Determinants of undernutrition among children aged 6-59 months during the COVID-19 pandemic: A hospital-based cross-sectional study in Ethiopia.

Background: The public health problem of undernutrition is common in Ethiopia, particularly among children aged 6-59 months. However, determinants of undernutrition among children in this age group are not well investigated particularly within the context of COVID-19 pandemic. This study was, therefore, designed to assess the magnitude and determinants of undernutrition among children aged 6-59 months at Tirunesh Beijing general hospital, Ethiopia. Methods and materials: An institutional-based cross-sectional study was conducted involving 283 children aged 6-59 months in March 2022. The data were collected using structured questionnaire and anthropometric measurements. Undernutrition was defined as a Z-score value of weight for height (WFH), height-for-age (HFA), and weight-for-age (WFA) <2SD as calculated by the world health organization plus software. A multivariable logistic regression model was used to identify the independent factors associated with undernutrition. p-values less than 0.05 were considered statistically significant. Results: The response rate in this study was 97.9%. The overall magnitude of undernutrition was 34.3%, of which 21.2%, 12.7%, and 9.5% were stunted, underweight, and wasted, respectively. Occupation of mothers [AOR = 13.64, 95% CI (4.21-14.77)], amount of meal [AOR = 14.68, 95% CI (4.09-52.81)], feeding by caregivers [AOR = 8.96, 95% CI (2.81-18.60)], and breastfeeding [AOR = 0.06, 95% CI (0.02-0.22)] were significant predictors of undernutrition. Conclusions: The prevalence of undernutrition among children under the age of five remains high. Therefore, promoting breastfeeding and motivating children to feed adequate amount of meal are recommended. Besides, counseling and/or guiding caregivers on how to feed children shall be suggested. The findings could help inform the design and prioritization of effective intervention strategies at early life stage.

Quality of family planning counseling and associated factors among women attending family planning clinics at selected health centers in Akaki Kality sub-city, Addis Ababa, Ethiopia.

Background: Ethiopia has achieved a remarkable improvement in the provision of family planning. The modern contraceptive prevalence rate has shown a fivefold increment in the last two decades, yet the family planning service in the country is still deficient and characterized by poor counseling quality. Objective: The aim of the study is to assess the quality of family planning counseling provided and the associated factors at selected health centers in Akaki Kality sub-city, Addis Ababa, Ethiopia. Method: A cross-sectional study was conducted among 678 randomly selected women attending family planning services at health centers in Addis Ababa, Ethiopia. Multivariable logistic regression analysis was performed to identify factors associated with the quality of family planning counseling. Result: A total of 678 women participated in the study. About 29.1% [95% confidence interval (CI): 25.7%-32.6%] of the respondents were adequately counseled. Age groups 37-49 [adjusted odds ratio (AOR) = 2.7; 95% CI: 1.1-6.6], being in marital union (AOR = 2.8; 95% CI: 1.2-6.7), attaining secondary education (AOR = 1.9; 95% CI: 1.1-3.6) or higher education (AOR = 2.2; 95% CI: 1.2-4.3), and visit status (AOR = 1.6; 95% CI: 1.1-2.4) were significantly associated with good counseling. Conclusion: Less than one in three women was counseled adequately. Health professionals should give due attention to younger women, single clients, and clients with their first presentation to the health facility. It also indicates that promoting education among Ethiopian women is crucial for a positive outcome of family planning counseling.

Impact of COVID-19 on HIV services and anticipated benefits of vaccination in restoring HIV services in Ethiopia: A qualitative assessment.

Background: HIV services were inevitably disrupted and affected due to COVID-19. There are many challenges in implementing appropriate HIV services, particularly in the provision of health care and the link between people living with HIV/AIDS and retention in care. The study investigated the impact of COVID-19 on HIV services and the anticipated benefit of the COVID-19 vaccination on HIV service restoration in North Shewa, Oromia, Ethiopia. Methods: A qualitative descriptive study approach was used to explore how healthcare delivery evolved during the outbreak of COVID-19 in Ethiopia. Sixteen antiretroviral therapy (ART) clinics were selected from 13 districts and one administrative town in Ethiopia. From them, 32 ART providers were purposively selected based on their experience in ART provision. Data were collected from June to July 2021 using in-depth interviews. A thematic analysis approach was used to analyze the data, based on themes and subthemes emerging from the data. ATLAS.ti software was used for coding. Results: Healthcare for people living with HIV was interrupted due to the COVID-19 pandemic. Medical appointments, HIV testing and counseling services, opportunistic infection treatment, medicine supply, and routine viral load and CD4 T-cell count tests were interrupted. Due to a shortage of healthcare staff, outreach testing services and home index testing were discontinued and HIV testing was limited only to hospitals and health centers. This has substantially affected accessibility to HIV testing and reduced the quality of HIV service delivery. Telehealth and less frequent visits to health facilities were used as alternative ways of delivering HIV services. The COVID-19 vaccination campaign is expected to restore healthcare services. Vaccination may also increase the confidence of healthcare providers by changing their attitudes toward COVID-19. Conclusions: The COVID-19 pandemic has substantially impacted HIV services and reduced the quality of HIV care in Ethiopia. Health facilities could not provide routine HIV services as they prioritize the fight against COVID-19, leading to an increase in service discontinuation and poor adherence.

Magnitude of NNM and associated factors among Newborns delivered at the North Shewa zone Public Health Hospital, Central Ethiopia: A multi-level analysis.

Background: Neonatal near miss refers to a condition where a newborn is close to death within the first 28 days of life but ultimately survives either by chance or because of the quality of care they received. It is considered a major public health problem that contributes to the global burden of disease in less developing countries. For every death due to NMM, many others develop a severe complication. Despite this grim reality, there seems to be a gap in terms of the magnitude of and predictors of NNM in Ethiopia, where the previous study focused on neonatal death investigation. This study aimed to determine the magnitude of NNM and its determinants among the neonates delivered in the North Shewa zone, Central Ethiopia. Methods: A facility-based cross-sectional study was conducted using a systematic random sampling technique among 747 newly delivered babies in the North Shewa zone public hospital from January 30 to June 30, 2021. Neonatal near misses were identified with the help of the World Health Organization labeling criteria. Collected data were coded, entered, and cleaned by using Epi data 4.4.6 and analyzed using SPSS software (version 26) for analysis. Descriptive statistics were used to compute summary statistics and proportions. Variables at a cutoff value of 0.25 on bivariate and 0.05 on multivariate logistic regression were used to identify predictors. Result: The prevalence of NNM was 35.3% (95% CI = 31.9-38.6) per 1,000 live births. Participant occupation [AOR: 0.55, CI: 0.33-0.90], marital status [AOR: 2.19; CI: 1.06-4.51], instrumental delivery [AOR: 1.98; CI: 1.10-3.55], intrapartum hemorrhage [AOR: 2.27; CI: 1.03-5.01], abortion history [AOR: 1.59; CI: 1.03-2.44], mal-presentation [AOR: 1.77; CI: 1.14-2.77], premature rupture of membrane [AOR: 2.36; CI: 1.59-3.51], and pregnancy-related infection [AOR: 1.99; CI: 1.14-3.46] were found to have statistically significant association. Conclusion and recommendation: One-third of neonates face serious neonatal health conditions. Given this, addressing modifiable obstetric risk factors through providing skilled and quality care to mothers during pregnancy and during and after childbirth was important for improving neonatal health. Additionally, strengthening antenatal care services to minimize the infection occurring during pregnancy through the provision of appropriate services and counseling about the consequences of abortion was essential in reversing the problem.

Current intimate partner violence and associated factors among sero-positive women attending Adama town ART Clinics, Central Ethiopia 2019.

BACKGROUND: Intimate partner violence against women is a behavior within an intimate relationship that causes physical, sexual, or psychological harm to the victim. It is well recognized as a gross violation of human rights and affects the health of women, families, and the community at large. However, the level to which Human Immuno Deficiency virus sero-positive women are experiencing recent intimate partner violence and its associated factors have not been well investigated as the majority of the study done so far were focused on the study of lifetime violence and violence among women in the general population. The study was conducted to determine the prevalence and factors associated with current intimate partner violence among sero-positive women. METHODS: A facility-based cross-sectional study was conducted from March 2019 to April 2019 among 396 sero-positive women visiting anti-retroviral therapy (ART) units of Adama town public health facilities. A systematic random sampling technique was used to select individual participants. Validated World Health Organization (WHO) tools were used to collect information on the outcomes and key independent variables. The collected data were entered into Epidata version 4.4.6 and analyzed using SPSS version 24. Descriptive statistics were used to compute summary statistics and proportion. Variables at a cut-off value of 0.25 on bivariate analysis and 0.05 during multivariate logistic regression were used to identify factors associated with recent intimate partner violence. RESULT: The response rate in this study was 100% since all women approached took part in this study. The prevalence of current intimate partner violence was 32.3% while lifetime intimate partner violence (IPV) was 45.5%. Exposure to coerced first sexual intercourse [AOR = 3.0 (1.73, 5.44)], male multi-partnership [AOR = 2.2 (1.21, 4.06)], believing in the husband's right to sex [AOR = 2.3 (1.29, 4.12)], contraceptive use [AOR = 3.33 (1.67, 6.62)], and having farmer partner [AOR = 3.9 (1.43, 10.79)] were significantly associated with current intimate partner violence. CONCLUSION: One-in-three women reported at least 2 or more forms of violence from their intimate partner. Individual-level factors (Exposure to coerced first sexual intercourse, partner's occupation, contraceptive use, and believing in husband's right to sex and relationship factor (Male multi-partnership) were significantly associated with recent intimate partner violence. Combined efforts are required to avert intimate partner violence among women on ART while targeting risky sexual behavior practiced among male partner factors significantly associated with violence.

Management of polychlorinated biphenyls stockpiles and contaminated sites in Africa: A review of 34 countries.

Polychlorinated biphenyls (PCBs) are industrial chemicals that are designated as persistent organic pollutants. They were used for the production of multifarious products but their manufacture, and uses were banned under the Stockholm convention which took effect in 2004. The parties to the convention had prepared national implementation plans (NIPs) detailing management measures for persistent organic pollutants including PCBs. In the current review, the NIPs of 34 African countries were reviewed to assess the size of PCBs stockpiles, their storage conditions, and the management of PCBs contaminated sites. The results showed that each of the African countries examined, except Egypt, has stored PCBs stockpiles in open fields. There are several PCBs contaminated sites scattered across African countries with Malawi having the largest number of contaminated sites, 211 as of 2005. Many of these sites are not well managed and there are only few monitoring activities of the levels of PCBs. Thus, strict implementation of the Stockholm Convention and the NIPs to reduce the PCBs stockpiles size, and appropriate management of PCBs are required in Africa.