Usage of cervical cancer screening services among HIV-positive women in Southern Ethiopia: a multicentre cross-sectional study.

OBJECTIVES: To assess the usage of cervical cancer screening services and associated factors among HIV-positive women on antiretroviral treatment in Southern Ethiopia in 2020. DESIGN: A multicentre cross-sectional study. SETTING: The study was conducted in Wolaita Sodo University Teaching Referral Hospital and Sodo Health Centre, Southern Ethiopia, from 1 July 2020 to 30 September 2020. PARTICIPANTS: Four hundred and seventeen HIV-positive women on antiretroviral treatment attending public health facilities were approached during the study period. A multivariable binary logistic regression model was carried out to identify independent factors associated with the usage of cervical cancer screening services, and a p value<0.05 was used to declare statistical significance. RESULTS: The uptake of cervical cancer screening services among HIV-positive women was 27.8% with a 95% CI of 24.2% to 33.1%. Married women and women reporting a high level of perceived barriers were 75% and 66% less likely to receive cervical cancer screening services, adjusted OR (AOR)=0.25; 95% CI: 0.07 to 0.93, and AOR=0.34; 95% CI: 0.12 to 0.98, respectively. Whereas, being a government employee, AOR=3.85; 95% CI: 1.31 to 11.3, sexual debut before the age of 20, AOR=2.39; 95% CI: 1.09 to 5.26, using modern contraceptives, AOR=2.43; 95% CI: 1.05 to 5.65, having a high perceived self-efficacy, AOR=4.42; 95% CI: 1.79 to 10.89 and having a high perceived benefit of cervical cancer screening services, AOR=12.23; 95% CI: 2.22 to 67.35 were significantly associated with the usage of cervical cancer screening services. CONCLUSIONS: The usage of cervical cancer screening services among HIV-positive women remains low in this setting. Married HIV-positive women and those with a high perceived barrier were associated with low uptake of cervical cancer screening services. Being a government employee, having an early sexual experience, using modern contraceptives, having a high perceived self-efficacy and having a high perceived benefit were identified as factors associated with increased uptake of cervical cancer screening services.

Dual contraception method utilization and associated factors among women on anti-retroviral therapy in public facilities of Bishoftu town, Oromia, Ethiopia.

INTRODUCTION: Dual contraception is a method used to prevent sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV) and unintended pregnancies. Prevention of unintended pregnancy in people living with HIV (PLHIV) and ART given to pregnant women to suppress viral load prevent transmission of HIV to children. Counseling and provision of dual contraceptive methods is a very cost-effective method to tackle this double burden among women living with HIV. However, little has been known about utilization of dual methods among HIV positive women in Bishoftu town and its surroundings. OBJECTIVE: The aim of this study was to assess dual contraception method utilization and associated factors among reproductive age women who were on antiretroviral therapy in public health facilities of Bishoftu town. METHODS: A facility based cross- sectional study was conducted from November 01 to December 30, 2020. The study participants were selected by using simple random sampling technique. Data were collected using a pretested and structured questionnaire through a face to face interview. Data were processed and analyzed using SPSS version 20. Frequencies and percentages were used to describe characteristics of participants. Bivariable and multivariable logistic regression analyses were used to identify variables which had an independent association with the dependent variable. The degree of association between dependent and independent variables were measured using odds ratio with 95% confidence interval. Level of significance was set at a p-value less than 0.05. RESULTS: The Magnitude of dual contraceptive utilization of women living with HIV in Bishoftu town was 56.9% (95% Cl (51.6, 62.1). Being married (AOR = 4.33; 95% Cl (1.67, 11.27), not getting pregnant since the start of chronic care follow up (AOR = 2.19; 95% Cl (2.90, 3.70), having a partner positive for HIV (AOR = 2.67; 95% Cl (1.34, 5.32) and having a partner negative for HIV (AOR = 2.38; 95% Cl (1.09, 5.20) were factors independently associated with dual method contraceptive use. CONCLUSION: The study showed that use of dual contraceptive methods was low; factors like marital status, partner HIV status, and pregnancy after chronic HIV care follow up were found to be significantly associated with dual contraceptive method use. In addition to ART, use of dual contraceptive methods utilization may play a role in prevention of HIV infection in children and is important in the prevention of unintended pregnancy.

Utilization of preconception care and associated factors in Hosanna Town, Southern Ethiopia.

INTRODUCTION: There is substantial body of evidence that portrays gap in the existing maternal and child health continuum of care; one is less attention given to adolescent girls and young women until they get pregnant. Besides, antenatal care is too late to reduce the harmful effects that a woman's may have on the fetus during the critical period of organogenesis. Fortunately, preconception care can fill these gaps, enhance well-being of women and couples and improve subsequent pregnancy and child health outcomes. Therefore, the main aim of the current study was to assess preconception care utilization and associated factors among pregnant women attending antenatal care clinics of public health facilities in Hosanna town. METHODS: A facility based cross-sectional study design was carried out from July 30, 2020 to August 30, 2020. Data were collected through face-to-face interview among 400 eligible pregnant women through systematic sampling technique. Epi-data version 3.1 and SPSS version 24 was used for data entry and analysis respectively. Both bivariable and multivariable logistic regression analysis was conducted to identify association between dependent and independent variables. Crude and adjusted odds ratio with respective 95% confidence intervals was computed and statistical significance was declared at p-value <0.05. RESULT: This study revealed that 76 (19%, 95% Cl (15.3, 23.2) study participants had utilized preconception care. History of family planning use before the current pregnancy (AOR = 2.45; 95% Cl (1.270, 4.741), previous history of adverse birth outcomes (AOR = 3.15; 95% Cl (1.650, 6.005), poor knowledge on preconception care (AOR = 0.18; 95% Cl (0.084, 0.379) and receiving counseling on preconception care previously (AOR = 2.82; 95% Cl (1.221, 6.493) were significantly associated with preconception care utilization. CONCLUSIONS: The present study revealed that nearly one-fifth of pregnant women have utilized preconception care services. History of family planning use before the current pregnancy, previous history of adverse birth outcomes, poor knowledge on preconception care and receiving counseling on preconception care previously were significantly associated with preconception care utilization. Integrating preconception care services with other maternal neonatal child health, improving women's/couples knowledge & strengthening counseling services is pivotal.

Factors associated with preterm birth at Wachemo University Nigist Eleni Mohammed memorial hospital, southern Ethiopia: case-control study.

BACKGROUND: Preterm birth is defined as the birth of a baby before 37 completed weeks of gestation. Worldwide, prematurity is the second foremost cause of death in children under the age of 5 years. Preterm birth also gives rise to short and long term complications. Therefore, the primary aim of this study was to identify the factors associated with preterm birth in Wachemo University Nigist Eleni Mohammed Memorial referral hospital, Hadiya Zone, Southern Ethiopia. METHODS: An institution-based unmatched case-control study was conducted from July 01, 2018 to June 30, 2019 among mothers who gave birth in Wachemo University Nigest Eleni Mohammed Memorial referral hospital. A retrospective one-year data was retrieved from medical records of mothers with their index neonates. Simple random sampling technique was employed to recruit study participants. SPSS version 20 software was used for data entry and computing statistical analysis. Both bivariable and multivariable logistic regression analyses were used to determine the association of each independent variable with the dependent variable. Odds ratio with their 95% confidence intervals was computed to identify the presence and strength of association, and statistical significance was affirmed if p < 0.05. RESULT: The current study evaluated 213 medical records of mothers with index neonates (71 cases and 142 controls). Urban residency [AOR = 0.48; 95% Cl; 0.239, 0.962], antenatal care follow up [AOR = 0.08; 95 Cl; 0.008, 0.694], premature rupture of membranes [AOR = 3.78; 95% Cl; 1.467, 9.749], pregnancy induced hypertension [AOR = 3.77; 95% Cl; 1.408, 10.147] and multiple pregnancies [AOR = 5.53; 95% Cl; 2.467, 12.412] were the factors associated with preterm birth. More than one-third (36.6%) preterm neonates died in the present study. CONCLUSIONS: The present study found that urban residency, antenatal care follow up, premature rupture of membranes, pregnancy induced hypertension and multiple pregnancies were factors associated with preterm birth. The mortality among preterm neonates is high. Enhancing antenatal care follow up and early detection and treatment of disorders among pregnant women during antenatal care and undertaking every effort to improve outcomes of preterm birth and reduce neonatal mortality associated with prematurity is decisive.

Long-acting reversible contraception utilization and associated factors among women in extended postpartum period in Hossana town, southern Ethiopia: cross sectional study.

BACKGROUND: In low and middle-income countries, 95% of postpartum women want to avoid a pregnancy for 2 years, but 70% are not using contraception. Delay in use of contraception by couples during postpartum period can result in many unwanted pregnancies. Long-acting reversible contraception (LARC) is ideal for postpartum women. Therefore this study aimed at assessing the prevalence and factors associated with LARC use among postpartum women. METHODS: Facility based cross sectional study was conducted from July 23-Aug 25, 2018. Systematic random sampling technique was employed to recruit a total of 381 women in extended postpartum period visiting Child Immunization service in hosanna health institutions. Pretested structured questionnaire was used for data collection. Data was analyzed by SPSS version 20. Binary and multiple logistic regression analysis was done. The presence and strength of association was determined using AOR with its 95% CI. Variables with P value less than 0.05 were considered as statistical significant. RESULTS: The prevalence of LARC use was 36.5% (95%CI (33.05-39.95)). The main reason for not using LARC was fear of side effect and false information. Previous use of LARC (AOR = 3.3, 95%CI (1.7-6.5)) and have ever discussed with health providers on LARC (AOR = 2.5, 95%CI (1.1-5.74)) were found to be significantly associated with LARC use. CONCLUSIONS: The utilization of LARC among postpartum women was found to be higher than other studies in Ethiopia. Provision of effective contraceptive counseling during Antenatal, delivery and postnatal care services with emphasis on LARC/Postpartum Intra-Uterine Device is important.

Postpartum modern contraceptive use and associated factors in Hossana town.

BACKGROUND: Postpartum family planning is the initiation and use of family planning services within the first 12 months following childbirth to impede closely spaced and unintended pregnancies. Globally, spacing pregnancies at least 2 years apart can prevent an estimated 10% of infant deaths and 21% of deaths in children 1-4 years of age. The main purpose of this study was to determine postpartum modern contraceptive use and associated factors in Hossana town, Hadiya zone, Southern nation nationalities peoples region, Ethiopia. METHODS: Facility based cross-sectional study was conducted from June 03 to July 03, 2018, in Hossana town, Hadiya zone. Data was collected by structured questionnaires using face-to-face interview on 368 women. Systematic random sampling technique was employed to approach the study participants. SPSS version 20 software was used for data analysis. Both bivariate and multiple variable logistic regression analysis were computed. Odds ratio with their 95% confidence intervals were calculated and statistical significance was decided if p < 0.05. RESULT: Two hundred seventy one (72.9%) women used postpartum modern contraception. Educational status of mothers [AOR = 0.26; 95% Cl; 0.09-0.744], resumption of sex [AOR = 4.20; 95% Cl; 1.533-11.517], menses resumption [AOR = 8.48; 95% Cl; 3.072-23.228] and duration postpartum period [AOR = 0.26; 95% Cl; 0.107-0.644] had significant association with postpartum modern contraceptive use. CONCLUSIONS: The prevalence of postpartum modern contraception use is relatively high. Educational status of mothers, resumption of sex, menses resumption and duration of postpartum period were factors significantly associated with postpartum modern contraceptive use. Improving women education & delivering messages for couples on the risk of getting pregnant prior to menses is crucial.

Exclusive breastfeeding and associated factors among HIV positive mothers in Northern Ethiopia.

BACKGROUND: It is estimated that sub-optimal feeding, especially non-exclusive breastfeeding in the first 6months of life, results in 1.4million deaths and 10% of disease burden in children younger than five years. Worldwide, it is estimated that only 34.8% of infants are exclusively breastfed for the first 6months of life, the majority receiving some other food or fluid in the early months. Besides, the Ethiopian demographic and health survey (2016) stated that the median duration of exclusive breastfeeding in Tigray region was 3.8 months which is shorter than the recommended duration. The main purpose of this study was to determine the magnitude of exclusive breastfeeding practice and associated factors among HIV positive mothers in public hospitals of Tigray region, Northern Ethiopia. METHODS: A facility based cross-sectional study was conducted from July 9 to October 11, 2016, in public hospitals of Tigray region. Data was collected by using structured questionnaire using face-to-face interview among 304 eligible women through a systematic sampling technique. Data was analyzed using SPSS version 20.0. Binary and multiple variable logistic regressions ("odds ratio") analyses were calculated with 95% CI and p value ≤ 0.05 as significance were used. RESULT: Two hundred seventy (88.8%) of mothers practiced exclusive breastfeeding for the first six months of life. Infant feeding counseling during antenatal care of last pregnancy [AOR = 6.9, 95% CI; 2.63, 17.99], knowledge on exclusive breastfeeding (AOR = 5.5, 95% CI; (2.12, 14.02] and attitude towards exclusive breastfeeding [AOR = 7.9; 95% CI; 2.96, 21.21] had significant association with exclusive breastfeeding practice. CONCLUSIONS: A high proportion of mothers practiced exclusive breastfeeding for the first six months of life. Infant feeding counseling, knowledge and attitude towards exclusive breastfeeding practice were the predictors of exclusive breastfeeding among HIV positive mothers. Strengthening infant feeding counseling during antenatal care and improving mothers' knowledge and attitude on exclusive breastfeeding is essential.

Prevalence and contributing factors of birth asphyxia among the neonates delivered at Nigist Eleni Mohammed memorial teaching hospital, Southern Ethiopia: a cross-sectional study.

BACKGROUND: Birth asphyxia is a major contributor to neonatal mortality worldwide. In Ethiopia, birth asphyxia remains a severe condition that leads to significant mortality and morbidity. This study aims to assess the prevalence and contributing factors of birth asphyxia among the neonates delivered at the Nigist Eleni Mohammed Memorial Teaching Hospital, Southern Ethiopia. METHODS: This hospital-based cross-sectional study was carried out on 279 participants using the systematic sampling method during June 1-30, 2019. Data were collected using a pretested structured interviewer administered questionnaire, check list and chart review, which was used to retrieve medical information and mother's test results that could not be captured by the interview. Data were entered into EpiData (version 3.1) and analyzed using SPSS software (version 24). Multivariable regression analysis was used to identify the association between the independent variables and outcome variable with a 95% confidence interval (CI). RESULT: The overall prevalence of birth asphyxia among newborns was found to be 15.1%. Factors that were significantly associated with birth asphyxia included mothers aged ≥35 (AOR = 6.4; 95% CI = 2.0-20.5), primigravida (AOR = 5.1; 95% CI =2.0-13.3), prolonged second stage of labor (AOR = 4.6; 95%CI =1.6-13.3), preterm birth (AOR = 4.7; 95% CI =1.5-14.1), meconium stained amniotic fluid (AOR = 7.5; 95% CI =2.5-21.4) and tight nuchal (AOR = 3.1; 95% CI =1.2-9.3). CONCLUSION: Birth asphyxia is still prevalent in the study setting. The obtained findings indicated that the mothers aged ≥35, being primigravida, preterm birth, meconium stained amniotic fluid and tight nuchal were the factors associated with birth asphyxia. The results of this study show the need for better maternal care, creating awareness about contributing factors of birth asphyxia to the maternity health professionals, careful monitoring of labor, and identifying and taking proper measures that could help in reducing the occurrence of birth asphyxia.