ABSTRACT
BACKGROUND: Breast milk is the first, highly valuable, and solely natural food recommended for infants in their first six months of life, which is critical for children's overall growth and development. Evidence suggests that exclusive breastfeeding differs by geographic area in Ethiopia. However, little is known regarding the geographic distribution of exclusive breastfeeding practice. Hence, this study aimed to assess exclusive breastfeeding practice, its geographic variation and associated factors among Ethiopian mothers. METHOD: The study used the 2019 Ethiopian mini demographic and health survey data. All living children born 0-23 months before the survey were included. Global Moran's I statistics on Arc-GIS and Getis Ord Gi* statistics was used to visualize the spatial pattern and hotspot and cold spot areas, respectively. Kulldorff SaTScan was used to show purely significant spatial clusters. The associated factors were identified using a multilevel mixed-effects logistic regression model. Statistically significant factors were reported using the AOR with a 95% CI and a p-value of < 5%. RESULT: The coverage of exclusive breastfeeding practice in Ethiopia was 56.05% (95% CI: 53.95%, 58.10%). The spatial pattern was non-random across the country's regions. Somalia, Gambela, Benshangul Gumuz, Dire Dawa, and Harari regions had low clustering of exclusive breastfeeding practices, whereas Amhara, Eastern SNNPR, and Central and Northern Oromia regions had high clustering. Children born through caesarean delivery [AOR = 0.36; 95% CI: 0.21, 0.63], initiated breastfeeding within the first 1 h [AOR = 0.55; 95% CI: 0.34, 0.90], after 1-24 h of delivery [AOR = 0.36; 95% CI: 0.24, 0.54], after a day [AOR = 0.04; 95% CI: 0.02, 0.08], and women residing in the pastoralist region [AOR = 0.22; 95% CI: 0.12, 0.39] or city administrations [AOR = 0.49; 95% CI: 0.27, 0.89] had lower odds of exclusive breastfeeding practice. CONCLUSION: Exclusive breastfeeding practice in Ethiopia remained low. The practice had a spatial variation across the country. Caesarean section delivery, late breastfeeding initiation, and region were statistically significant variables. Therefore, promoting timely initiation of breastfeeding and improving the utilization of maternal health services and designing special intervention strategy for women residing in city administrations and pastoralist regions of the country may increase the coverage of exclusive breastfeeding practice.
Subject(s)
Breast Feeding , Mothers , Multilevel Analysis , Spatial Analysis , Humans , Breast Feeding/statistics & numerical data , Ethiopia , Female , Infant , Adult , Mothers/statistics & numerical data , Infant, Newborn , Young Adult , Adolescent , Health Surveys , Male , Pregnancy , Rural Population/statistics & numerical dataABSTRACT
BACKGROUND: The importance of the health information system faces multiple challenges such as supply, acceptance, and pressure from other professions in Ethiopia. Work-related challenges might cause low professional satisfaction and hinder service provision. There is a paucity of evidence for policy decisions to improve these challenges. Therefore, this study aims to assess Health Informatics professional satisfaction in the Ethiopian health system and associated factors to provide evidence for future improvements. METHODS: We conducted an institutions-based cross-sectional study on health informatics professionals in three zones in Southern Ethiopia in 2020. We used a simple random sampling technique to select 215 participants. The local health officials were contacted regarding the research questions, and letters of permission were collected for data collection. RESULTS: Out of 211(98%) Health Informatics professionals who accepted the interview, 50.8% (95%CI: 47.74%-53.86%) were satisfied. Age (AOR = 0.57; 95% CI: 0.53, 0.95), experience (AOR = 5; 95% CI: 1.50, 19.30), working time (AOR = 1.35; 95% CI: 1.10, 1.70), working as HMIS officers (AOR 2.30; 95% CI: 3.80, 13), single marital status (AOR = 9.60; 95% CI: 2.88, 32), and urban residence (AOR = 8.10; 95% CI: 2.95, 22) were some of the associated factors. CONCLUSIONS: We found low satisfaction among health informatics professionals compared to other studies. It was suggested that the responsible bodies must keep experienced professionals and reduce pressure from other professions through panel discussions. Work departments and working hours need consideration, as they are the determinants of satisfaction. Improving educational opportunities and career structure is the potential implication area.
Subject(s)
Medical Informatics , Humans , Ethiopia , Cross-Sectional Studies , Surveys and Questionnaires , Personal SatisfactionABSTRACT
BACKGROUND: Early sexual initiation is one of the risky sexual practices. Early sexual beginning is associated with an increased risk of HIV/AIDS, sexually transmitted infections (STIs), unexpected pregnancies, unsafe abortion, premature deliveries, and psychosocial issues. However, there is still a lack of evidence, particularly in East Africa, where community-level factors are not investigated. Therefore, this study aimed to estimate the pooled prevalence and to identify associated factors of early sexual initiation among female youth in Eastern Africa. METHODS: A total weighted sample of 49,716 female youth was included in this analysis. STATA version 14 software was used for data extraction, recoding, and analysis. A multilevel binary logistic regression model was fitted to identify determinants of early sexual initiation in the region. Finally, Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was reported to declare the factors that are significantly associated with early sexual initiation. RESULT: The prevalence of early sexual initiation in East Africa was 21.14% [95% CI: 20.00%, 21.50%]. In the multivariable multilevel analysis; being age 20-24 years [AOR = 0.65: 95% CI; 0.61, 0.69], primary [AOR = 0.73: 95% CI; 0.67, 0.78], secondary &above education [AOR = 0.30: 95% CI; 0.27,0.33], married [AOR = 1.85: 95% CI; 1.73,1.97], middle wealth [AOR = 0.78: 95% CI; 0.72,0.84], richest [AOR = 0.74: 95% CI; 0.68,0.80], and reading newspaper [AOR 0.77: 95% CI;0.71,0.83] were significantly associated with early sexual initiation. CONCLUSION: The study revealed that early sexual initiation among female youth was high in East Africa. Educational status, respondent age, marital status, wealth index, age at first cohabitation, contraceptive use, reading newspaper, and place of residence were associated with early sexual initiation. Therefore, the survey findings will help policymakers, as well as governmental and non-governmental organizations, design the most effective interventions. Moreover, strengthening information, education, and wealth status are important intervention areas to delay the age of early sexual debut.
Subject(s)
Sexual Behavior , Adolescent , Adult , Africa, Eastern/epidemiology , Female , Health Surveys , Humans , Marital Status , Pregnancy , Prevalence , Young AdultABSTRACT
Low height/length-for-age (stunting) is a public health problem in Ethiopia. Efforts that have been made to evaluate factors affecting national and international strategies related to the problem are very limited and poorly achieved. The present study aimed to evaluate low length/height-for-age (stunting) and its associated factors among children 6 to 23 months of age in Ethiopia. We used cross-sectional data collected for 2019 EMDHS. We cleaned, processed, and analyzed in Stata v.15. Socio-demographic, socio-economic parameters, and nutritional (wasting, diet frequency, breast milk, and animal milk) factors were used in the analysis. We fitted Generalized Linear Latent and Mixed Model (GLLAMM) to examine the associations. We analyzed the data of 2,037 children aged 6-23 months and found stunting of 933.07(45.80%). Some factors such as home delivery [coef. = -4.58, 95% CI:-7.81,-1.34] and household size of ≥6 [coef. = -5.53, 95% CI:-10.36,-7.10] were positively associated. No current breastfeeding [coef. = 10.70, 95% CI: 2.16, 19.23] and still breastfeed [coef. = 10.68, 95% CI: 2.62, 18.74] were negatively associated with stunting. Stunting among 6-23 months aged children in Ethiopia is very high above all the national, regional, and international targets. Feeding practice, socio-economic, and psychosocial-support for mothers need revised commitment for pragmatic solution.
Subject(s)
Growth Disorders , Mothers , Animals , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Growth Disorders/epidemiology , Growth Disorders/etiology , Humans , PrevalenceABSTRACT
BACKGROUND: Caesarian section is a vital emergency obstetric intervention for saving the lives of mothers and newborns. However, factors which are responsible for caesarian section (CS) were not well established in the country level data. Therefore, this study aimed to assess the prevalence and associated factors of caesarian section in Ethiopia. METHODS: Data from the Ethiopian Mini Demographic and Health survey 2019 were used to identify factors associated with the caesarian section in Ethiopia. We applied multi-level logistic regression and a p-value of <0.25 to include variables before modeling and a p-value<0.05 with 95% confidence interval (CI) for final results. RESULT: The prevalence of caesarian section in Ethiopia was 5.44% (95% CI; 0.048-0.06) in2019. Women in age group of 30-39 and 40-49 years had a higher odd of caesarian section (AOR = 2.14, 95%CI = 1.55-2.94) and (AOR = 2, 95%CI = 1.20-3.97) respectively compared to women in age group of 15-29 years. Women with secondary and higher educational level had higher odds of caesarian section (AOR = 2.15, 95%CI = 1.38-3.34) and (AOR = 2.8, 95%CI = 1.73-4.53) compared to those in no education category. Compared to Orthodox, Muslims and Protestant religions had lower odds of caesarian section with AOR of 0.50 (0.34-0.73) and 0.53 (0.34-0.85). Having <2 births was also associated with the low caesarian section 0.61(0.52-1.22). Using modern contraceptive methods, having ANC visits of 1-3, 4th, 5 plus, and urban residence were associated with higher odds of caesarian section as 1.4 (1.05-1.80]), 2.2 (1.51-3.12), 1.7 (1.12-2.46), and 2.4 (1.65-3.44) 1.6(1.04-2.57) respectively. CONCLUSION: Although evidence indicates that the caesarian deliveries increased both in developed and underdeveloped countries, the current magnitude of this service was very low in Ethiopia which might indicate missing opportunities that might costing lives of mothers and newborns. Women's age, religion, educational status, parity, contraceptive method, and ANC visit were individual level factors influenced caesarian section. whereas, region and place of residence were community level factors affected caesarian section in the country. Depending on these factors, the country needs policy decisions for further national level interventions.
Subject(s)
Cesarean Section/statistics & numerical data , Adolescent , Adult , Demography , Ethiopia/epidemiology , Female , Humans , Middle Aged , Multilevel Analysis , Odds Ratio , Pregnancy , Prevalence , Socioeconomic Factors , Young AdultABSTRACT
INTRODUCTION: Maternal and child mortality remained higher in developing regions such as Southern Ethiopia due to poor maternal and child health. Technologies such as mobile applications in health may be an opportunity to reduce maternal and child mortality because they can improve access to information. Therefore, the main aim of this study was to explore the role of mHealth in improving maternal and child health in Southern Ethiopia. METHODS: This study employed a qualitative study design to explore the role of mHealth in improving maternal and child health among health professionals in Southern Ethiopia from December 2022 to March 2023. We conducted nine in-depth interviews, six key informants' in-depth interviews, and four focused group discussions among health professionals. This is followed by thematic analyses to synthesize the collected evidence. RESULTS: The results are based on 226 quotations, 5 major themes, and 24 subthemes. The study participants discussed the possible acceptance of mHealth in terms of its fitness in the existing health system, its support to health professionals, and its importance in improving maternal and child health. The participants ascertained the importance of awareness creation before the implementation of mHealth among women, families, communities, and providers. They reported the importance of mHealth for mothers and health professionals and the effectiveness of mHealth services. The participants stated that the main challenges related to acceptance, awareness, negligence, readiness, and workload. However, they also suggested strategic solutions such as using family support, provider support, mothers' forums, and community forums. CONCLUSION: The evidence generated during this analysis is important information for program implementations and can inform policy-making. The planned intervention needs to introduce mHealth in Southern Ethiopia. Planners, decision-makers, and researchers can use it in mobile technology-related interventions. For challenges identified, we recommend solution-identified-based interventions and quality studies.
Subject(s)
Child Health , Telemedicine , Child , Humans , Female , Ethiopia , Telemedicine/methods , Qualitative Research , MothersABSTRACT
INTRODUCTION: Vaccine-preventable diseases are the public health problems in Africa, although vaccination is an available, safe, simple, and effective method prevention. Technologies such as mHealth may provide maternal access to health information and support decisions on childhood vaccination. Many studies on the role of mHealth in vaccination decisions have been conducted in Africa, but the evidence needs to provide conclusive information to support mHealth introduction. This study provides essential information to assist planning and policy decisions regarding the use of mHealth for childhood vaccination. METHODS: We conducted a systematic review and meta-analysis for studies applying mHealth in Africa for vaccination decisions following the Preferred Reporting Items for Systematic and Meta-Analysis [PRISMA] guideline. Databases such as CINAHL, EMBASE, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, Global Health, HINARI, and Cochrane Library were included. We screened studies in Endnote X20 and performed the analysis using Revman 5.4.1. RESULTS: The database search yielded 1,365 articles [14 RCTs and 4 quasi-experiments] with 21,070 participants satisfied all eligibility criteria. The meta-analysis showed that mHealth has an OR of 2.15 [95% CI: 1.70-2.72; P<0.001; I2 = 90%] on vaccination rates. The subgroup analysis showed that regional differences cause heterogeneity. Funnel plots and Harbord tests showed the absence of publication bias, while the GRADE scale showed a moderate-quality body of evidence. CONCLUSION: Although heterogeneous, this systematic review and meta-analysis showed that the application of mHealth could potentially improve childhood vaccination in Africa. It increased childhood vaccination by more than double [2.15 times] among children whose mothers are motivated by mHealth services. MHealth is more effective in less developed regions and when an additional incentive party with the messaging system. However, it can be provided at a comparably low cost based on the development level of regions and can be established as a routine service in Africa. REGISTRATION: PROSPERO: CRD42023415956.
Subject(s)
Telemedicine , Vaccination , Humans , Africa , Vaccination/statistics & numerical data , Vaccination/methods , ChildABSTRACT
OBJECTIVE: Childhood vaccination is a cost-effective, essential service to reach a larger population globally. Due to unclear reasons, new emergence and resurgence of vaccine-preventable diseases increase. Thus, the aim of this study is to identify prevalence and determinants of childhood vaccination in Ethiopia. DESIGN: Community-based cross-sectional study. SETTING: We used data from 2019 Ethiopia Mini Demographic and Health Survey. The survey included all the nine regional states and two city administrations of Ethiopia. PARTICIPANTS: A weighted sample of 1008 children 12-23 months of age was included in the analysis. MAIN OUTCOME MEASURES: A multilevel proportional odds model was fitted to identify determinants of childhood vaccination status. In the final model, variables with a p value of less than 5% and an adjusted OR (AOR) with a 95% CI were reported. RESULT: The full childhood vaccination coverage of Ethiopia was 39.09% (95% CI: 36.06%-42.28%). Mothers who attended primary (AOR=2.16; 95% CI: 1.43-3.26), secondary (AOR=2.02; 95% CI: 1.07-3.79) and higher education (AOR=2.67; 95% CI: 1.25-5.71); being in union (AOR=2.21; 95% CI: 1.06-4.58); kept vaccination cards (AOR=26.18; 95% CI: 15.75-43.53); children receiving vitamin A1 (AOR=4.14; 95% CI: 2.9-5.9); living in Afar (AOR=0.14; 95% CI: 0.04-0.45), Somali (AOR=0.19; 95% CI: 0.06-0.60), Gambela (AOR=0.22; 95% CI: 0.06-0.77), Harari (AOR=0.14; 95% CI: 0.04-0.52) and Dire Dawa (AOR=0.23; 95% CI: 0.06-0.79) regions; and rural residents (AOR=0.53; 95% CI: 0.30-0.93) were factors significantly associated with childhood vaccination. CONCLUSION: The full childhood vaccination coverage in Ethiopia was low and remained unchanged since 2016. The study identified that both the individual-level and community-level factors affected the vaccination status. Accordingly, public health interventions targeted to these identified factors can increase childhood full vaccination status.
Subject(s)
Mothers , Vaccination , Female , Humans , Child , Cross-Sectional Studies , Ethiopia/epidemiology , Vaccination Coverage , Multilevel AnalysisABSTRACT
INTRODUCTION: Although the timing of antenatal care has a high potential of reducing maternal and child health problems and can be improved through different mass media exposure, it has been overlooked and remained a major life-costing delinquent issue. Therefore, the aim of this study is to identify the relationship between mass media exposure and ANC for further insight. METHODS: We used the 2016 Ethiopian Health and Demography (EDHS) data. EDHS is a community-based cross-sectional survey that applies a two-stage stratified cluster sampling and it is a country-representative. We included 4740 reproductive-age women with complete records in EDHS dataset in this study. We excluded records with missing data from the analysis. We used ordinal logistic regression followed by generalized ordinal logistic to examine mass media relationships with timely antenatal care (ANC). We presented data using numbers, mean, standard deviations, percent or proportions, coefficient of regression, and 95% confidence interval. All analyses were performed using STATA version 15. RESULT: We examined the data of 4740 participants for the history of timely initiation of ANC and found 32.69% (95% CI = 31.34, 34.03) timely ANC. Factors such as watching television (TV) less than once a week [coef. = -0.72, CI: -1.04, -0.38], watching TV at least once a week [coef. = -0.60, CI: -0.84, -0.36], listening to radio [coef. = -0.38, CI: -0.84, -0.25], and use internet every day[coef. = -1.37, CI: -2.65, -0.09], are associated with the timely ANC. CONCLUSION: Despite its association with improving the timing of ANC, our findings showed mothers need additional support on the use of the media and the timing of ANC. In addition to the mass media, other covariates such as educational status, family size, and husband's desire affected the timely ANC imitation. These need attention during implementation to avert the current. This is also an essential input for policy and decision-makers.
Subject(s)
Family Characteristics , Prenatal Care , Pregnancy , Child , Humans , Female , Cross-Sectional Studies , Ethiopia , Mass MediaABSTRACT
BACKGROUND: Despite the high fertility and population growth rates, the use of modern contraceptives remains low in low- and middle-income countries. Different pocket-sized studies on the use of modern contraceptive methods conducted in various parts of Ethiopia have been extremely varied and ambiguous. Therefore, this study aimed to assess modern contraceptive use and its associated factors in women of reproductive age in Ethiopia. METHODS: Cross-sectional data from the Ethiopia Interim Demographic Health Survey (EMDHS) 2019 in a stratified, two-stage, and cluster sampling study. Multilevel binary logistic regression analysis was used to fit the associated factors. The interclass correlation (ICC), median odds ratio (MOR), proportional change variance (PVC), and deviance were used for model comparison and fitness. The adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to identify the significant factors of modern contraceptive use. RESULT: The multilevel analysis demonstrated that Orthodox religion [AOR = 1.7; 95%CI: 1.4-2.10] protestant religion [AOR = 1.2; 95%CI: 0.93-1.62], married [AOR = 4.2; 95%CI: 1.93-9.07], primary education [AOR = 1.5; 95%CI: 1.26-1.76], secondary education [AOR = 1.36; 95%CI: 1.04-1.77 [AOR = 1.89; 95%CI: 1.37-2.61], middle [AOR = 1.4; 95%CI: 1.14-1.73], rich [AOR = 1.3; 95%CI: 1.06-2.68] were positively associated with modern contraceptive utilization, while the age group of 40-49 [AOR = 0.45, 95% CI: 0.34-0.58], and high community poverty [AOR = 0.62; 95%CI: 0.46-0.83] were negatively associated with modern contraceptive utilization. CONCLUSION: The prevalence of modern contraception in Ethiopia remains low. Maternal age, religion, maternal education, marital status, wealth index, region, and community poverty were significant predictors of modern contraceptive utilization in Ethiopia. Governments and non-governmental organizations should expand their public health programs to poorer communities to increase the use of modern contraception in the country.
Subject(s)
Contraceptive Agents , Female , Humans , Adult , Middle Aged , Cross-Sectional Studies , Ethiopia/epidemiology , Multilevel Analysis , DemographyABSTRACT
INTRODUCTION: Poor child feeding practice is a public health problem in Africa. Mobile health (mHealth) is a supportive intervention to improve this problem; however, the evidence available in the current literature is inconsistent and inconclusive in Africa. Some studies state that exclusive breastfeeding is not different between controls and mHealth interventions in the first month. Other studies state that health providers need additional training for the success of mHealth interventions. OBJECTIVE: This systematic review and meta-analysis aims to provide the summarized effect of mHealth on child-feeding practices in Africa to improve future planning and decisions. METHOD: We conducted a systematic review and meta-analysis based on the published and unpublished evidence gathered from PubMed, Web of Science, Cochrane Library, and Embase databases between January 1, 2000, and March 1, 2022. Studies included were randomized control trials and experimental studies that compared mHealth to standards of care among postpartum women. Preferred Reporting Items for Systematic Review and Meta-analysis guidelines followed for the reporting. RESULTS: After screening 1188 studies, we identified six studies that fulfilled the study criteria. These studies had 2913 participants with the number of total intervention groups 1627 [1627/2913 = 56%]. Five studies were completed within 24 weeks while one required 12 weeks. We included two RCTs, two cluster RCTs, and two quasi-experimental studies all used mHealth as the major intervention and usual care as controls. We found significant improvement in child-feeding practices among intervention groups. CONCLUSION: This systematic review and meta-analysis showed that the application of mHealth improved child-feeding practices in Africa. Although the finding is compelling, the authors recommend high-quality studies and mHealth interventions that consider sample size, design, regional differences, and environmental constraints to enhance policy decisions. The place of residence, access, low socioeconomic development, poor socio-demographic characteristics, low women empowerment, and low women's education might cause high heterogeneity in the included regions and need consideration during interventions. REGISTRATION NUMBER: PROSPERO: CRD42022346950.
Subject(s)
Breast Feeding , Postpartum Period , Humans , Female , Africa , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND: Wasting is an immediate, visible, and life-threatening form of undernutrition in children aged <5 years. Within a short time, wasting causes recurrent sickness, delayed physical and mental growth, impatience, poor feeding, and low body weight. The long-term consequences of wasting and undernutrition are stunting, inability to learn, poor health status, and poor work performance. Wasting remains a public health problem in Ethiopia. According to the World Health Organization, countries have to reduce undernutrition including child wasting to below 5% by 2025. Ethiopia is attempting to attain national and international targets of undernutrition while struggling with many problems. OBJECTIVE: This study aimed to identify the prevalence and associated factors of wasting to provide information for further renewing policy commitments. METHODS: We used community-based, cross-sectional data from the Ethiopian Mini Demographic and Health Survey. The survey was conducted in 9 regions and 2 city administrations. Two-stage cluster sampling was used to recruit study participants. In the first stage, enumerations areas were selected, and 28-35 households per enumeration area were selected in the second stage. Our analysis included 2016 women with children aged <5 years from the 2019 EMDHS data set. We dropped incomplete records and included all women who fulfilled the eligibility criteria. We used multilevel ordinal regression using Generalized Linear Latent and Mixed Models (GLLAMM) and predicted probability with log-likelihood ratio tests. Fulfilling the proportional odds model's assumption during the application of multilevel ordinary logistic regression was a cumbersome task. GLLAMM enabled us to perform the multilevel proportional odds model using an alternative method. RESULTS: In our analysis, wasting was 7.68% (95% CI 6.56%-8.93%). Around 26.82% of mothers never used antenatal care for their current child. Most mothers (52.2%) did not have formal education, and 86.8% did not have postnatal care for their children. Additionally, half (50.93%) of the mothers have ≥6 household members. Wasting was associated with feeding diverse foods (coefficient 4.90, 95% CI 4.90-4.98), female sex of the household head (-40.40, 95% CI -40.41 to -40.32), home delivery (-35.51, 95% CI -35.55 to -35.47), first (16.66, 95% CI, 16.60-16.72) and second (16.65, 95% CI 16.60-16.70) birth order, female child (-12.65, 95% CI -12.69 to -12.62), and household size of 1 to 3 (10.86, 95% CI 10.80-10.92). CONCLUSIONS: According to the target set by World Health Organization for reducing undernutrition in children aged <5 years to below 5% by 2025, child wasting of 7.68% in Ethiopia should spark an immediate reaction from the government and stakeholders. Informed policy decisions, technology-based child-feeding education, and food self-sufficiency support could improve the current challenges. Additional effort is important to improve low maternal education, family planning, awareness of sex preferences, women empowerment, and maternal health services.
Subject(s)
Malnutrition , Wasting Syndrome , Pregnancy , Humans , Female , Cross-Sectional Studies , Ethiopia/epidemiology , Wasting Syndrome/epidemiology , Wasting Syndrome/etiology , Malnutrition/complications , Malnutrition/epidemiology , Family CharacteristicsABSTRACT
Introduction: Ethiopians work very hard to control and eradicate the vector and the parasite of Onchocerciasis. However, some hard-to-reach areas are not adequately covered by interventions that have previously taken place in various endemic sites in the country. This study aimed to assess knowledge, attitude, and preventive practice of Onchocerciasis among Selamogo residents to enhance the expansion of interventions. Methods: We used a survey questionnaire to capture the data on 572 Selamago residents. We checked, cleaned, entered the data into EPI Info v.7, and analyzed it in STATA v.15. We fitted a binary logistic regression model to examine the associated factors. Variables significant at P < 0.20 were included in the model. We declared association at P < 0.05. Results: Of the 578 residents we approached, 572 (99%) responded to the interview. We found 48.30% of poor knowledge, 90.90% of poor attitude, and 85.70% preventive practice related to Onchocerciasis. Factors like Amhara ethnicity (AOR = 2.35, 95% CI: 1.05, 5.27), Orthodox Christianity (AOR = 1.87, 95% CI: 1.12, 3.10), Muslims (AOR = 2.28, 95% CI: 1.05, 4.94), secondary school (AOR = 2.31, 95% CI: 1.50, 3.55), diploma (AOR = 10.34, 95% CI: 4.62, 23.16), and preventability of Onchocerciasis (AOR = 3.02, 95% CI: 1.39, 6.55) were associated with KAP. Other factors like medical treatability, admission history to the health facilities, sex, and the number of households were also associated. Conclusion: The KAP related to Onchocerciasis is very poor compared to the indicators and evidence in the country. An intervention that considers local resources like taking the experience of groups with good knowledge, attitude, and preventive practice led by educated plus positive attitude people regarding the preventability and treatability of Onchocerciasis might be mandatory to improve the status.
ABSTRACT
Introducing complementary feeding either early or later than 6 months is associated with future negative health outcomes. However, many women in Ethiopia do not follow WHO standard time to feed their children, which might be due to various demographic, economic, access, and availability of services. Thus, we aimed to identify factors attributing to the problems to assist future interventions. We used cross-sectional EMDHS 2019 for this analysis. We cleaned the data and 4061 women with under 2 years children were identified. We applied multilevel binary logistic regression in Stata v.15. Model comparison was based on log-likelihood ratio, deviance, and other criteria. We presented data using mean, percent, 95% CI, and adjusted odds ratio (AOR). The timely complementary feeding was 36.44% (34.93-37.92%). Factors like preceding birth intervals (AOR = 1.97 95% CI 1.62-1.39), primary education (AOR = 2.26 95% CI 1.40-3.62), secondary above education (AOR = 1.62 95% CI 1.10-2.38), and rich wealth index (AOR = 1.25 95% CI 1.03-1.52) were some of the associated factors. The magnitude of timely initiation of complementary feeding was diminutive. Authors suggest that interventions considering maternal education, empowering mothers economically, equity access to health services, and birth planning a good remedy.
Subject(s)
Infant Nutritional Physiological Phenomena , Mothers , Infant , Child , Humans , Female , Cross-Sectional Studies , Ethiopia , Odds RatioABSTRACT
OBJECTIVE: This study aims to assess the prevalence of early initiation of breast feeding (EIBF) and associated factors among mothers having children less than 2 years of age in Ethiopia. DESIGN: Community-based cross-sectional study. SETTING: In this analysis, data from 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) was used. The survey included all the nine regional states and two city administrations of Ethiopia. PARTICIPANTS: We extracted data of 2054 mothers who had last-born children and those mothers who ever breast fed or still breast feeding their children during the survey from the 2019 EMDHS datasets. MAIN OUTCOME MEASURES: We performed a two-stage multilevel mixed-effects logistic regression to identify individual and community-level determinants of EIBF. In the final model, variables with a p-value less than 5% and an adjusted OR with a 95% CI were reported as statistically significant variables with EIBF. RESULT: The prevalence of EIBF among mothers having children aged 0-23 months was 73.56% (95% CI: 71.65% to 75.47%). Women who delivered at a health facility (adjusted OR (AOR)=1.98; 95% CI: 1.39 to 2.79) and have children with birth order second-fourth (AOR=1.76; 95% CI: 1.24 to 2.49) were more likely to initiate early breast feeding than their counterparts. On the other hand, women who gave birth by caesarean section (AOR=0.21; 95% CI: 0.13 to 0.33), had multiple births (AOR=0.35; 95% CI: 0.13 to 0.92) and had postnatal check-up (AOR=0.62; 95% CI: 0.44 to 0.91) were less likely to practise EIBF as compared with their counterparts. Region of residence of women was also significantly associated with EIBF. CONCLUSION: In this study, the overall prevalence of EIBF was good. Place of delivery, mode of delivery, postnatal check-up, type of birth, birth order and region were factors significantly associated with EIBF. Therefore, government and stakeholders need to show commitment to improve access and utilisation of basic maternal health services to increase the practice of EIBF.
Subject(s)
Breast Feeding , Mothers , Child , Female , Pregnancy , Humans , Child, Preschool , Cross-Sectional Studies , Cesarean Section , Ethiopia/epidemiology , Socioeconomic FactorsABSTRACT
BACKGROUND: Over the past few decades, maternal and child mortality had drawn the attention of governments and policymakers. Institutional delivery has been among the implementations needed to reduce maternal and child mortality. The fact that the problem was persisted intensified studies to research for more factors. Thus, the current study was intended for further analyses of EMDHS to identify the magnitude, spatial patterns, and predictors of institutional delivery. METHODS: A cross-sectional survey data from EMDHS 2019 was analyzed involving 5488 reproductive-age women regarding institutional deliveries. We presented descriptive statistics using mean, standard deviations, and proportions. To check the nature of the distribution of institutional delivery, we applied the global Moran's I statistics. Getis-Ord Gi statistics was applied to detect spatial locations, and we applied spatial interpolation to predict unknown locations of institutional delivery using the Ordinary Kriging method. Kulldorff's SatScan was also applied to identify the specific local clustering nature of institutional delivery using the Bernoulli method. We applied multilevel binary logistic regression for the scrutiny of individual and community-level factors. We applied P < 0.25 to include variables in the model and P < 0.05 to declare associations. AOR with 95% CI was used to describe variables. RESULTS: The prevalence of institution/facility delivery was 2666.45(48.58%) in the survey. The average number of children was 4.03 ± 2.47, and most women in this survey were in the age range of the 25-29 years (31.84%) and 30-34 years (21.61%). Women who learned primary education (AOR = 1.52; 95% CI 1.20-1.95), secondary education (AOR = 1.77; 95% CI 1.03-3.07), and higher education (AOR = 5.41; 95% 1.91-15.25), while those who can read and write sentences (AOR = 1.94; 95% 1.28-2.94), Rich (AOR = 2.40 95% CI 1.82-3.16), and those followed 1-2 ANC (AOR = 2.08; 95% CI 1.57-2.76), 3 ANCs (AOR = 3.24; 95% CI 2.51-418), and ≥ 4 ANCs (AOR = 4.91; 95% CI 3.93-6.15) had higher odds of delivering at health institutions. CONCLUSION: The institutional delivery was unsatisfactory in Ethiopia, and there were various factors associated differently across the different regions. Pastoralist regions showed high home delivery than institutions which invites further interventions specific to those regions. Factors like age, highest education level achieved, preceding birth interval, literacy status, wealth status, birth order, regions, and rural residences were all affected institutional delivery so that interventions considering awareness, access, and availability of the services are vital.
Maternal and child mortality had drawn the attention of governments and policymakers internationally since 1990s. A lot has been said and tried to reduce maternal and child mortality rates by the government of Ethiopia. Initially, toward the end of MDGs period, the country has been successful in achieving some of the goals related to child and maternal mortality. However, after scene of many implementations, now everything looks downcast again. This fact sparked the need to re-assess the status of the country and provide information for further policy decisions. Currently, we were aimed at providing country representative information from EMDHS data regarding the magnitude, spatial pattern, and predictors of in institutional delivery.Factors like age, highest education level achieved, preceding birth interval, literacy status, wealth status, birth order, regions, and rural residences were all affected institutional delivery. However, since home delivery was higher and more worsen in pastoralist regions in the country, it should draw more attentions to make interventions considering awareness, access, and availability of the services in vital areas.
ABSTRACT
Background: Routine health information is the pillar for planning and management of health services and plays a vital role in effective and efficient health service delivery, decision making, and the improvement of programs. Therefore, this study aimed to assess routine health information utilization and associated factors among health professionals working in public health facilities of the south region. Methods: Institution based cross-sectional study design was employed. Data was collected from randomly selected 719 participants using a pre-tested, interviewer administered structured questionnaire. Bivariate and multivariate logistic regression analyses were carried out. Result: The overall utilization of routine health information was 63.1. Place of residence, HMIS personnel, HMIS code, overwhelming data source, population based data, data quality control, feedback, monitoring chart, 8.467) and data transfer policy were factors significantly associated with utilization of routine health information. Conclusion: Six out of ten health professionals had utilized routine health information. Place of residence, HMIS personnel, HMIS code, overwhelming data source, population based data, data quality control, feedback, monitoring chart and data transfer policy had significant associations with routine health information utilization. Therefore, concerned health authorities need to work on these factors to improve the utilization.
Subject(s)
Health Facilities , Health Personnel , Cross-Sectional Studies , Ethiopia , Humans , Surveys and QuestionnairesABSTRACT
BACKGROUND: Health facility delivery is vital in reducing maternal mortality however, the percentage of deliveries taking place in health facilities were remained below 50%. Therefore, this study was aimed to assess spatial variation and determinant factors of home delivery in Ethiopia. METHODS: We used cross-sectional survey data from Ethiopian Mini Demographics and health 2019. A total of 5,527 reproductive-age women were included in this study. ArcGIS 10.7 was applied to explore the spatial distribution of home delivery and Sat scan 9.6.1 version software was used for spatial cluster analysis. A mixed effect multilevel binary logistic regression model was fitted for determinant factors due to the hierarchical nature of the data. Finally, an adjusted odds ratio (AOR) with 95% confidence level was used to declare significant determinants of home delivery. RESULT: According to EMDHS 2019, the spatial variation of home delivery was non-random across the country. Somali, Afar, SNNPR, and part of Amhara were hot spot areas, where some parts of Benishangul, central Oromia, Addis Ababa, Dire Dawa, and Harari were identified as cold spot areas. The odds of women who had primary, secondary and higher education was decreased by 50% (AOR = 0.50; 95% CI: 0.42-0.61), 72% (AOR = 0.28; 95% CI: 0.19-0.40) and 90% (AOR = 0.10; 95% CI: 0.05-0.19) as compared to women no-education respectively. Mothers who had ANC visits were 70% (AOR = 0.30; 95% CI: 0.26-0.36) less likely to have a home birth as compared to women who had no ANC visit. The odds of having home birth among rural residents were 5.2 times (AOR = 5.2; 95% CI: 3.11-8.55) more likely higher compared to the counterpart. CONCLUSION: The prevalence of home delivery in Ethiopia was still more than half percent. The spatial distribution was varied across the region. Maternal age, religion, wealth status, had ANC visit, birth order, region, and residence were significant factors with home delivery. Therefore, improving maternal educational status, interventional design in hotspot region, and inspire the mother to take antenatal care is essential to reduce the prevalence of home delivery.
Subject(s)
Home Childbirth , Birth Order , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Health Surveys , Humans , Multilevel Analysis , Pregnancy , Spatial AnalysisABSTRACT
BACKGROUND: According to the world health organization, the COVID-19 outbreak has currently affected millions of people worldwide. Since the start of the pandemic in China, everything countries have thrown at the virus turned unsuccessful. As there is no established vaccine to halt the virus transmission, it might be very difficult for developing countries like Ethiopia even after vaccine development. Thus, focusing on improving knowledge, perception, and preparedness related to the virus might be very vital. METHODS: A community-based cross-sectional survey was conducted using the questionnaire applied in most countries which is suitable to apply in the Konso zone in South Nations Nationalities Region (SNNPR) from April.2020 to July 2020. Data were collected, cleaned, coded, checked, and entered into Epi Info and then exported and analyzed in STATA 15. We fitted a binary logistic regression model. Categorical variables were presented using figure tables, and proportion and for continuous variables, mean and standard deviation were used. The results were also presented using Adjusted Odds Ratio (AOR) with 95% CI. RESULTS: From 636 respondents expected, 615(97%) were participated and possessed the knowledge of 39%, and 64% perception and preparedness each. Measurements related to the policy and interventions like restrictions to movement, self-isolation, wearing a face mask, & the need for more tests was not supported by most participants. CONCLUSION: The poor knowledge, perception, and preparedness were correlated with the unavailability of water and electricity, less education, and informal source of information which could be improved through area appropriate health education interventions.
Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Ethiopia/epidemiology , Health Knowledge, Attitudes, Practice , Humans , Perception , Rural Population , SARS-CoV-2 , Surveys and QuestionnairesABSTRACT
BACKGROUND: Most of unwanted pregnancies among adolescent girls and young women (AGYW) in Africa result in pregnancy termination. Despite attempts to enhance maternal health care service utilization, unsafe abortion remains the leading cause of maternal death in Sub-Saharan Africa (SSA), there is still a study gap, notably in East Africa, where community-level issues are not studied. Therefore, this study aimed to assess pooled prevalence pregnancy termination and associated factors among youth (15-24 year-old) women in the East Africa. METHODS: The study was conducted based on the most recent Demographic and Health Surveys (DHS) in the 12 East African countries. A total weighted sample of 44,846 youth (15-24) age group women was included in this study. To detect the existence of a substantial clustering effect, the Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), and Likelihood Ratio (LR)-test were used. Furthermore, because the models were nested, deviance (-2LLR) was used for model comparison. In the multilevel logistic model, significant factors related to pregnancy termination were declared using Adjusted Odds Ratios (AOR) with a 95%Confidence Interval (CI) and p-value of 0.05. RESULT: The pooled prevalence of pregnancy termination in East African countries was 7.79% (95% CI: 7.54, 8.04) with the highest prevalence in Uganda 12.51% (95% CI: 11.56, 13.41) and lowest was observed in Zambia 5.64% ((95% CI: 4.86, 6.41). In multilevel multivariable logistic regression result, age 20-24 [AOR = 1.93; 95% CI: 1.71, 2.16], media exposure [AOR = 1.22; 95% CI: 1.12, 1.34], married [AOR = 1.32, 95% CI: 1.21, 1.43], had working [AOR = 1.13; 95% CI: 1.04, 1.23],no education[AOR = 3.98, 95% CI: 2.32, 6.81], primary education [AOR = 4.05, 95% CI: 2.38, 6.88], secondary education [AOR = 2.96, 95% CI: 1.74, 5.03], multiparous [AOR = 0.85; 95%CI: 0.79, 0.93], sexual initiation greater or equal to 15 [AOR = 0.82; 95%CI: 0.74, 0.99] were significantly associated with pregnancy termination. CONCLUSION: The pooled prevalence of pregnancy termination in East Africa was high in this study. Maternal age, marital status, education status, parity, age at first sex, media exposure, working status and living countries were significantly associated with pregnancy termination. The finding provides critical information for developing health interventions to decrease unplanned pregnancies and illegal pregnancy termination.