Prevalence and its Associated Factors of Episiotomy Practice Among Mothers Who Gave Birth in Debre Tabor Town Northwest Ethiopia: An Institutional Based -Cross-Sectional Study.

BACKGROUND: An episiotomy is a surgical technique that widens the perineum during the second stage of childbirth. Therefore, the goal of this study was to assess the prevalence of episiotomy and the variables that affect it among women who gave birth in the town of Debre Tabor, in 2021. METHODS: In the Debre Tabor municipality's four designated health center regions, 402 women who gave birth were included in a cross-sectional study. Systematic random selection was used to choose the study subjects. In SPSS version 23, data were entered, cleaned up, and analyzed using descriptive and inferential statistics. The use of binary and multivariable logistic regression models allowed the researchers to identify characteristics related to episiotomy magnitude. Using a 0.05 p value, the level of statistically significant variables was also calculated. RESULT: Out of a total of 402 deliveries for this inquiry, the magnitude of the episiotomy was calculated to be 35.1% of those deliveries. About 127 women, or the bulk of respondents, were between the ages of 25 and 29 (33.1%). Face presentation was 4.7 times more common among primiparous women than breech and vertex presentation, and midwifery professionals and midwifery students were 5.5 times higher than internship medicine and health officer students. The odds of performing an episiotomy were 3.7 times higher among primiparous women compared to multiparous women (AOR = 3.754 (1.382-15.108)). CONCLUSION: The magnitude of episiotomy in this study was somewhat larger than the World Health Organization's recommendation of 10% .Instrumental delivery, neonatal presentation, experts allocated to the delivery ward, and the mother's parity were all shown to be strongly linked with the practice of episiotomy.

Perception towards preeclampsia and perceived barriers to early health-seeking among pregnant women in selected Hospitals of South Gondar Zone, Northwest Ethiopia: A qualitative study.

BACKGROUND: Preeclampsia is one of the top maternal morbidity and mortality that disproportionately affects pregnant women in low and middle-income countries where access and quality of health services are limited. People in different areas perceive preeclampsia differently which directly or indirectly affects the timing and place of heath seeking. Positive perception about perceived causes, perceived complications, and prevention of preeclampsia is central for the prediction and early diagnosis of the disease. However, little is known about the perception of pregnant women towards preeclampsia in Ethiopia. This study aimed to assess the perception towards preeclampsia and perceived barriers to early health-seeking among pregnant women in selected Hospitals of South Gondar Zone, Northwest Ethiopia. METHODS: A qualitative study using phenomenological approach was implemented among 20 purposively selected pregnant women who visited health facilities for antenatal care service in four selected Hospitals of the South Gondar Zone of the Amhara Region. Data were collected through an in-depth interview (IDI) using a semi-structured interview guide from January to February 2020. Thematic analysis was executed using Open Code Software version 4.03. RESULTS: The majority of the participants believed preeclampsia as a pregnancy-specific hypertensive disease and mainly associated it with overweight and nutritional problems. With regards to the perceived severity, the study participants agreed that preeclampsia can lead women to death. Personal delay, lack of awareness about the disease, transport problem, and low socioeconomic condition were perceived as the major reasons for the delay to early health-seeking (the 1st and the 2nd delay). While poor service provision and long waiting times were the barriers to receive services at the health facility level (the 3rd delay). CONCLUSION: The majority of the participants believed preeclampsia as a pregnancy-specific hypertensive disease and mainly associated it with overweight and nutritional problems. The finding of this study implied that awareness creation about the danger of hypertension during pregnancy and its risk reduction mechanisms shall be emphasized. The care provision at health facilities shall be improved by decreasing long waiting time which discourages service utilizations aside from improving early seeking behavior of pregnant women through different interventions.

Factors associated with sexual violence among waitresses working in Bahir Dar City, Ethiopia: a mixed-method study.

BACKGROUND: When a worker is abused, threatened, or assaulted while at work, it poses an explicit or implicit threat to his/her safety, well-being, or health. However, the magnitude and understanding of the problem and its associated factors have received little attention in low and middle-income countries, including Ethiopia. Thus, this study aimed to ascertain the magnitude, perceptions, and associated factors of workplace sexual violence among waitresses in Bahir Dar, Ethiopia. METHODS: Parallel sampling was used in a facility-based convergent mixed-methods study. A multistage sampling technique was used to select study participants. Four hundred six waitresses provided quantitative information. To collect data, a pretested structured interview administered questionnaire was used. Qualitative data from ten in-depth interviews and six focus group discussions were also collected using a semi-structured questionnaire. The data were cleaned before being entered into Epidata version 7 and exported to STATA version 15 for analysis. Using odds ratios with a 95% confidence interval and a P value of less than 0.05, binary logistic regression was used to identify independent predictors. Thematic analysis was performed using ATLAS ti version 8.4.25 after the recorded audios were transcribed. RESULTS: The overall prevalence of workplace sexual violence was 45.9% (95% CI 41, 50.8). Waitresses who had heard about sexual violence and workplace sexual violence, had witnessed family violence as a child, had a family who valued their honor over their children's safety and health, and lacked employment opportunities were more likely to experience workplace sexual violence. Waitresses who worked in emotionally supportive work environments and were educated were less likely to experience workplace sexual violence. CONCLUSIONS: Many of the waitresses in this study had experienced workplace sexual violence. Its awareness, witnessing family violence as a child, growing up in a family that prioritized their honor over their children's safety and health, and lack of employment opportunities exacerbated it. In contrast, emotionally supportive work environments and education have protected them. This implies that organizations, both governmental and non-governmental, civic organizations, and other responsible bodies must pay attention to the identified factors. Additionally, Ethiopian hospitality workplaces should develop policies to protect women.

Continuum of maternal healthcare services utilization and its associated factors in Ethiopia: A systematic review and meta-analysis.

The continuum of care throughout pregnancy, childbirth, and postnatal period is one of the vital strategies for improving maternal and neonatal health and preventing maternal and neonatal mortalities and morbidities. The level and determinants of the complete continuum of care for maternal health services reported by different studies were extremely varied in Ethiopia. Therefore, this meta-analysis aimed to estimate the overall prevalence of a complete continuum of maternal health care services utilization and its associated factors in Ethiopia. Databases such as PubMed/MEDLINE, Science Direct, DOJA, African journals online, Cochrane library, Google scholar, web of science, and Ethiopian universities' institutional repository were used to search for relevant studies. A total of seven studies with 4854 study participants were involved in this study. Data were extracted by two reviewers and exported to STATA Version 11 for analysis. The I2 statistics and Egger's test were used to assess heterogeneity and publication bias, respectively. The random-effects random effects model was used to estimate the level of complete continuum of care for maternal health services. The pooled prevalence of complete continuum of maternal healthcare services utilization was 25.51%. Employed mothers (OR = 3.16, 95%CI = 1.82, 5.47), first antenatal ante natal care visit before 16 weeks (OR = 7.53, 95% CI = 2.94, 19.29), birth preparedness and complication readiness plan (OR = 1.95, 95% CI = 1.12, 3.41), secondary and above educational status (OR = 2.97, 95% CI = 2.00, 4.41), planned pregnancy (OR = 6.86, 95% CI = 3.47, 13.58) and autonomy (OR = 3.73, 95% CI = 2.24-6.23) were significantly associated with continuum of maternal healthcare services utilization. In conclusion, the national level of complete continuum of maternal healthcare service utilization was low in Ethiopia. Being employed mothers, first ante natal care visit before 16 weeks, birth preparedness and complication readiness plan, secondary and above educational status, autonomy, and planned pregnancy were the major determinants of continuum of maternal healthcare services utilization.

Youth-friendly sexual and reproductive health services utilization and its determinants in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: In most developing countries, meeting young people's sexual and reproductive health (SRH) needs remains a problem. Despite policy initiatives and strategic measures aimed at increasing youth utilization of sexual and reproductive health services in Ethiopia, its utilization remains very low. Therefore, this study aimed to assess Ethiopia's youth-friendly sexual and reproductive health services' utilisation and determinants. METHODS: Scopus, Medline, Google Scholar, and CINAHL databases were searched for articles published until March 2021. The pooled prevalence and effect size of youth-friendly sexual and reproductive health service use and associated factors were estimated using a weighted DerSimonian-laird random effect model. The I2 statistics were used to determine the degree of heterogeneity. The funnel plot and Egger's regression test were used to examine publication bias. Subgroup analyses were performed to reduce underlying heterogeneity. RESULTS: One thousand one hundred and ninety-one articles were generated from various databases, and a final 26 articles were included in the review, including 16246 participants. Ethiopia's pooled prevalence of youth-friendly sexual and reproductive health service utilization was 42.73 % (95% CI: 35.38-50.09). The findings of this study showed that grade level 11-12, grade level 9-10, close to home sexual and reproductive health services, male sex, and discussion of sexual and reproductive health service with family, friends, and groups, ever experience sexual activity were associated with utilization of youth-friendly sexual and reproductive health services. Maternal educational status secondary school and above, age 15-19 years, age 20-24 years, having ever experienced reproductive problems, living with a partner, living alone, knowing about sexual and reproductive health, having a convenient working hour for youth-friendly service, and participation in a school clubs were also associated with the utilization of youth-friendly sexual and reproductive health services. CONCLUSION: We found several determinant factors for adolescent and youth utilization of sexual and reproductive health services. The review highlights the importance of improving service usage through youth education and promotion and the scaling up and institutionalizing of youth-friendly services through extensive capacity building.

Predictors of adverse pregnancy outcome at Hospitals in South Gondar Zone, North-central Ethiopia: A multicenter facility-based unmatched case-control study.

BACKGROUND: Adverse pregnancy outcomes are the most significant public health problem which leads to serious short and long-term health consequences to the mother and the newborn baby. Adverse pregnancy outcomes, especially prematurity and low birth weights are the major cause of neonatal morbidity and mortality in Ethiopia, particularly in the study area. Therefore, this study was aimed to determine predictors of adverse pregnancy outcome among mothers who gave birth at Hospitals in South Gondar zone, North-central Ethiopia. METHODS: Hospital-based unmatched case-control study was conducted. A total of 441 study participants with 147 cases and 294 controls were included. The study participants were selected by multi-stage sampling technique. A combination of chart review and interview were used. Data entry and analysis were done by using Epi data version 3.1 and SPSS version 23 respectively. Descriptive & analytical statistics were computed. In the binary logistic regression, both bivariable and multivariable analysis was computed. Statistical significance was considered at P < 0.05 and the strength of association were assessed by using the adjusted odds ratio with their 95%confidence interval. RESULT: A total of 147 cases and 294 controls were included. The mean age (±SD) of study participants was 26.8 ± 5.5 years. History of adverse birth outcome (AOR = 6.39, 95%CI = 2.55, 15.99), did not receive dietary counseling during pregnancy (AOR = 5.17, 95%CI = 2.09, 12.84), pregnancy induced hypertension (AOR = 3.74, 95%CI = 1.20, 11.62), history of hyperemesis gravidarum in the recent pregnancy (AOR = 4.01, 95%CI = 1.58, 10.21) and inter-pregnancy interval less than 24 months (AOR = 2.02, 95%CI = 1.04, 3.91) were significantly associated with adverse pregnancy outcome. CONCLUSION: This study showed that history of adverse pregnancy outcome, pregnancy induced hypertension, did not receive dietary counseling, history of hyperemesis gravidarum, and inter-pregnancy interval less than 24 months were significantly associated with adverse pregnancy outcome. This study implies the need to improve dietary counseling for pregnant mothers during antenatal care visits. Beside to this, counseling on birth spacing should be given to improve inter-pregnancy intervals.

Knowledge and attitude of pregnant women towards preeclampsia and its associated factors in South Gondar Zone, Northwest Ethiopia: a multi-center facility-based cross-sectional study.

BACKGROUND: Preeclampsia has the greatest impact on maternal mortality which complicates nearly a tenth of pregnancies worldwide. It is one of the top five maternal mortality causes and responsible for 16 % of direct maternal death in Ethiopia. Little is known about the level of knowledge and attitude towards preeclampsia in Ethiopia. This study was designed to assess the knowledge and attitude towards preeclampsia and its associated factors in South Gondar, Northwest Ethiopia. METHODS: A multicenter facility-based cross-sectional study was implemented in four selected hospitals of South Gondar Zone among 423 pregnant women. Multistage random sampling and systematic random sampling techniques were used to select the study sites and the study participants respectively. Data were entered in EpiData version 3.1 while cleaned and analyzed by Statistical Package for Social Sciences (SPSS) version 23. Descriptive and inferential statistics were performed. Adjusted odds ratio with 95 % confidence interval were used to identify the significance of the association between the level of knowledge on preeclampsia and its predictors. RESULTS: In this study, 118 (28.8 %), 120 (29.3 %) of the study participants had good knowledge and a positive attitude towards preeclampsia respectively. The likelihood of having good knowledge on preeclampsia was found to be low among women with no education (AOR = 0.22, 95 % CI (0.06, 0.85)), one antenatal care visit (ANC) (AOR = 0.13, 95 % CI (0.03, 0.59)). Whereas, those who booked for ANC in the first trimester (AOR = 6.59, 95 % CI (1.43, 30.33)), gave the last birth at a health facility (AOR = 2.61, 955 CI (1.03, 6.61)), and experienced a complication during previous births (AOR = 3.67, 95 % CI (1.78, 7.57)) were more likely to be knowledgeable on preeclampsia. CONCLUSIONS: No formal education and not attending four ANC visits were associated with poor knowledge of preeclampsia. While participants who visited health facilities during the first trimester, who gave birth at health facilities, and those who experienced a complication in previous births were more likely to be knowledgeable on preeclampsia. Improving the numbers of ANC visits and encouraging facility delivery are important measures to improve women's knowledge on preeclampsia. Health education regarding preeclampsia risk factors, symptoms, and complications shall be emphasized.

Determinants of early marriage among married women in Injibara town, north West Ethiopia: community-based cross-sectional study.

BACKGROUND: Early marriage is occurred when one or both of the spouses are below the age of 18 years at the time of their first marriage. It is one of the major traditional practices in developing counties particularly in Ethiopia; which has significant physical, intellectual, psychological and emotional effects and reduces educational opportunities and the chance for personal growth for both boys and girls. Even though this traditional practice was the common cultural events in the study area, there is no prior study on the magnitude and its determinant factors. Hence, the study was aimed to determine the prevalence and determinant factors of early marriage among married women in Injibara town, North West Ethiopia. METHODS: A Community-based cross-sectional study was conducted from September to December 2018. A total of 373 women were included in the study. A multistage sampling procedure was applied to select the study participants. Data analysis was done by using SPSS versions 23. Both descriptive & analytical statistics were computed. Statistical significance was considered at P < 0.05 and the strength of association were assessed by using adjusted odds ratio with 95% confidence interval. RESULT: The prevalence of early marriage was 167(44.8%). The minimum and maximum ages at first marriage were 9 and 23 years respectively. Non-formal educational level of the father [Adjusted Odd Ratio (AOR) =2.32; 95%CI = 1.33-4.05], family's average monthly income <1000 Ethiopian birr [AOR = 2.32, 95%CI = 1.27-4.24], family size ≥7 [AOR = 3.59, 95%CI = 1.94-6.63] and non-formal education level of the respondents [AOR = 5.16; 95%CI = 2.87-9.28] were found to be associated with early marriage. CONCLUSION: The prevalence of early marriage was high in Injibara town, Ethiopia. Factors that tend to facilitate early marriage in this town include family income, family size, educational level of the father and that of the respondent. Improving on the strategies that promote formal education will reduce the level of early marriage in Injibara town, Ethiopia.