Modern Postpartum Family Planning and Associated Factors Among Postpartum Women in a Rural District of Ethiopia, 2021: A Cross-Sectional Study.

The first year after a woman has given birth is critical for use of contraceptives although many women do not realize that they are at a risk for pregnancy. The main objective of this study was to assess the utilization of modern Postpartum Family Planning (PPFP) and associated factors among postpartum women in a rural district, Ethiopia. A cross-sectional study involving randomly selected 389 postpartum women was conducted in Ambo rural district from May 20, 2021 to June 10, 2021. Data were collected through face to- face interviews, entered into EPI Data version 3.1, and analyzed by SPSS version 25.0. In multivariable binary logistic regression, adjusted odds ratios (AOR) with 95% confidence interval (CI) were computed and statistical significance was declared at p < 0.05. The prevalence of modern PPFP was 72.5% (95% CI: 68%, 77%). Utilization of PPFP was significantly associated with women's self decision making (AOR = 6.43, 95% CI: 1.98, 20.90), counseling during antenatal care (AOR = 9.71, 95% CI: 3.83, 24.61), visit health facility after delivery (AOR = 5.24, 95% CI: 2.32, 11.84), ever heard of modern family planning (AOR = 5.17, 95% CI: 1.88, 14.23), perceived partner approval (AOR = 4.31, 95% CI: 1.62, 11.47), and the lowest income (AOR = 0.12, 95% CI: 0.02, 0.68). The use of modern PPFP in the study area was encouraging, which helps to prevent unplanned and unwanted pregnancies and spacing pregnancies. Therefore, family planning providers should focus on raising women's awareness and counseling their partners as part of a continuum of points of contact to encourage women to use the service.

Prevalence and factors associated with post-traumatic stress disorder among internally displaced people in camps at Debre Berhan, Amhara Region, Ethiopia: a cross-sectional study.

BACKGROUND: Post-traumatic stress disorder (PTSD) is a common mental disorder after traumatic exposure that can have long-lasting physical and mental health consequences. In 2021, Ethiopia saw the highest number of internally displaced people (IDP) due to conflict and war with the scope of the internal displacement being very high in the study area and less attention has been given to mental health. OBJECTIVE: To determine the prevalence and associated factors of PTSD among internally displaced people in camps at Debre Berhan, Ethiopia. METHODS: A cross-sectional study was conducted from December 1-30, 2021 among 406 IDPs, who were selected by random systematic sampling from the registration and proportionally allocated to three IDP camps in Debre Berhan. Post-traumatic stress disorder was measured by the PTSD checklist (DSM-5). Data were collected through an interviewer-administered pre-tested questionnaire, entered into EpiData version 3.1, and analyzed by Statistical Package for Social Sciences version 25. Bivariate binary logistic regression was used to select candidate variables with p < 0.25. Multicollinearity was checked by using the variance inflation factor and it was less than 10. Model adequacy was checked by Hosmer & Lemeshow goodness of test (p > 0.05). In the multivariable binary logistic regression, the association between outcome and independent variables was declared at p < 0.05 with its adjusted odds ratio (AOR) at a 95% confidence level. RESULTS: The prevalence of PTSD among the respondents was 67.5% (95% CI: 63-72). Being a merchant (AOR = 0.41 [95% CI: 0.02-0.85]), witnessing the destruction of property (AOR = 1.67 [95% CI: 1.01-2.74]), facing trauma during displacement (AOR = 6.00 [95% CI: 2.75-13.10]), frequency of displacement (AOR = 0.31 [95% CI: 0.11-0.85]), being distressed (AOR = 5.42 [95% CI: 3.25-9.05]), and unemployment (AOR = 2.09 [95% CI: 1.24-3.54]) were factors significantly associated with PTSD. CONCLUSION: This study provides evidence of the high prevalence of PTSD among internally displaced people. Therefore, mental health and psychosocial support are urgently required to address the identified factors and help the displaced people against long-term avoidable suffering.

Spoligotype analysis of Mycobacterium bovis isolates from cattle and assessment of zoonotic TB transmission among individuals working in bovine TB-infected dairy farms in Ethiopia.

Bovine tuberculosis (bTB) is a disease with impact on dairy productivity, as well as having the potential for zoonotic transmission. Understanding the genetic diversity of the disease agent Mycobacterium bovis is important for identifying its routes of transmission. Here we investigated the level of genetic diversity of M. bovis isolates and assessed the zoonotic potential in risk groups of people working in bTB-infected dairy farms in central Ethiopia. M. bovis was isolated and spoligotyped from tissue lesions collected from slaughtered cattle as well as from raw milk collected from bTB positive cows in dairy farms from six urban areas of central Ethiopia. From consented dairy farm workers, knowledge and practices related to zoonotic TB transmission, together with demographic and clinical information, was collected through interviews. Sputum or Fine Needle Aspirate (FNA) samples were collected from suspected TB cases. Spoligotyping of 55 M. bovis isolates that originated either from cattle tissues with tuberculous lesion or from raw milk revealed seven spoligotype patterns where SB1176 was the most prevalent type (47.3%). Most isolates (89.1%) were of the M. bovis African 2 clonal complex. All sputum and FNA samples from 41 dairy farm workers with symptoms of TB were culture negative for any mycobacteria. Among the 41 TB suspected farm workers, 61% did not know about bTB in cattle and its zoonotic potential, and over two-third of these workers practiced raw milk consumption. Our spoligotype analysis suggests a wider transmission of a single spoligotype in the study area. The results reported here may be useful in guiding future work to identify the source and direction of bTB transmission and hence design of a control strategy. Isolation of M. bovis from milk, knowledge gap on zoonotic TB and practice of consumption of raw milk in the study population showed potential risk for zoonotic transmission.

Occupational Exposure of Health-Care Workers to Blood and Body Fluids in West Shewa Zone, Ethiopia, 2018: A Cross-Sectional Study.

Background: Health-care workers are susceptible to acquiring blood and body fluids borne infections due to their occupations involving contact with patients and their body fluids, although studies conducted in Ethiopia are scarce. Therefore, the aim of this study was to investigate the magnitude of exposure to blood and body fluids among health-care workers in governmental health facilities in West Shewa Zone, Ethiopia. Materials and Methods: A facility-based cross-sectional study was conducted from May 19 to June 25, 2018. A total of 381 health-care workers were selected by simple random sampling from 31 sampled governmental health facilities using proportional to size allocation. Data were collected through self-administered questionnaires, entered into Epi Info version 7, and analyzed by SPSS version 21. Adjusted odds ratio (AOR) with 95% confidence intervals (CI) calculated for variables retained in the multivariable logistic regression and significance declared at p < 0.05. Results: Of 377 health-care workers who participated, the study found that 233 (61.2%) were exposed to blood and body fluids in their lifetime. Previous needlestick injury (AOR = 0.30; 95% CI: 0.12-0.75), type of health facility (AOR = 0.42; 95% CI: 0.26-0.68), handwashing practice (AOR = 0.15; 95% CI: 0.07, 0.31), and perceiving at risk (AOR = 0.16; 95% CI: 0.03, 0.98) were protective factors, whereas long work experience (AOR = 1.47; 95% CI: 1.13-1.93) was a risk factor for the exposure. Conclusions: Exposures to blood and body fluids during patient care were common among health-care workers in the study area. Therefore, health-care workers especially those newly hired and working in hospitals should pay due attention to their occupation's safety and regularly practice handwashing during critical times.

Unmet need for family planning and associated factors among currently married reproductive age women in Tiro Afeta District, South West Ethiopia, 2017: cross-sectional study.

BACKGROUND: Unmet need for family planning in Oromia region was very high (28.9%) compared to other regions in Ethiopia. To address problems associated with unmet need for family planning locally available evidences are essential, however, there were no clear evidences on unmet need for family planning in Tiro Afeta district. This study aims to assess the magnitude and associated factors of unmet need for family planning among currently married women in Tiro Afeta district, South West Ethiopia, 2017. METHODS: Community based cross sectional study was conducted in April, 2017. A total of 348 currently married women of reproductive age were enrolled from eight villages selected by simple random sampling and using proportional to size allocation. Data were entered using EpiData 3.1 and analyzed by SPSS version 22. Adjusted odds ratios at 95% confidence interval with p-value of < 0.05 were considered as significant variables. RESULTS: Unmet need for family planning among currently married women in Tiro Afeta was 26.1%. Factors significantly associated with unmet need for family planning were: never use of family planning before survey (AOR: 5.09, 95% CI: 2.73-9.50); multiparity (AOR: 3.02, 95% CI: 1.56-5.85); perceived husband's attitude as disapproval (AOR: 2.75, 95% CI: 1.43-5.26); lack of counseling from health workers (AOR: 2.07, 95% CI: 1.11-3.85); and unavailability of Radio and/or Television in the house (AOR: 2.05, 95% CI: 1.15-3.66). CONCLUSION: Unmet need for family planning in Tiro Afeta was higher than national average but lower than Oromia region. Never use of family planning, women's parity, husband's attitude towards contraceptives, women counseling and unavailability of Radio and/or Television in the respondent's home were significantly associated factors with unmet need for family planning. Therefore, the service providers and the district health office should strengthen counseling and partner involvement to reduce unmet need for family planning.

Appropriateness and timeliness of care-seeking for complications of pregnancy and childbirth in rural Ethiopia: a case study of the Maternal and Newborn Health in Ethiopia Partnership.

BACKGROUND: In 2014, USAID and University Research Co., LLC, initiated a new project under the broader Translating Research into Action portfolio of projects. This new project was entitled Systematic Documentation of Illness Recognition and Appropriate Care Seeking for Maternal and Newborn Complications. This project used a common protocol involving descriptive mixed-methods case studies of community projects in six low- and middle-income countries, including Ethiopia. In this paper, we present the Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) case study. METHODS: Methods included secondary analysis of data from MaNHEP's 2010 baseline and 2012 end line surveys, health program inventory and facility mapping to contextualize care-seeking, and illness narratives to identify factors influencing illness recognition and care-seeking. Analyses used descriptive statistics, bivariate tests, multivariate logistic regression, and thematic content analysis. RESULTS: Maternal illness awareness increased between 2010 and 2012 for major obstetric complications. In 2012, 45% of women who experienced a major complication sought biomedical care. Factors associated with care-seeking were MaNHEP CMNH Family Meetings, health facility birth, birth with a skilled provider, or health extension worker. Between 2012 and 2014, the Ministry of Health introduced nationwide initiatives including performance review, ambulance service, increased posting of midwives, pregnant women's conferences, user-friendly services, and maternal death surveillance. By 2014, most facilities were able to provide emergency obstetric and newborn care. Yet in 2014, biomedical care-seeking for perceived maternal illness occurred more often compared with care-seeking for newborn illness-a difference notable in cases in which the mother or newborn died. Most families sought care within 1 day of illness recognition. Facilitating factors were health extension worker advice and ability to refer upward, and health facility proximity; impeding factors were time of day, weather, road conditions, distance, poor cell phone connectivity (to call for an ambulance), lack of transportation or money for transport, perceived spiritual or physical vulnerability of the mother and newborn and associated culturally determined postnatal restrictions on the mother or newborn's movement outside of the home, and preference for traditional care. Some families sought care despite disrespectful, poor quality care. CONCLUSIONS: Improvements in illness recognition and care-seeking observed during MaNHEP have been reinforced since that time and appear to be successful. There is still need for a concerted effort focusing on reducing identified barriers, improve quality of care and provider counseling, and contextualize messaging behavior change communications and provider counseling.