Effect of contacts with health professionals on modern contraceptives uptake during the first 6 weeks after child birth: a prospective cohort study in Arsi Zone.

BACKGROUND: Healthy timing and spacing of pregnancy refers to the spacing between deliveries and subsequent pregnancies. The World Health Organization recommends waiting at least 24 months between the date of the live birth and the conception of the subsequent pregnancy in order to lower the risk of unfavorable maternal, perinatal, and newborn outcomes. Low use of contraception contributes to the high level of short inter-pregnancy intervals. Different studies conclusively demonstrate that this is a reality existing in Ethiopia right now. Limited data is available regarding the effects of contacts with health professionals on the use of contraception during the postnatal period. METHODS: A prospective cohort study was performed from October 01, 2020 to March 01, 2021. The study included 418 postnatal women who gave birth during the previous week. They were followed throughout the full postnatal period. A pre-tested structured questionnaire was used to gather the data. Data were gathered twice: once during the first week following birth and once again from the eighth to the 42nd day after birth. Epi-Info version 7 was used to enter data, which was subsequently exported to SPSS version 21 for analysis. The effect of contacts with health professionals where contraceptives were discussed on contraception uptake was measured using adjusted relative risk and its 95% confidence interval. RESULTS: Modern contraceptive uptake rate during the postnatal period was 16% (95% CI: 12.50-19.50%). Contraceptive use was 3.56 times more likely in women who were counseled about contraceptives during a contacts with health professionals at a health facility compared to those who did not have a contact (aRR = 3.56, 95% CI: 1.97-6.32). Women's age, place of residence, knowledge of whether they can become pregnant before menses return, menses return after birth, and resuming sexual activity after birth were all significantly associated with contraceptive use during the first six weeks following child birth. CONCLUSIONS: Modern contraceptive uptake rate during the postnatal period among women in the study area was low. Contacts with health professionals where contraception is discussed was the main factor associated with contraception uptake during the postnatal period. We recommend that the Arsi Zone Health Office, the Weardas Health Office in the Arsi Zone, and the health care providers in the Arsi Zone health facilities strengthen contraceptive counseling in postnatal health services to reduce the proportion of women with short inter-pregnancy intervals.

Factors associated with modern contraceptives uptake during the first year after birth in Ethiopia: A systematic review and meta-analysis.

Though postpartum family planning helps women to achieve the recommended birth interval before next pregnancy, its utilization in Ethiopia is low. Understanding drivers and barriers is key to improve postpartum family planning uptake. The aim of this systematic review and meta-analysis is to analyze and summarize predictors of postpartum family planning uptake, during the first year after birth, in Ethiopia. We conducted a systematic review and meta-analysis of observational studies published in English before April 16, 2021. We searched electronic sources like PubMed, MEDLINE, CINHAL Embase, Google and supplemented it with manual search. Two reviewers appraised independently the studies using the Joanna Briggs Institute Quality Assessment Tool for the observational studies. Data synthesis and analysis were conducted using Review Manager Version 5.3. The Cochrane Q test statistic and I2 tests were used to assess the heterogeneity among the included studies. A random-effects and fixed effect model were used to calculate pooled Odds Ratio and its 95% CI. A total of 22 studies were included in the review. Better educational status of women[OR = 2.60; 95% CI: 2.15, 3.14], women's marital status [OR = 4.70; 95% CI: 1.51, 14.60], resumption of sexual intercourse [OR = 6.22; 95% CI: 3.01, 12.86], menses return [OR = 3.72; 95% CI: 1.98, 6.99], PPFP discussion with partner [OR = 2.53; 95% CI: 2.00, 3.20], women's previous PPFP information [OR = 4.93; 95% CI: 2.26, 10.76], PPFP counseling during ANC [OR = 3.95; 95% CI: 2.50, 6.23], having PNC [OR = 4.22; 95% CI: 2.80, 6.34], having experience of modern contraceptive use [OR = 2.90; 95% CI: 1.62, 5.19], facility birth [OR = 6.70; 95% CI: 3.15, 14.25], and longer interval after last delivery [OR = 0.37; 95% CI: 0.32, 0.43] were significantly associated with modern contraceptive uptake during postpartum period. Our systematic review identified modifiable factors and estimated their association with PPFP uptake. Since most of these factors are related to reproductive health characteristics and MNCH services, integrating PPFP into MNCH services particularly at primary health care unit may improve contraceptive uptake during postpartum period. Systematic review registration: PROSPERO: 2020: CRD42020159470.

Precancerous Cervical Lesions and Associated Factors Among Women Attending Cervical Screening at Adama Hospital Medical College, Central Ethiopia.

BACKGROUND: Cervical cancer is the third most common form of cancer among women worldwide. Yet it is one of the few cancers that can be detected and prevented at precancerous stage. Even though different studies were conducted in different areas in Ethiopia, the risk factors for cervical precancerous lesions in the Ethiopian setting are not well identified. PURPOSE: To determine prevalence of precancerous cervical lesion and associated factors among women of reproductive age group attending screening center at Adama Hospital and Medical College. PATIENTS AND METHODS: A cross-sectional study was carried out from June 11 to July 11, 2019. Data was collected through interview aided questionnaires and visual inspection with acetic acid applied for screening and treatment. A random sample of 293 were included in the study. Data was entered into Epi Info version 7, and analyzed by SPSS version 21. Descriptive analysis was conducted to describe the study population and a logistic regression analysis was applied to assess the association of independent variables with the outcome variable. The level of significance of association was determined at p- value<0.05. RESULTS: Out of the total 293 screened women, 15.7% (95% CI: 11.3%-20.1%) were found to be positive for precancerous cervical lesion. After controlling for the effect of other confounding factors, four variables, absence of menses (adjusted odds ratio (AOR) = 0.18, 95% CI (0.04, 0.87)), history of pelvic infection [AOR = 2.82; 95% CI (1.21, 6.59)], history of STI [AOR = 2.65; 95% CI (1.26, 5.56)] and having a partner who had another partner [AOR = 2.41; 95% CI (1.08, 5.38)] were found to be significantly associated with precancerous cervical cancer at cut-off point p-value less than 0.05. CONCLUSION: Menstrual history, history of pelvic infection, history of STI, and had a partner who had another partner were found to be significantly associated with precancerous cervical lesion.