Changes in Levels and Determinants of Maternal Health Service Utilization in Ethiopia: Comparative Analysis of Two Rounds Ethiopian Demographic and Health Surveys.

BACKGROUND: Antenatal care (ANC), delivery by skilled birth attendants, and postnatal care (PNC) are critical components of maternal health services for reducing maternal mortality. The study aimed to compare the utilization of maternal health services in the two most recent rounds of Ethiopia Demographic and Health Surveys (EDHS) and identify the factors influencing the utilization of these services using the 2016 EDHS. METHODS: Two rounds of EDHS data in 2011 and 2016 were used to estimate the proportion of women who had ANC, delivered by skilled birth attendants, and had a postnatal checkup and other characteristics of the surveyed population. The most recent round of data-the 2016 EDHS-was used to examine the socio-cultural and reproductive health factors associated with the three maternal health services utilization. Chi-square tests and multivariate logistic regression analyses with adjusted Odds Ratios (AOR) were conducted using Stata 15.0. RESULTS: The use of ANC services and skilled birth attendants increased significantly between 2011 and 2016 EDHS, utilization of ANC services increased from 34.0 to 65.5%, and use of skilled birth attendants increased from 11.7 to 35.9%, respectively. The use of postnatal care decreased from 9.3 to 6.9%. Utilization of maternal health service was significantly associated with urban residence, Protestant religion, Oromo ethnicity, more education, more household wealth, and less parity. Furthermore, women who had ANC visits during pregnancy were more likely to subsequently use skilled birth attendants (AOR 5.5, p < 0.001) and PNC (AOR 2.9, p < 0.001). CONCLUSION: The study highlighted the inequalities in the utilization of maternal health services between rural and urban areas, and the need of addressing the social, economic, and physical barriers that prevent women from using these services. Further, programs should be targeted at promoting the use of professional birth and postnatal services in Ethiopia.

Society's Attitude Toward Spousal Physical Abuse: Findings from the Philippines National Demographic and Health Survey, 2022.

Background: Societal attitude toward spousal physical abuse plays a crucial role in preventing violence against women. Yet, this public health issue has been insufficiently addressed. This study examines the relationship between the societal attitude toward spousal physical abuse and various social determinants. Methods: We used data from the 2022 Philippines' National Demographic and Health Survey. The outcome variable was attitude toward spousal physical abuse. Covariates included women's sociodemographic characteristics, experiences of witnessing their father's abusive behavior, intimate partner violence (IPV), and controlling behavior. Partner-related variables (age, educational level, employment status, and alcohol consumption behavior) were also considered. Descriptive and logistic regression analyses were performed to examine the associated factors of spousal physical abuse by using Stata 18.0. Results: Overall, 1,920 (9%) of 19,228 women reported that spousal physical abuse is justifiable in at least one of the presented scenarios. Women IPV survivors (adjusted Odds Ratio [aOR] = 1.35, 95% confidence interval [95% CI] = 1.06-1.73) and those who experienced controlling behavior by their partners (aOR = 1.77, 95% CI = 1.45-2.15) were more likely to accept spousal physical abuse than their counterparts. Conversely, women with a higher decision-making score were less likely to accept spousal physical abuse than those who had a lower score (aOR = 0.74, 95% CI = 0.56-0.98). Conclusions: Finding suggests that women's attitudes toward spousal physical abuse are significantly influenced by their experience of IPV. Future health research, programs, and policies should address individual, interpersonal, and systemic-level risk factors that profoundly impact women's health.

The Influence of Organizational Culture on School-Based Obesity Prevention Interventions: A Systematic Review of the Literature.

BACKGROUND: Although the influence of organizational culture has been examined on a variety of student outcomes, few studies consider the influence that culture may have on school-based obesity prevention interventions. We present a systematic review of the literature to examine how elements of organizational culture may affect the adoption, implementation, and sustainability of school-based obesity prevention interventions. METHODS: Fourteen studies examining the impact of organizational-level characteristics on school-based obesity prevention interventions were identified through the online databases EBSCO (CINAHL, ERIC, Agricola), Web of Science, Medline (PubMed), and Scopus. RESULTS: Five themes were identified as elements of organizational culture that influence the adoption, implementation, and sustainability of school-based obesity prevention interventions: organizational response to limited resources, value placed on staff training and professional development, internal support, organizational values, and school climate. CONCLUSIONS: Organizational culture can greatly influence the success of school-based obesity interventions. The collection of data related to organizational-level factors may be used to identify strategies for creating and sustaining a supportive environment for obesity prevention interventions in the school setting.