urethral status significantly affect the presence of UI. Therefore, interventions are necessary to prevent and manage UI among patients who underwent obstetric VVF repair and had a closed fistula.

Prevalence and associated risk factors for failed obstetric fistula repair in East African countries: A systematic review and meta-analysis.

Objective: Obstetric fistula repair failure is a combination of unsuccessful fistula closure and/or incontinence following a successful closure. There is an inconsistent finding on the failure of obstetric fistula repair in East Africa. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of failed obstetric fistula repair and its associated factors among women who have undergone fistula repair in East Africa. Methods: This systematic review and meta-analysis were written following the PRISMA guideline protocol. A web-based electronic search of PubMed, Google Scholar, and HINARI was performed to find primary studies. Additional articles were searched by cross-referencing references. A random-effects model was used to estimate the pooled prevalence of failed obstetric fistula repair. The heterogeneity of studies was weighed using I2 test statistics. Publication bias was assessed by Eggers and funnel plot test. Results: The 16 studies that met the inclusion criteria for this systematic review and meta-analysis of failed obstetric fistula repair were included. Nonetheless, one study was used for factor analysis but not in pooled prevalence analysis. The pooled prevalence of obstetric fistula repair failure in East Africa was 26.89% (95% confidence interval: 21.71, 32.07). Labor duration > 48 h (Pooled odds ratio = 2.46; 95% confidence interval 1.58, 3.82), fistula size >3 cm (Pooled odds ratio = 3.92; 95% confidence interval 2.19, 7.05), previous fistula repair (Pooled odds ratio = 3.20; 95% confidence interval 1.94, 5.29), Goh Type 4 fistulas (Pooled odds ratio = 6.07; 95% confidence interval 2.50, 14.75), completely destructed urethra (Pooled odds ratio = 3.35; 95% confidence interval 1.69, 6.65), and severe vaginal scaring (Pooled odds ratio = 3.89; 95% confidence interval 1.99, 7.62) were significantly associated with obstetric fistula repair failure. Conclusions: One in four women with obstetric fistula repair experienced repair failure. To fight the problem The Ministry of Health in every part of the country, in collaboration with obstetric care providers, shall intervene on factors affecting obstetric fistula repair failure to reduce or prevent the failure of obstetric fistula repair.

Obstetric fistula repair failure and its associated factors among women underwent repair in Yirgalem Hamlin fistula center, Sidama Regional State, Southern Ethiopia, 2021: a retrospective cross sectional study.

BACKGROUND: Obstetric fistula repair failure is a combination of unsuccessful fistula closure and/or incontinence following a successful closure. It causes a burden on both the patients and the fistula centers. The aim of this study was to assess the magnitude and associated factors of obstetric fistula repair failure among women who underwent fistula repair at Yirgalem Hamlin fistula center in Southern Ethiopia. METHODS: A facility-based retrospective cross-sectional study was conducted among women who underwent fistula repair at Yirgalem Hamlin fistula center, Southern Ethiopia, during the period from January 2016 to December 2020. All 562 women who underwent fistula repair in the last 5 years were included in the study. The data were collected using a pre-tested checklist from September 22 to October 22, 2021. The data were then imported into EPI info-data version 3.1, exported to SPSS version 25, and analyzed. Descriptive and logistic regression analyses were performed, and the significant statistical test was assessed at a 95% confidence interval. Variables with a p value of < 0.05 in multivariable logistic regression were regarded to have a statistically significant relationship. RESULTS: The magnitude of obstetric fistula repair failure in this study was 28.8%. Obstetric fistula repair failure was found to be associated with labor duration > 48 h (AOR = 2.037; 95% CI 1.268, 3.272), Goh Type 4 fistulas (AOR = 3.939; 95% CI 1.623, 9.560), fistula size > 3 cm (AOR = 6.627; 95% CI 3.802, 11.554), completely destructed urethra (AOR = 3.192; 95% CI 1.234, 8.256), and bladder catheterization > 14 days (AOR = 2.944; 95% CI 1.380, 6.281). CONCLUSIONS: The magnitude of obstetric fistula repair failure was significantly higher than the World Health Organization standard. Obstetric fistula repair failure had a positive association with a longer duration of labor, Goh Type 4 fistulas, large fistula size, total urethral injury, and a longer period of bladder catheterization. Therefore, the concerned bodies need to implement interventions on factors affecting obstetric fistula repair failure to reduce or prevent the failure of obstetric fistula repair.