Level of skin-to-skin care practices among postnatal mothers in Ethiopia. A systematic review and meta-analysis.

Introduction: Even though skin-to-skin contact offers several advantages for the survival of the newborn, it is not often practiced in Ethiopia. For instance, hypothermia which increases the risk of neonatal mortality by five times is prevented by this practice. Despite this, there are inconsistent findings that can affect policymaking. Consequently, this metanalysis aimed to produce trustworthy national data regarding skin-to-skin care practice and its determinants among postpartum mothers in Ethiopia. Methods: A search of the publications was conducted using MEDLINE, PubMed, Embase, Scopus, Web of Sciences, and Google Scholar. The program used for cleaning and analysis was STATA version 18.2. The random-effects model was utilized to estimate the pooled prevalence, which was then presented using a forest plot with a 95 % confidence interval. We evaluated heterogeneity using I2 and Cochrane Q statistics. Moreover, a visual examination of a funnel plot and Egger's regression test were used to evaluate publication bias. Results: This study included eight studies with a total of 10410 postpartum mothers. The overall level of skin-to-skin care practices was 48 % (95%CI: 31, 65. I2=99.38 %, P = 0.001). Based on subgroup analysis by year of publication, studies published between 2017 and 2019 years showed that the level of skin-to-skin care practice among postnatal mothers was 52 % (95 % CI: 14-89, I2 = 99.19). The knowledge of mothers about skin-to-skin care was significantly associated with practicing a level of skin-to-skin care. Conclusions: The findings showed that in Ethiopia, comparatively less than half of the newborns received skin-to-skin care. Moreover, there was a substantial correlation between the mother's knowledge and practice of skin-to-skin care. Therefore, both the government and all stakeholders should take coordinated action to improve and expand skin-to-skin care practices through health education, so that all postnatal mothers can practice this vital newborn care.

Determinants of Health Care Providers' Attitudes Toward Safe Abortion Care in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Unsafe abortion is a serious reproductive health problem in developing countries including Ethiopia. The attitude of healthcare providers toward abortion is one of contributing factors to unsafe abortion. This study aimed to determine the pooled effect of healthcare workers' attitudes toward safe abortion care and its determinants factors in Ethiopia. Methods: Search engines such as Scopus, CINAHL, EMBASE, PubMed, Web of Science, and CAB Abstracts were used to find published studies where as Google and Google Scholar were used to find unpublished research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. The analysis was performed using STATA 14 and the random-effects model was used to calculate the odds ratios of medical professionals' attitudes regarding safe abortion services. Study heterogeneity was assessed by using I2 and P-values. To evaluate the stability of pooled values to outliers and publication bias, respectively, sensitivity analysis and funnel plot were also performed. Results: A total of 15 published and unpublished articles with a sample size of 4060 were incorporated in this Review. The overall pooled prevalence of this study was 56% (95% CI: 45-67). Sex of participants (AOR: 2.37; 95% CI: 1.57, 3.58), having training (AOR: 2.86; 95% CI: 1.58, 5.17), Professional type (AOR: 1.55; 95% CI: 1.04, 4.46), and knowledge of abortion law (AOR:2.26; 95% CI: 1.14, 4.46) were the determinants factors that significantly associated with health care workers' attitude toward safe abortion care. Sensitivity analysis shows that the pooled odds ratios were consistently stable throughout all meta-analyses, and the funnel plot shows no evidence of publication bias. Conclusion: Half of health care providers sampled among the pooled studies have favorable attitudes toward abortion services in Ethiopia; which could hamper women's access to safe abortion care. Sex, training, type of profession, and knowing abortion law were determinants of health care workers' attitudes toward safe abortion services. Stakeholders should emphasize improving the attitude of healthcare workers toward safe abortion care which has a vital role in reducing maternal mortality. Moreover, working on modifiable factors like training, assigning personnel whose professions align with the service, and updating care providers about abortion law is also the essential key point to improve their intentions to deliver the services.

Diarrheal disease and associated factors among children aged 6 to 59 months in Oda Bultum District, Eastern Ethiopia: a community-based cross-sectional study.

BACKGROUND: Diarrhea is a serious health problem in children under the age of five that is both preventable and treatable. In low-income countries like Ethiopia, children under the age five years frequently experience diarrhea. However, the burden and associated factors of these diarrheal diseases are understudied in Eastern Ethiopia, Thus, this study aimed to determine the factors associated with the prevalence of diarrheal diseases in Eastern Ethiopia from September 1-30, 2022. METHODS: A cross-sectional study was conducted on the total of 602 children aged 6 to 59 months in Oda Bultum district in eastern Ethiopia. A multistage sampling method was used. Three kebeles were selected from nine kebeles by the lottery method. Data was entered into Epi data 4.0.2 and exported to SPSS version 21 for analysis. Descriptive analysis was used for frequency, mean, and standard deviations. In addition, bivariable, and multivariable Poisson regression model was used to identify predictors of diarrhea along with a 95% confidence interval. Finally, statistical significance was declared at a p-value of 0.05. RESULT: A total of 602 children were included in this study. The prevalence of diarrhea 7.4% (47/602), 95% CI; 5.5-9.7%) among the children. Factors such as being unvaccinated for any vaccine (AOR = 10.82, 95%CI; 4.58-25.48) and born from a mother who had medium level of empowerment (AOR = 0.34, 95%CI; 0.11-0.88) in the household had statistically significant association with diarrhea among the children compared to their counterparts. CONCLUSION: The study found that nearly one out of thirteen children aged 6 to 59 months had any form of diarrheal diseases in Oda Bultum District, Eastern Ethiopia. In addition, the study revealed that children who were vaccinated for their age developed diarrhea less likely compared to those who did not receive any form of vaccine for their age. Moreover, children with mothers who had a medium level of empowerment were less likely to get diarrhea than children with mothers who had a low level of empowerment.

Two out of every three pregnant women who gave birth in public health facilities of Tullo Woreda were dissatisfied with deliveries services, Eastern Ethiopia.

Background: The level of maternal satisfaction with delivery services significantly affects health service utilization among women. Ethiopia's healthcare system and health facilities' quality have not much improved, which may contribute to women's generally poor levels of satisfaction and there was a limited study about client satisfaction on delivery services in the study area. Thus, the purpose of this study was to assess level of maternal satisfaction with delivery service and its associated factors among women who gave birth in Tullo Woreda public health facilities, Eastern Ethiopia. Methods: A facility-based cross-sectional study was conducted from 1 to 30 September 2020 among 355 women who gave birth in Tullo Woreda public health facilities, Eastern Ethiopia Data were collected using a pretested structured questionnaire through a face-to-face interview and entered into Epidata version 3.1 and analyzed using statistical package for the social sciences (SPSS) version 25. The prevalence was reported using a 95% confidence interval and summary measures. Predictors were assessed using a multivariable logistic regression analysis model and reported using an adjusted odds ratio with 95% CI. Statistical significance was declared at a p-value of <0.05. Results: The overall satisfaction of mothers on delivery service was 33.5% (95% CI: 27.81, 39.13). Factors such as having no antenatal care (ANC) for the index pregnancy (AOR = 0.33; 95% CI: 0.19, 0.56), women who came to health centers on foot (AOR = 0.17; CI: 0.04, 0.74) and by auto-rickshaw (AOR = 0.16; 95 % CI: 0.04, 0.64), mothers who did not satisfied with toilet service at the delivery room (AOR = 0.49; 95% CI: 0.12, 0.86) and who were not satisfied with maternal drugs availability (AOR = 0.65; 95% CI: 0.11, 0.95) were predictors of maternal satisfaction. Conclusions: This study pointed out that only 33.5% of women were satisfied with delivery care services provided in public health facilities of the study area. Factors such as not having ANC, using foot and auto-rickshaw as means of transportation, availability of drugs, and toilets were predictor of maternal satisfactions. Awareness creation for the benefit of ANC follow-up and delivery in the health facilities and providing safe transportation during referral time may help mothers get a timely healthcare service, which may increase client satisfaction. The concerned entities must pay attention in timely availability of drugs and improving the toiles, which play a role in shaping and molding level of satisfaction of women.

Health extension workers' level of job satisfaction in western Hararghe Zone, eastern Ethiopia: an institutional-based cross-sectional study.

Background: There is a concern that job dissatisfaction among health extension workers (HEWs) reduces the benefit of investment in the execution of health extension programs. Hence, the purpose of this study was to explore the level of job satisfaction and factors affecting it among the HEWs in the West Hararghe Zone, Oromia Regional State, eastern Ethiopia. Method: An institutional-based cross-sectional study was conducted among 416 randomly selected health extension workers from 20 September 2020 to 20 October 2020. A pretested, structured questionnaire was used to collect the data. STATA 14.2 was used for data analysis. Bivariable and multivariable binary logistic regression analyses were also performed. Statistical significance was set at P < 0.05. Results: The overall level of satisfaction of health extension workers was 51.8% [95% confidence interval (CI): 46.97%, 56.6%]. Earning more than 5,260 ETB as salary [adjusted odds ratio (AOR) = 1.69, 95% CI: 1.01, 2.85], working more than 10 km from the district town (AOR = 1.59, 95% CI: 1.01, 2.53), receiving supportive supervision (AOR = 1.64, 95% CI: 1.06, 2.55), and not living with parents (AOR = 1.94, 95% CI: 1.24, 3.04) were significantly associated factors with HEW job satisfaction. Conclusion: Nearly half of the health extension workers were dissatisfied with their jobs. Supportive supervision, compensation, distance, and parental home location were all predictors of job satisfaction. It is critical to establish intervention tactics that may satisfy and motivate HEWs to expand health coverage, strengthen health extension programs, and improve service delivery.

Prevalence and adverse outcomes of twin pregnancy in Eastern Africa: a systematic review and meta-analysis.

INTRODUCTION: Multiple pregnancies are much more common today than they were in the past. Twin pregnancies occur in about 4% of pregnancies in Africa. Adverse pregnancy outcome was more common in twin pregnancy than in singleton pregnancy. There is no pooled evidence on the burden and adverse pregnancy outcome of twin pregnancy in eastern Africa. Thus, this systematic review and meta-analysis were conducted to assess the prevalence and adverse pregnancy outcomes of twin pregnancies. METHODS: This systematic review and meta-analysis covers published and unpublished studies searched from different databases (PubMed, CINAHL (EBSCO), EMBASE, DOAJ, Web of Sciences, MEDLINE, Cochrane Library, SCOPUS, Google Scholar, and Google search). Finally, 34 studies were included in this systematic review and meta-analysis. JBI checklist was used to assess the quality of included papers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Data synthesis and statistical analysis were conducted using STATA Version 14 software. Heterogeneity and publication bias were assessed. A forest plot was used to present the pooled prevalence using the random effect model. RESULTS: The prevalence of twin pregnancy in eastern Africa was 3% [95% CI: 2, 3]. The adverse pregnancy outcomes like neonatal intensive care unit admission (78%), low birth weight (44%), low APGAR score (33%), prematurity (32%), stillbirth (30%), neonatal mortality (12%) and maternal complications like hypertensive disorder of pregnancy (25%), postpartum hemorrhage (7%), Cesarean section (37%), premature rupture of membrane (12%) and maternal mortality are more common among twin pregnancy than singleton pregnancy. CONCLUSION: One in every 33 children born a twin in east Africa; admission to neonatal intensive care unit, low birth weight, low APGAR score, prematurity, stillbirth, neonatal mortality and maternal complications are its associated adverse birth outcomes. Since twin pregnancy is a high-risk pregnancy, special care is needed during pregnancy, labor and delivery to reduce adverse pregnancy outcomes.

Clinical practice competence and associated factors among undergraduate midwifery and nursing sciences students at Bahir Dar city, Northwest Ethiopia.

Background: Competence describes actions that will be demonstrated or observed and assessed while competency refers to the skill itself. Following appropriate theoretical and practical training, clinical experience is required to achieve the highest level of clinical competence. It is estimated that many women and newborns die each year due to a lack of qualified health professional around the world. As a result, the purpose of this study was to determine the prevalence and factors influencing clinical competency in the study area. Methods: An Institutional-based cross-sectional study was conducted from 12 August to 12 September 2022, among 403 undergraduate health sciences students of Bahir Dar University. Participants were approached through simple random sampling technique. Data were collected using a pre-tested structured questionnaire through a face-to-face interview, and entered into Epidata version 3.1 and analyzed using SPSS version 22. The prevalence was reported using proportion with 95% CI and summary measures. Predictors were assessed using a multivariable logistic regression analysis model and reported using an adjusted odds ratio (AOR) with 95% CI. Statistical significance was declared at P value less than 0.05. Results: Overall, the prevalence of clinical practice competency was 36.5% [95% CI; 33.5, 39.1]. Students who were provided a logbook (AOR=5.40, 95% CI 2.91, 10.02), adequate clinical cases in the clinical practice placement (AOR=2.72, 95% CI 1.60, 4.60), preceptor show different procedures (AOR=2.50, 95% CI 1.33, 4.71), student's confidence during conducting procedure (AOR=4.16, 95% CI 1.67, 10.35) and the suitability of the way of teaching to the learning styles of students during skills demonstration (AOR=2.10, 95% CI 1.00, 4.40) were factors statistically associated with clinical practice competence. Conclusions: According to this study, more than three out of every five participants were found to be clinically incompetent. Providing logbooks, adequate clinical cases, preceptors showing different procedures, students' confidence, and suitability of the way of teaching to the learning styles of students were significantly associated with clinical practice competence. Implementing logbooks, selecting clinical sites, enhancing the confidence of students, preferred teaching/learning styles, and clinical preceptor support were important to improve the clinical competence of students.

Neonatal sepsis and its predictors in Ethiopia: umbrella reviews of a systematic review and meta-analysis, 2023.

Background: Although neonatal sepsis is acknowledged as the primary cause of newborn death in Ethiopia, data on its impact at the national level are limited. Strong supporting data are required to demonstrate how this affects neonatal health. This umbrella study was conducted to determine the overall prevalence of newborn sepsis and its relationship with maternal and neonatal factors. Methods: This umbrella review included five articles from various databases. The AMSTAR-2 method was used to assess the quality of included systematic review and meta-analysis studies. STATA Version 18 software was used for statistical analysis. A random-effects model was used to estimate the overall effects. Results: In this umbrella review, 9032 neonates with an outcome of interest were included. The overall pooled prevalence of neonatal sepsis was 45% (95% CI: 39-51%; I2=99.34). The overall pooled effect size showed that prematurity was significantly associated with neonatal sepsis [odds ratio=3.11 (95% CI: 2.22-3.99)]. Furthermore, maternal factors are strongly associated with neonatal sepsis. Conclusions: Nearly half of Ethiopian neonates are affected by neonatal sepsis. It is critical to reduce premature birth, low birth weight, and preterm membrane rupture to reduce the incidence of neonatal sepsis. Furthermore, it is preferable to design and strengthen policies and programs aimed at improving maternal nutritional status and treating maternal infections, which all contribute to lowering the burden of neonatal sepsis.

Level of exposure to aflatoxins during pregnancy and its association with adverse birth outcomes in Africa: a meta-analysis.

BACKGROUND: Aflatoxins are various poisonous carcinogens and mutagens produced by Aspergillus species. Exposure to aflatoxins during pregnancy results in adverse birth outcomes. This meta-analysis was carried out to determine the estimates of how much aflatoxin is harmful to the pregnancy and its outcome, including birthweight, birth length, low birthweight (LBW), small for gestational age (SGA), stunting, poverty, food insecurity, income, pesticides and stillbirth, in an African context. METHODS: Both published and unpublished studies in Africa were searched on MEDLINE, PubMed, Embase, SCOPUS, Web of Science and Google Scholar. Stata version 18.2 software was used for cleaning and analysis. The prevalence with a 95% confidence interval (CI) was estimated using the random effects model and a forest plot was used to present the findings. In addition, the heterogeneity of the study was assessed using Cochrane I2 statistics and publication bias was assessed using Egger's intercept and funnel plot. RESULTS: This review included 28 studies with a total of 6283 pregnant women and newborns. The analysis showed the overall level of exposure to aflatoxins was 64% (95% CI 48 to 78, τ2=0.66, I2=99.34%, p=0.001). In the subgroup analysis by publication year, the highest level of exposure to aflatoxins (82% [95% CI 69 to 92]) was observed among studies published from 2020 to 2023. This study also found that exposure to aflatoxins during pregnancy had an association with prematurity, LBW, SGA and stillbirth. CONCLUSIONS: The data analysed in this study indicated that three of every five pregnant women had exposure to aflatoxins in Africa. Moreover, pregnant women exposed to aflatoxins had a higher likelihood of having a LBW and SGA newborn. Thus governments and all stakeholders should initiate policies that mitigate the toxicity of aflatoxins in pregnant women, foetuses and newborns.

The burdens, associated factors, and reasons for traditional uvulectomy in Ethiopia: A systematic review and meta-analysis.

INTRODUCTION: Traditional uvulectomy is a harmful procedure in which the entire or a portion of the uvula is removed by traditional practitioners. It causes complications like septicemia, transmission of infectious diseases, anemia, excessive bleeding, infection, tetanus, meningitis, and death. A summary of national data was lacking, thus, the study aimed to determine the pooled national burden and determinants of traditional uvulectomy in Ethiopia. METHODS: Studies were retrieved from PubMed, EMBASE, CINHAL (EBSCO), Google Scholar, Web of Sciences, MEDLINE, Cochrane Library, SCOPUS, and Google databases. Finally, 19 studies were included. The methodological quality of the included studies was assessed using the JBI checklist. Data synthesis and statistical analysis were conducted using STATA Version 17 software. Heterogeneity and publication bias were assessed. Forest plots were used to present the pooled and summarized with random-effects meta-analysis models. RESULTS: Totally 19 articles with 23,559 study participants were included in this systematic review and meta-analysis. The overall pooled prevalence of uvulectomy in Ethiopia was 44 % (95 % CI: 31%-57 %). The highest prevalence was observed among studies conducted in the Tigray region (63 % (95 % CI: 34%-94 %), between the year 2011-2014 (58 % (95 % CI: 29%-87 %)) and, community setting (57 % (95 % CI: 36%-78 %). Mothers' educational status (AOR: 1.66, 95 % CI: 1.31-2.01) and residence (AOR: 1.70, 95 % CI: 1.16-2.23) were found to be significantly associated with traditional uvulectomy in Ethiopia. Frequently cited reasons for traditional uvulectomy were to prevent swelling, pus, and rupture of the uvula, for better care, prevention of sore throats and coughs, religion, and culture. CONCLUSION: The pooled result revealed that almost half of children are still subjected to traditional uvulectomy in Ethiopia. There is a need to intensify awareness creation campaigns against the practice by giving special attention to rural residents and uneducated ones.

Early newborn bathing practice and its determinants among postpartum women in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Early baby bathing has a major negative impact on the newborn's health. Even though early newborn bathing has numerous detrimental effects on neonatal health, evidence has provided little attention on the current level of practice. Furthermore, there is a dearth of data regarding the overall effects of early newborn bathing in Ethiopia, which would be helpful to program and policy designers. This meta-analysis aimed to ascertain the level of early bathing practice and its determinants among postpartum women in Ethiopia. METHODS: All articles were searched from the Web of Sciences, CINAHL (EBOSCO), Science Direct, MEDLINE, PubMed, Google Scholar, and Google websites from inception to October 10, 2023. The meta-analysis was performed using Stata version 18. The summary estimates with 95% CI were estimated using the random effect model with the Der Simonian Liard method. Heterogeneity was explored using Galbraith plot, Cochrane Q statistics, I2 statistics, and test of theta. To deal with the observed heterogeneity, subgroup analysis, sensitivity analysis, and meta-regression were done. RESULTS: This meta-analysis included a total of 2787 postpartum women. The pooled level of early newborn bathing practice among postpartum women in Ethiopia was 55% [95% CI: 38-71]. Based on subgroup analysis by region, the highest level of early newborn bathing practice was among studies conducted in the Afar region which was 73% (95% CI: 69-77). There is a significant association between maternal level of education and early newborn bathing practice among postpartum women in Ethiopia (AOR = 0.51, 95% CI: 0.24, 0.78). CONCLUSIONS: In this meta-analysis, the overall estimate illustrates that more than half of postpartum women practice early newborn bathing in Ethiopia. Maternal level of education was significantly associated with early newborn bathing practice. Thus, both the government and all the concerned stakeholders should take coordinated action to boost information dissemination and awareness creation among postpartum women thereby reducing the practice of early newborn bathing and alleviating consequences of early newborn bathing.

Fertility desires of antiretroviral therapy-attending HIV-positive women and its associated factors in Harari region, Ethiopia.

BACKGROUND: The desire to have children among mothers living with HIV remains a serious public health issue in nations with low coverage for antiretroviral therapy and the prevention of mother-to-child transmission, even if it is feasible to have an HIV-negative child. Therefore, this study aimed to assess fertility desire and associated factors among antiretroviral therapy-attending HIV-positive women at Hiwot Fana Specialized University Hospital, in Harari, Ethiopia. METHODS: A facility-based cross-sectional study design was employed among 639 anti retro-viral therapy attending HIV - positive women by systematic random sampling method selected from June 15 to November 30, 2020. A binary logistic regression model was fitted to identify the associated factors with fertility desire. Descriptive results were presented in percentages, whereas analytical results were reported in adjusted ORs (AORs) with a 95% CI. At p=0.05, statistical significance was declared. RESULTS: A total of 639 participants were included in the study; 69.5%(95% CI 65.7 to 72.9%) of the participants had fertility desire. Younger age (<35 years) (AOR=2.35, 95% CI 1.27 to 4.35), married women (AOR=3.02, 95% CI 1.32 to 12.25), childless women (AOR=2.86, 95% CI 1.17 to 4.82) and women whose duration of HIV diagnosis was ≤5 years (AOR=0.41, 95% CI 0.20 to 0.71) were significantly associated with fertility desire. CONCLUSION: The majority of the study participants have a desire to have children. In light of the high prevalence of fertility desire among antiretroviral therapy-attending HIV-positive women, it is recommended to counsel younger women on reproductive planning and encourage partner testing.

Is intimate partner violence and obstetrics characteristics of pregnant women associated with preterm birth in Ethiopia? Umbrella review on preterm birth.

BACKGROUND: Preterm birth is a significant contributor to newborns morbidity and mortality. Despite the availability of highly effective and powerful interventions, the burden of preterm birth has not decreased. Given the relevance of the topic to clinical decision-making, strong conclusive and supporting evidence emanating from the umbrella review is required. To this end, this umbrella review study sought to determine the association between intimate partner violence and obstetrics characteristics of women with preterm birth in Ethiopia. METHODS: Six systematic review and meta-analysis studies searched across multiple databases were included in this umbrella review. The quality of the included systematic review and meta-analysis studies was evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR-2) checklist. STATA version 18 was used for the statistical analysis. A random-effects model was used to calculate the overall effect measurement. RESULTS: A total of 114 observational studies in the six systematic review and meta-analysis studies involving 75,624 pregnant women were included in this comprehensive analysis. The preterm birth rate among mothers in Ethiopia was 11% (95% CI 10-13%; I2 = 98.08). Preterm birth was significantly associated with intimate partner violence (POR: 2.32; 95% CI 1.74-2.90), multiple pregnancies (POR: 3.36; 95% CI 2.41-4.32), pregnancy-induced hypertension (POR: 4.13; 95% CI 3.17-5.10), anemia (POR: 2.76; 95% CI 1.97-3.56), and premature rupture of pregnancy (POR: 5.1; 95% CI 3.45-6.75). CONCLUSIONS: More than one out of ten pregnant women experienced preterm birth in Ethiopia. Intimate partner violence is significantly associated with preterm birth. Furthermore, multiple pregnancies, pregnancy-induced hypertension, anemia, and premature rupture of the membrane were significant predictors of preterm birth. Therefore, policymakers should consider further instigations and implementations of policies and strategies closely related to reductions of intimate partner violence. It is also crucial to the early identification and treatment of high-risk pregnancies.

Insecticide-treated net utilization and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis.

Background: Malaria is a major public health problem in many developing countries, particularly in sub-Saharan Africa. The pregnant woman, fetus, and newborn infant are all at risk from malaria during pregnancy. Hence, insecticide-treated bed net (ITN) use is the most effective and advisable method for preventing malaria during pregnancy. Studies on the prevalence of ITN utilization among pregnant women in Ethiopia are inconsistently reported and highly varied. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of ITN utilization and associated factors among pregnant women in Ethiopia. Methods: A comprehensive search of databases such as PubMed, CINAHL, Web of Science, SCOPUS, Science Direct, Google, and Google Scholar was performed to find studies conducted in Ethiopia. All original observational studies that reported the prevalence of ITN utilization were identified and screened. The Newcastle-Ottawa scale tool was used to assess the quality of the studies. Data were extracted in Microsoft Excel 2010 format and analyzed using STATA Version 14. A random-effect meta-analysis model was utilized to estimate the pooled prevalence of ITN utilization. The statistical heterogeneity was checked using the I2 test and subgroup analysis. The publication bias was assessed using funnel plots and Egger's regression test. The size of the pooled effect of the factors influencing the use of ITNs was estimated using an odds ratio (OR) with a 95% confidence interval (CI), and a P-value <0.05 was considered statistically significant. Results: Twenty-nine cross-sectional studies with 13,957 study participants were included in this meta-analysis. The overall pooled prevalence of ITN utilization among pregnant women in Ethiopia was 51% (95% CI: 43-60). A statistically significant heterogeneity was observed across studies (I2 = 99.09%; P < 0.001). Being literate [OR = 2.93 (95% CI: 2.14-4.01)], rural residence [OR = 1.76 (95% CI: 1.37-2.26)], and having knowledge of ITN [OR = 4.13 (95% CI: 1.57-10.81)] were factors significantly associated with ITN utilization among pregnant women. Conclusion: The utilization of ITNs among pregnant women was substantially lower than the national target, alarmingly highlighting the need for urgent and effective interventions. Maternal education status, place of residence, and knowledge of ITNs were independent predictors of ITN utilization. Health policymakers and programmers should design and implement the most effective strategies to scale up the utilization of ITNs by pregnant women and reduce malaria-related morbidity during pregnancy. Systematic Review Registration: CRD42022304432.

Determinants of Unsuccessful TB Treatment Outcomes Among Patients on Directly Observed Treatment Short Course in Jimma Town Health Facilities, Southwest Ethiopia: A Case-Control Study.

Background: Even though Ethiopia's Federal Ministry of Health has been implementing several programs aimed at reducing the burden of tuberculosis (TB), It does not demonstrate adequate progress. As a result, identifying the determinants of unsuccessful outcomes of directly observed treatment, short-course (DOTS) is critical. Purpose: This study aimed to assess the determinants of unsuccessful TB treatment outcomes among patients with DOTS in Jimma town, southwest Ethiopia. Patients and Methods: An unmatched case-control study using secondary data was conducted among 118 cases and 472 controls from April 1 to June 1, 2021. Cases were TB cases with unsuccessful treatment courses whereas controls were those of successful treatment. Data were collected using a standardized tool. Statistical analysis was done using SPSS version 23 software. A binary logistic regression model was used to identify the determinants. Results: We found that the determinants including age > 35 years (AOR=1.9, 95% CI: 1.14-3.2), lack of contact person (AOR= 27, 95% CI: 15.8-46.3), being HIV positive (AOR=7.3, 95% CI: 3.7-14.2)), and being malnourished (AOR=4.5, 95% CI: 1.5-12.9) were significantly associated with unsuccessful tuberculosis treatment outcome. Conclusion: In this study, advanced age, being HIV positive, lack of contact person, and being malnourished were determinant factors for unsuccessful TB treatment outcomes. Hence, careful monitoring, screening, and management of risk factors are recommended.

Adherence to diabetic foot care recommendations and associated factors among people with diabetes in Eastern Ethiopia: a multicentre cross-sectional study.

OBJECTIVE: This study aimed to determine the level of adherence to foot care recommendations and associated factors among people with diabetes on follow-up in public hospitals in Eastern Ethiopia. SETTING: An institutional-based cross-sectional study was conducted in public hospitals found in Eastern Ethiopia from 25 February to 25 March 2022. PARTICIPANTS: A total of 419 patients with chronic diabetes who visited diabetic clinics in public hospitals in Eastern Ethiopia for follow-up were included. MAIN OUTCOME MEASURE: The level of adherence to diabetic foot care recommendations and associated factors. RESULTS: The findings indicated that 44.3% (95% CI: 39.3, 49.0) of people with diabetes had inadequate adherence to diabetic foot care recommendations. Age between 28-37 (adjusted OR (AOR)=1.10; 95% CI: 1.27, 5.63) and 38-47 years (AOR=2.19; 95% CI: 2.74, 8.89), rural residence (AOR=1.71; 95% CI: 1.15, 2.57), absence of comorbidity (AOR=2.22; 95% CI:1.34, 5.14), obesity (AOR=1.43; 95% CI: 1.10, 5.05) and inadequate foot care knowledge (AOR=2.10; 95% CI: 1.52, 4.35) were factors significantly associated with inadequate adherence to diabetic foot care recommendations. CONCLUSION: More than two-fifths of people with diabetes had inadequate adherence to diabetic foot care recommendations. Younger age, rural residence, absence of comorbidity, obesity and inadequate foot care knowledge were significantly associated with inadequate adherence to diabetic foot care recommendations. It is very essential to educate people with diabetes about the importance of foot care recommendations in preventing and delaying the risks of foot-related problems and complications.

Missed Opportunity of Antenatal Care Services Utilization and Associated Factors among Reproductive Age Women in Eastern Hararghe Zone, Eastern Ethiopia: Mixed Methods Study.

Background: Despite the enormous advantages of early pregnancy-related problem diagnosis and therapy during prenatal care visits, not all pregnant women begin antenatal care at the proper time. Thus, this study aims to identify factors associated with missed opportunities for antenatal care service utilization among reproductive-age women in Eastern Ethiopia. Methods: A mixed methods study design (quantitative and qualitative) was conducted in Grawa, Meta, and Haramaya woredas from September 5 to December 5, 2019. The quantitative data were analyzed using SPSS version 25. A multivariable logistic regression analysis model was used to identify the predictors. Statistical software programs based on ATLAS.ti version 8.2 was were used to conduct the thematic analysis of the qualitative data. Results: Overall, missed opportunities for antenatal care were 15.4% of 95% (12.1, 19.1%). Factors such as maternal age being 15-24 (AOR = 6.9, 95% CI: 2.89-8.81); having a college education (AOR = 0.02, 95% CI: 0.001, 0.42), elementary (AOR = 0.05, 95% CI: 0.002, 0.98), and secondary education (AOR = 0.04, 95% CI: 0.001, 0.88); having five and more parity (AOR = 0.08, 95% CI: 0.01, 0.75); three visits (AOR = 0.10, 95% CI: 0.02, 0.71); those in the first trimester (AOR = 0.02, 95% CI: 0.001, 0.35) and the second trimester (AOR = 0.01, 95% CI: 0.001, 0.26); and get information from a health facility (AOR =0.09, 95% CI: 0.01, 0.67) and traditional birth attendance (AOR = 0.02, 95% CI: 0.001, 0.74) were factors statistically associated with outcome variables. Conclusions: According to this report, relatively high proportions of pregnant women experienced missed opportunities in antenatal care follow-up. Factors such as maternal age, education, parity, frequency, timing, and media access were statistically significantly correlated with missed antenatal care follow-up. Therefore, all stakeholders should emphasize advocating for and enhancing the benefits of antenatal care; this in turn plays a crucial role in increasing the follow-up of clients for these crucial services. Moreover, health policy implementers need to coordinate their tracking of pregnant women who missed their antenatal care session.

Active management of the third stage of labor and associated factors among maternity care providers in public health facilities in Eastern Ethiopia: a multi-center study.

INTRODUCTION: The third stage of labor is the shortest, most critical, and hazardous stage as it is linked with postpartum hemorrhage, the leading cause of maternal mortality and morbidity. Postpartum hemorrhage can be prevented by 60% with active management of the third stage of labor (AMTSL). Few studies have been conducted in different parts of Ethiopia showing rates of AMTSL ranging from 16.7% to 43.3%. Limited information, however, exists about its practice in our study area. Thus, we aimed to assess the practice of AMTSL and associated factors among maternity care providers in public health facilities in eastern Ethiopia. METHODS: An institution-based cross-sectional study design was used among 270 maternity care providers in public health facilities in eastern Ethiopia. They were recruited using cluster sampling techniques in their health facilities from July 15-October 30/2021. Pretested self-administered questionnaires and an observational checklist were used to collect data. Descriptive, binary, and multivariable logistic regression analyses were performed. Adjusted odds ratios with 95% confidence intervals were used for statistically significant associations. RESULTS: Good practice of AMTSL occurred in 40.3% (95% CI: 34.5%-46.1%) of births. Being trained (aOR 3.02; 95% CI 1.60-5.70); presence of birth assistance (aOR 2.9; 95% CI 1.42-6.04); having the highest educational level (aOR 4.21; 95% CI 1.08-16.40); and having good knowledge (aOR 3.00; 95% CI 1.45-6.20) were factors statistically associated with maternity care providers' good practice of AMTSL. CONCLUSION: Active management of the third stage of labor was practiced with low rates in the study area. Therefore, we suggest that the stakeholders could enhance the presence of birth assistance during all births and provide education to attain higher educational levels and continuously update the maternity care providers' level of knowledge through comprehensive and on-the-job training to increase the good practice of the third stage of labor.

Demand of and Access to Health Messages Through Mass Media in the Rural Community of Eastern Ethiopia: A Mixed Method Study.

Background: The demand for health-related information has increased dramatically in recent years. Media is crucial in reaching health messages to audiences, especially those who are distant and rural. Therefore, the study aimed to assess demands, access, and factors associated with access to health messages through mass media in the rural community of Kersa District of East Hararghe, Eastern Ethiopia. Methods: A mixed-methods study was conducted from October 15 to November 20, 2020. A quantitative cross-sectional and a qualitative phenomenological study design were applied. A total of 578 participants were included by using a systematic sampling technique. Collected data were entered into Epidata version 3.1 and analyzed using SPSS version 22.0. A multivariate logistic regression analysis model was used and reported using an adjusted odds ratio (AOR) with a 95% confidence interval (CI). Statistical significance was set at p <0.05. For qualitative, six-focused group discussions (FGDs) were used and then analyzed thematically. Results: Overall, the demand of and access to health messages through mass media was 32.5% (95% CI=28.5-34.2%) and 26.6% (95% CI=24.6-28.7%), respectively. Factors such as having electric services (AOR=2.36, 95% CI=2.13-5.41), having a mobile phone (AOR=4.56, 95% CI=4.32-8.73), exposure to TV (AOR=4.73, 95% CI=1.03-11.62), and exposure to social media and printed media (AOR=5.24, 95% CI=1.07-15.63), a preference for programs such as news, current affairs, entertainment, health and educational were 2.37, 9.47, 4.75 and 7.55 times more likely to access health messages (AOR=2.37, 95% CI=1.00-5.61; AOR=9.47, 95% CI=3.54-25.34; AOR=4.75, 95% CI=1.23-18.38; and AOR=7.55, 95% CI=3.12-8.66, respectively). Qualitative findings, participants demand for health messages from health workers, radio, and the main source for accessing the message was the radio. Conclusion: Approximately one in every three and one in every four rural communities in the study area had demand, and access to health messages through mass media, respectively. As a result, all stakeholders should emphasize and strengthen expanding methods of reaching health messages using mass media.

Sexual Coercion is Associated with HIV Risk Behavior Among Female Waiters in Jimma Town, Southwest Ethiopia.

Background: Female waiters are at higher risk of workplace violence including sexual coercion. Even though there are numerous studies on the prevalence of sexual coercion among students, nurses, adolescents, and young pregnant women, studies on the prevalence of sexual coercion among female waiters are limited. Furthermore, there is no evidence existed that show a relationship between sexual coercion and HIV risk behavior in Ethiopia. Purpose: The purpose of this study was to examine the relationship between sexual coercion and HIV risk behavior among female waiters in Jimma, southwest Ethiopia. Patients and Methods: We conducted a cross-sectional survey from 1st April to 30, 2018, among 420 female waiters of reproductive age working in the licensed food and drinking establishments in Jimma town. A structured interviewer-administered questionnaire was used to collect data. Statistical analysis was conducted with SPSS version 21 statistical software. A binary logistic regression model was used to determine the association between independent variables and outcome variables. Results: The lifetime prevalence of sexual coercion among female waiters was 71.4% (95% confidence interval: 67.1-76.8). More than two-thirds (71.6%) of female waiters engaged in HIV-related risk behaviors. Working in the bar (AOR 4.64, 95% CI: 2.15-10.0), being a substance user (AOR 3.37, 95% CI: 1.7-6.7), experiencing sexual coercion (AOR 7.6, 95% CI: 3.8-15.3) were significantly associated with HIV risk behaviors. Conclusion: A significant number of female waiters experienced sexual coercion and engaged in HIV-risk behaviors. Workplace, substance use, and sexual coercion were significantly associated with HIV risk behavior. As a result, establishments, town health offices, and other stakeholders should work together to safeguard female waiters from the burdens of sexual coercion, HIV risk behavior, and sexually transmitted infections.