Double burden of malnutrition and associated factors among adolescent in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: As adolescence is a transition period from childhood to adulthood malnutrition occurring at this age resonates through generations. Although there were many individual studies in Ethiopia about different form of malnutrition among adolescent, their results are inconclusive indicating the need for generating a pooled estimate of adolescent nutritional status and associated factors. This review and meta-analyses aimed at estimating the pooled prevalence of different forms of malnutrition and associated factors among adolescents in Ethiopia. METHOD AND MATERIALS: We searched data bases from Pub Med, Cochrane Library, Health Inter Network Access to Research Initiative (HINARI), Science Direct and search engines; Google and Google Scholar and other sources; Reference of References and expert contact which were used to select the studies. Joanna Briggs Institute (JBI) quality appraisal tool was applied to identify eligible studies. STATA/SE V.14 was used to analyze the data. Effect size with 95% Confidence Interval (CI) and heterogeneity were estimated. Heterogeneity of studies was quantified with I2 statistic >50% used as an indicator of heterogeneity. Potential publication bias was assessed using Funnel plots and Egger's regression test. Trim and fill analysis was also performed. The presences of a statistical association between independent and dependent variables were declared at P <0.05. The PROSPERO registration number for the review is CRD42020159734. RESULTS: The pooled prevalence of overweight/obesity, stunting and thinness were 10.63% (95% CI: 8.86, 12.40), 20.06% (95% CI: 15.61, 24.51) and 21.68% (95% CI: 9.56, 33.81), respectively. Being female (OR: 2.02, CI: 1.22-3.34), low dietary diversity score (OR: 2.26 CI: 1.28-3.99) and high physical activity (OR: 0.36, 95%CI: 0.14-0.88) were significantly associated with adolescent overweight/obesity. Urban residence (OR: 0.82, 95%CI: 0.68-0.99), protected drinking water source (OR: 0.50, CI: 0.27-0.90) and having family size<5 people (OR: 0.54, CI: 0.44-0.66) were independent predictors of adolescent stunting. Early adolescent age (10-14 years) (OR: 2.38, CI: 1.70-3.34), protected water source for drinking (OR: 0.36, CI: 0.21-0.61), low wealth index (OR: 1.80, CI: 1.01-3.19) and family size <5 people (OR: 0.50, CI: 0.28-0.89) were significantly (P < 0.05) associated with adolescent thinness. CONCLUSION: The prevalence of overweight/obesity, stunting and thinness are high in Ethiopian adolescents indicating the upcoming challenge of double burden of malnutrition. The results imply the presence of double burden of malnutrition among adolescents which heralds the need for programmatic and policy response in terms of addressing modifiable risk factors including: dietary practices, physical activity, water source and economic status of these adolescents.

Optimal complementary feeding practices and associated factors among mothers having children 6 to 23 months, south WOLLO zone, Dessie ZURIA, Ethiopia.

INTRODUCTION: Optimal complementary feeding practice is a child feeding practice that fulfills the minimum dietary diversity, the minimum meal frequency, continuing breastfeeding with complementary feeding, and initiation of complementary feeding from 6 to 8 months. METHOD: A community-based comparative cross-sectional study was conducted on a total of 732 randomly selected mothers having children 6 to 23 months of age from March 10 to April 21 /2021.Data were collected using a pre-tested interviewer-administered questionnaire. Data entry was performed by using Epi data version 3.1 and was exported to Stata version 14.1. Descriptive statistics were done. Multivariable Logistic regression was used to predict the role of independent variables on optimal complementary feeding. Findings with a p-value <0.05 at a 95% confidence interval (CI) were considered statistically significant in the final model. RESULT: The overall proportion of mothers with optimal complementary feeding practice was 18.1% (95% C I 15.3% - 21.0). Only 90 (25.1%, 95% CI = 20.6-29.7) of mothers were found to have optimal complementary feeding practice in NGO supported kebeles but only 37 (10.8%, 95% CI = 7.5-14.1) practiced optimal complementary feeding is not NGO-supported kebeles. Mothers from Kebeles with no NGO support were 46% (AOR = 0.54, 95% CI 0.31, 0.96) less likely to practice optimal complementary feeding. On the other hand, mothers of children aged20-23 months were four times (AOR = 4.47, 95% CI 2.02-9.91) more likely to practice optimal complementary feeding than mothers having children 6-8 months of age. PRACTICE IMPLICATIONS: Different interventions have been implemented by governmental and non-governmental organizations to improve this condition in Dessie Zuria District. But, there is limited data on the extent to which intervention by governmental and non-governmental organizations reduces this improving condition. The aim of this study was to assess the Optimal Complementary Feeding Practice and Associated Factors among Mothers Having Children Aged 6-23 Months, Ethiopia 2021. CONCLUSION: Optimal complementary feeding practices among mothers in NGO-supported kebeles were higher than not supported kebeles. Therefore, strengthening and scaling up the program to not-supported kebeles is recommended to improve the optimal complementary feeding practiced.

The effect of lack of ANC visit and unwanted pregnancy on home child-birth in Ethiopia: a systematic review and meta-analysis.

Although extensive efforts were made to improve maternal and child health, the magnitude of home child-birth is considerably high in Ethiopia. Therefore, this meta-analysis aimed to estimate the effect of lack of ANC visit and unwanted pregnancy on home child-birth among reproductive-age women in Ethiopia. International databases, including Cochrane Library, Google Scholar, PubMed, Global Health, HINARI, and CINAHL were searched systematically to identify studies reporting the prevalence of home child-birth and its association with lack of ANC visit and unwanted pregnancy among reproductive-age women in Ethiopia. STATA/SE version-14 was used to analyze the data and Der Simonian and Liard's method of random effect model was used to estimate the pooled effects. The heterogeneity between study and publication bias was assessed by using I-squared statistics and Egger's test respectively. A total of 19 studies with 25,228 study participants were included in this meta-analysis. The pooled prevalence of home child-birth among reproductive-age women in Ethiopia was 55.3%. Sever heterogeneity was exhibited among the included studies (I2 = 99.8, p = 0.000). The odds of home child-birth among mothers who have no ANC visit was 3.64 times higher compared to their counterparts [OR = 3.64, 95%, CI: (1.45, 9.13)]. There was significant heterogeneity among the included studies (I2 = 94%, p = 0.000). However, there was no statistical evidence of publication bias in the pooled effect of lack of ANC visit on home child-birth (P = 0.302). Women who experienced unwanted pregnancy were 3.02 times higher to give birth at home compared to women with a wanted pregnancy [OR = 3.02, 95%CI: (1.19, 7.67)]. Severe heterogeneity was exhibited (I2 = 93.1%, p = 0.000) but, there was no evidence of significant publication bias in the pooled effect of unwanted pregnancy on home child-birth (P = 0.832). The proportion of home child-birth among reproductive-age women in Ethiopia remains high. Lack of ANC visit and unwanted pregnancy had a significant effect on the practice of home child-birth. Strengthening behavioral change communication programs should be the primary focus area to improve institutional delivery service utilization among women with lack of ANC visit and unwanted pregnancy.