Prevalence and Associated Factors of Cultural Malpractice During the Perinatal Period in Ethiopia: A Systematic Review and Meta-Analysis.

The health of the mother and children are potentially affected by several types of cultural malpractices that occur during the perinatal period. Ethiopia is a multi-ethnic nation where a variety of cultural practices are observed, especially during pregnancy, delivery, and the postpartum period. This study aimed to assess the prevalence and associated factors of cultural malpractice during the perinatal period in Ethiopia. Data searches were conducted in PubMed/Medline, Web of Science, Scopus, Google Scholar, African Journals Online, and the Cochrane Library. Data were extracted using Microsoft Excel, and analysis was done using STATA version 14. Less than a p-value of 0.05 was regarded to indicate potential publication bias: the funnel plot, Begg, and Egger's regression tests were used to examine publication bias. This study included 18 studies and 7880 mothers. The pooled prevalence of cultural malpractice during pregnancy, childbirth, and postpartum was 34.95% (95% CI: 27, 42.56), 31.18% (95% CI: 19.61, 42.76), and 45.83% (95% CI: 34.22, 57.45) respectively in Ethiopia. In addition, the following factors are statistically associated with the perinatal period: pregnancy: ANC follow-up (AOR = 3.06, 95%CI = 2.04, 4.58), educational status (AOR = 3.30, 95%CI = 1.99, 5.48), and residence (AOR 2.47, 95%CI, 1.601, 3.81); childbirth: ANC follow-up (AOR = 9.94, 95%CI = 2.05, 48.09), maternal age (AOR = 2.27, 95%CI = 1.56, 3.29), and maternal education (AOR = 10.37, 95%CI = 6.145, 17.51); during postpartum: ANC follow-up (AOR = 3.67, 95%CI = 1.96, 6.844), maternal education (AOR = 6.87, 95%CI = 3.26, 14.49), and residence AOR4.79, 95%CI, 2.97, 7.49). The pooled prevalence of cultural malpractice during the perinatal period was high. Health professionals should encourage beneficial practices through health education for a healthy perinatal period for mothers.

Unintended pregnancy and contraceptive use among women in low- and middle-income countries: systematic review and meta-analysis.

INTRODUCTION: Unintended pregnancy is a leading cause of maternal mortality associated with abortion, inadequate contraceptive use, contraceptive failure, and contraceptive discontinuation in low- and middle-income countries. Most unintended pregnancies occur in regions with limited availability of maternal health services, resulting in a significant number of maternal deaths. Therefore, this review aimed to assess the overall prevalence of unintended pregnancy among women using contraceptives in low- and middle-income countries. METHOD: PubMed, Science Direct, Google Scholar, Scopus, and the Ethiopian University Online Library were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (version 14). Publication bias was checked using forest plot, Begg rank test, and Egger regression test. To check for heterogeneity, I2 was calculated and an overall estimation analysis was performed. Subgroup analysis was conducted by study setting, study design, and publication. The Joanna Briggs Institute quality assessment tool was used to assess the quality of each study. We performed a one-time sensitivity analysis. RESULTS: Of the 1304 articles retrieved, 23 studies (involving 40,338 subjects) met the eligibility criteria and were included in this study. The pooled prevalence of unintended pregnancy among women using contraceptives in low- and middle-income countries was 44.68% (95% CI: 35.16-54.20; I2 = 99.7%, P < 0.001). Based on subgroup analysis, the pooled prevalence of unintended events was 43.58% (CI: 32.99, 54.173) and 49.93% (CI: 28.298, 71.555) for cross-sectional and cohort studies, respectively. Based on the study design, it was 34.47% (CI: 27.012, 41.933) for community studies and 55.85% (CI: 33.364, 78.339) for institutional studies. CONCLUSION: The overall prevalence of unintended pregnancy was high among women using contraceptives in low- and middle-income countries. Therefore, it is better to pay attention to prevention strategies for unintended pregnancy, such as information and education accessibility and contraceptive utilization.

Indoor air bacterial load and antibiotic susceptibility pattern of isolates at Adare General Hospital in Hawassa, Ethiopia.

Background: Air is the agent of pathogenic microbes that cause significant problems in the hospital environment. Multidrug resistance poses a major therapeutic challenge to these airborne microorganisms in hospital indoor environments. Method and materials: This study was conducted at Adare General Hospital in Hawassa City, Sidama, Ethiopia. A cross-sectional study was conducted. The proportional allocation method was used to select the sampled 50 rooms from the total available rooms in each category of wards and staff offices. A total of 100 indoor air samples were collected using settle plates in all units twice a day, morning (9:00-4:00 a.m.) and afternoon (3:00-4:00 p.m.). The types and number of colonies were determined in the laboratory, and the pathogenic bacteria were isolated by appropriate bacteriological techniques. Antimicrobial susceptibility testing was performed on Mueller-Hinton agar for each potentially pathogenic bacterium isolated. For each bacterium, a total of 12 antibiotics were tested using the Kirby-Bauer disk diffusion method. The test organism was adjusted to McFarland turbidity standards of 0.5. Data were entered and analyzed using the SPSS version 25 window. Descriptive analysis and one-way analysis of variance were performed. Results: The indoor air bacterial load of Adare General Hospital was found in the range between 210 and 3,224 CFU/m3. The highest indoor air bacterial load was identified from the gynecology ward with a mean of 2,542.5CFU/m3 at p < 0.05. From 100 indoor air samples, a total of 116 bacterial pathogen isolates were obtained. Gram-positive isolates predominated at 72.4%, of which 37.1% were Staphylococcus aureus, 26.7% were coagulase-negative Staphylococci, and the rest 8.6% were Streptococcus pyogenes. The isolation of pathogenic bacteria Staphylococcus aureus and coagulase-negative Staphylococci showed a high level of resistance to ampicillin. Conclusion: A high bacterial load was found in the study area as compared to different indoor air biological standards. Staphylococcus aureus and coagulase-negative Staphylococci were the isolated predominant bacteria. Attention should be given to preventing and minimizing those environmental factors that favor the multiplication of bacteria in the indoor environment of a hospital for the safe health of patients, visitors, and staff.

Practices and factors associated with active management of the third stage of labor in East Africa: systematic review and meta-analysis.

BACKGROUND: Active management of the third stage of labor involves prophylactic uterotonics, early cord clamping, and controlled cord traction to deliver the placenta. It is designed to facilitate the delivery of the placenta by increasing uterine contractions during the third stage of labor. It is also used to prevent postpartum hemorrhage by averting uterine atony.This systematic review and meta-analysis's emphasis was on the practice and factors associated with active management of the third stage of labor in East Africa. METHODS: PubMed, Web of Science, Science Direct (Scopus), Google Scholar, African Journals Online, and the Cochrane Library electronic databases were used. Data were extracted using Microsoft Excel, and STATA version 14 was used for analysis. A p-value of 0.05 is regarded to indicate potential publication bias: the funnel plot, Begg, and Egger's regression test were used to examine publication bias. Using I2 statistics, the heterogeneity of the studies was evaluated. Pooled analysis was carried out. By country, a subgroup analysis was conducted. RESULTS: Thirteen studies were included in this systematic review and meta-analysis. The pooled prevalence of the practice of active management of the third stage of labor in East Africa was 34.42%. Received training (OR = 6.25, 95%CI = 3.69, 10.58), years of experience (OR = 3.66, 95%CI = 2.35, 5.71), and good knowledge (OR = 3.66, 95%CI = 2.35, 5.71) were statically associated with the practice of active management of third stage of labor. CONCLUSION: The pooled prevalence of practice for active management of the third stage of labor in East Africa was low. Factors that were statistically associated with the practice were received training, years of experience, and good knowledge. Obstetric care providers should continue to receive training in all components of active management of the third stage of labor through training and education programs.

Delays in the decision to seek care and associated factors among mothers who delivered in rural health centers in Wolaita Zone, Southern Ethiopia.

Background: Delays in seeking care in health facilities during pregnancy and childbirth can potentially lead to adverse outcomes for women with obstetric complications. These complications lead to maternal mortality and morbidity in developing countries such as Ethiopia. The magnitude and underlying causes of maternal first delay in Ethiopia, particularly in rural areas of the country, are not well documented. This study aims to assess the magnitude of delay in the decision to seek care and associated factors among mothers who gave birth in rural health centers in Wolaita Zone, Southern Ethiopia. Method and materials: A facility-based cross-sectional study was undertaken among mothers who gave birth in rural health centers of Wolaita Zone, Southern Ethiopia, from 30 June 2020 to 30 July 2022. A sample size of 410 study participants was selected from each public health center using the systematic random sampling method. Data were collected from a pretested and structured questionnaire using an Open Data Kit; analysis was carried out using SPSS version 25. The determining factors for the first delay were identified using binary logistic regression. Variables with a p-value of less than 0.25 in binary analysis were selected for a multivariable analysis. Variables with a p-value of less than 0.05 were considered statistically significant. Results: The magnitude of delay in the decision to seek care in health facilities was 42.1% among mothers who gave birth in rural health centers in the Wolaita Zone, Southern Ethiopia. Unemployed mothers (Adjusted Odd Ratio, 2,529; 95% CI, 1.546, 4.136), husbands with no formal education (Adjusted Odd Ratio, 1.290; 95% CI, 1.029, 1.616), mothers who had negative attitudes towards seeking care in health facilities, and (Adjusted Odd Ratio; 1.695; 95% CI, 1.061, 2.709) were significantly associated with a delay in the decision to seek care at a health facility. Conclusion: The magnitude of the first maternal decision to seek care at health facilities among mothers was high in the study area. Efforts should be made to strengthen the literacy level of the husbands of mothers and increase household income through various income-generating approaches. In addition, the dissemination of health information could effectively raise community awareness of the importance of institutional delivery.

Women decision-making autonomy on maternal health service and associated factors in low- and middle-income countries: Systematic review and meta-analysis.

OBJECTIVE: This study was done to determine the overall estimate of decision-making autonomy on maternal health services and associated factors in low- and middle-income countries. METHOD: PubMed, Science Direct, Google Scholar, Scopus, and the Ethiopian University online library were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (version 14). Publication bias was checked by forest plot, Begg's rank test, and Egger's regression test. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by country, year, and publication. Joanna Briggs Institute quality assessment tool was used to check the quality of each study. We carried out a leave-one-out sensitivity analysis. RESULTS: Out of 1305 articles retrieved, 19 studies (with 104,871 study participants) met eligibility criteria and were included in this study. The pooled prevalence of women's decision-making autonomy on maternal health services in low- and middle-income countries was 55.15% (95% confidence interval: 44.11-66.19; I2 = 98.6%, P < 0.001). Based on subgroup analysis, decision-making autonomy in maternal health services was the highest in Ethiopia at 61.36% (95% confidence interval: 50.58-72.15) and the lowest in Nigeria at 36.16% (95% confidence interval: 12.99-43.39). It was 32.16% (95% confidence interval: 32.72-39.60) and 60.18% (95% confidence interval: 47.92-72.44) before and after 2016, respectively. It was also 54.64% (95% confidence interval: 42.51-66.78) in published studies and 57.91% (95% confidence interval: 54.80-61.02) in unpublished studies. Age (adjusted odds ratio = 2.67; 95% confidence interval: (1.29-5.55), I2 = 90.1%), primary level of education (adjusted odds ratio = 1.75; 95% confidence interval: (1.39-2.21), I2 = 63.8%), secondary education level (adjusted odds ratio = 2.09; 95% confidence interval: (1.32-3.32), I2 = 87.8%), being urban resident (adjusted odds ratio = 1.80; 95% confidence interval: (1.22-2.66), I2 = 73%), and monthly income (adjusted odds ratio = 3.23; 95% confidence interval: (1.85-5.65), I2 = 97%) were positively associated with decision-making autonomy on maternal health service. CONCLUSION: Decision-making autonomy on maternal health services in low- and middle-income countries was low. Sociodemographic factors also influenced it. Educational accessibility and income generation should have been recommended, enabling women to decide for themselves.

Knowledge, attitude and practice towards kangaroo mother care among postnatal women in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: Kangaroo mother care is a key procedure in reducing neonatal mortality and morbidity associated with preterm birth. In Ethiopia, neonatal death remains a serious problem, and this study aims to determine the prevalence of the knowledge, attitudes and practice of kangaroo mother care among Ethiopia women. METHODS: PubMed, Web of Science, Google Scholar, EMBASE and the Ethiopian University online library were searched. Data were extracted using Microsoft Excel and analysed using STATA statistical software (v. 11). Publication bias was checked by forest plot, Begg's rank test and Egger's regression test. To look for heterogeneity, I2 were computed and an overall estimated analysis carried out. Subgroup analysis was done by region, study setting, publication, gestational age, birth weight and component of kangaroo care. The Joanna Briggs Institute risk of bias assessment tool was used. We carried out a leave one out sensitivity analysis. RESULTS: Out of 273 articles retrieved, 16 studies met the eligibility criteria and are thus included in this study. Those 16 studies had a total of 12,345 respondents who reported kangaroo mother practice, with five (comprising 1,232 participants combined) reporting that both knowledge and attitude were used to determine the overall estimation. The pooled estimates of good knowledge, positive attitude and poor practice of kangaroo mother care were found to be 64.62% (95% CI: 47.15%-82.09%; I2 = 97.8%), 61.55% (49.73%-73.38%; I2 = 94.8%) and 45.7% (95% CI: 37.23%-54.09%; I2 = 98.5%), respectively. This study is limited to postnatal women and does not take account their domestic partners or health providers. CONCLUSION: The findings revealed significant gaps in the knowledge, attitudes and practice of kangaroo mother care in Ethiopia when compared with other developing countries. Therefore, kangaroo mother care training to women, along with further studies on domestic partners and health providers.

Knowledge and practice of mothers towards sunshine exposure of their children in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Early morning sunlight exposure for infants is a good practice to prevent rickets and alleviate the problem of vitamin D deficiency. Rickets is a major public health problem in many countries especially in developing country including Ethiopia. As mothers are frontline person for their children who should know and practice about sunlight exposure, this systematic review and meta-analysis aimed to assess the pooled level of knowledge and practice towards sunlight exposure of their children among mothers in Ethiopia. METHODS: PubMed, Google Scholar, Excerpta Medica database (EMBASE), Cochrane Library, Web of Science, and African Journal of Online (AJOL) were searched. The data were extracted using Microsoft Excel and analyzed using STATA version 14. Publication bias was checked by funnel plot and more objectively through Egger's regression test, with P < 0.05 considered to indicate potential publication bias. The heterogeneity of studies was checked using I2 statistics. Pooled analysis was conducted using a weighted inverse variance random-effects model. Subgroup analysis was done related to geographic region and time. A leave-one-out sensitivity analysis was also employed. RESULT: A total of 8 studies with 2974 study participants for knowledge, nine studies with 3475 study participants for practice were used to estimate the pooled level of good knowledge and good practice of sunshine exposure among Ethiopian mothers. The overall estimated good level of knowledge and good practice towards sunshine exposure of their children among mothers was found to be 56.08% ((95% CI: 46.26 - 65.89%; I2 = 96.8%) and 55.632% (95%CI: 44.091 - 67.174%; I2 = 98.2%). Regional subgroup analysis showed that the pooled level of good practice in Amhara and Sidama regions found to be 54.41 and 58.32% respectively. CONCLUSION: Study findings showed mothers knowledge and practice towards sunshine exposure of children was quite low in Ethiopia. This study therefore recommends that interventions are needed to increase knowledge and practice of sunlight exposure. This study provides much needed significant evidence for making health-policy recommendations for this vulnerable population group.

Communities' perceptions towards cervical cancer and its screening in Wolaita zone, southern Ethiopia: A qualitative study.

BACKGROUND: Cervical cancer is a malignant neoplasm from cells originating in the cervix uteri. Any woman who is sexually active is at risk of getting HPV. Women in sub-Saharan Africa region have higher chance of developing the disease. There are nearly 26 million Ethiopian women who are over the age of 15 and believed to be at risk of getting HPV. Regrettably, Ethiopian women typically present for cervical cancer care at a late stage in the disease, where treatment is most ineffective. OBJECTIVES: To explore communities' perceptions of cervical cancer and screening among women in Wolaita zone, southern Ethiopia. METHODS: A qualitative research using focused group discussions and in-depth interviews was used to explore communities' perceptions of cervical cancer and screening among women in Wolaita zone, southern Ethiopia from March 2018-November 2019. The study participants were men, women and communities who were residents of the study settings and were not health professionals. All focused group discussions (FGDs) and key informant interviews were transcribed and entered into Microsoft Word and thematic content analysis was done. RESULTS: A total of fifty-nine participants participated in both FGD (three with men and six with women) and in-depth interviews (IDIs). Most participants have not heard about cervical cancer but know cancer in general. Participants mentioned that the disease usually relates to many births and unprotected sexual intercourse but none mentioned HPV infection. Most of the participants perceive that cervical cancer is incurable and assume that it could be prevented but they think they are not vulnerable to the disease and screening is not necessary. CONCLUSION: This study indicates that rural communities in the zone had limited knowledge about cervical cancer and even less about risk factors, screening, treatment and prevention. There is a great need for cancer education and prevention in Ethiopia.

The magnitude of episiotomy among women who gave birth in Ethiopia: Systematic review and meta-analysis.

Episiotomy is one of the most common obstetric procedures done by health providers putting the client at high risk of developing complications and lacerations. These days, episiotomy has been done at an alarming rate in Ethiopia as compared to the slant set by World Health Organization. Be that as it may, there is a need for nationally representative data. This study aimed to determine the pooled prevalence of episiotomy practice among women who gave birth at public health institutions in Ethiopia. We accessed PubMed, Web of Science, Google Scholar, EMBASE, and manual search was used to retrieve articles. The extractions of the data were done by using Microsoft Excel and analyzed by STATA version 11 statistical software. The publication bias was checked by funnel plot visually and Egger's test and Begg's test, with P <0.05 considered indicating potential publication bias. I2 was used to check the presence of heterogeneity of the studies. Overall estimated analysis was done. Subgroup analysis was done by region. We carried out a leave-one-out sensitivity analysis. The Joanna Briggs Institute risk of bias assessment tool was used. Out of 254 articles retrieved, 9 studies met the eligibility criteria and are thus included in this study. The overall episiotomy practice in Ethiopia was 45.01% (95% CI: 36.288, 53.741). Based on the sub-group analysis, prevalence of episiotomy practice was 49.32% (95%CI: 12.67, 85.97), 46.92% (95%CI: 29.47, 64.37), 44.23% (95%CI: 37.77, 50.99) and 38.29 (95%CI: 32.38, 44.20) among South region, Addis Ababa, Amhara region and Tigray region respectively. The findings revealed that the prevalence of episiotomy practice in Ethiopia was high (45.01%). Therefore, it is better to have periodic training for birth attendants on the indication of episiotomy and the appropriate use of guidelines to reduce the rate of episiotomy.

Prevalence and associated factors of pelvic organ prolapse among women attending gynecologic clinic in referral hospitals of Amhara Regional State, Ethiopia.

INTRODUCTION AND HYPOTHESIS: While pelvic organ prolapse is common in clinical observation, there is a lack of evidence regarding its actual proportion and associated factors in the study area. Understanding the prevalence and risk factors could potentially help with prevention. Thus, this study aimed to determine the prevalence and associated factors related to pelvic organ prolapse in the Amhara region, northwest Ethiopia. METHODS: An institutional-based cross-sectional study was conducted among 424 women, recruited by the systematic random sampling technique. Data were collected in a face-to-face interview using a structured and pre-tested questionnaire to assess the symptoms of pelvic organ prolapse and the socio-demographic, obstetric, gynecologic, medical and surgical characteristics. The stage of prolapse was determined by pelvic examination using the Simplified Pelvic Organ Prolapse Quantification staging system. Descriptive statistics and logistic regression analyses were employed. RESULTS: The overall prevalence of pelvic organ prolapse (stage I-IV) was found to be 37.6% when determined by pelvic examination and 9.2% as assessed by prolapse symptoms. Age ≥ 40 years [AOR 2.46 (1.320, 5.314)], age at first delivery ≤ 20 years [AOR 4.719 (2.44, 9.11)], carrying heavy objects for ≥ 5 hours a day [AOR 12.724 (4.89, 33.07)], parity ≥ 4 [AOR 3.739 (1.693, 8.208)], prolonged labor [AOR 3.487 (1.699, 7.159)], constipation [AOR 2.835 (1.273, 6.317)] and anemia [AOR 2.22 (1.049, 4.694)] were significantly associated with pelvic organ prolapse. CONCLUSION: Prevalence of pelvic organ prolapse is high in the area; thus, developing information and education programs on avoiding risk factors is advisable to reduce the problem.

Knowledge, attitude and practice towards COVID-19 among health professionals in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: The World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) a global pandemic on 11th March, 2020. In Ethiopia, more than 90,490 and 1,300 confirmed cases and deaths were reported by the Federal Ministry of Health at the time of writing up this project. As health care providers are frontline workers managing the COVID-19 pandemic, this systematic review and meta-analysis aimed to assess the pooled level of knowledge, attitude, and practice towards COVID-19 among health professionals in Ethiopia. METHODS: PubMed, Google Scholar, Excerpta Medica database (EMBASE), Cochrane Library, Web of Science, and African Journal of Online (AJOL) were searched. The data were extracted using Microsoft Excel and analyzed using STATA version 14. Publication bias was checked by funnel plot and more objectively through Egger's regression test, with P < 0.05 considered to indicate potential publication bias. The heterogeneity of studies was checked using I2 statistics. Pooled analysis was conducted using a weighted inverse variance random-effects model. Subgroup analysis was done related to geographic region and time. A leave-one-out sensitivity analysis was also employed. RESULT: A total of 11 studies with 3,843 study participants for knowledge, eight studies with 2,842 study participants for attitude and 10 studies with 3, 435 study participants for practice were used to estimate the pooled level of good knowledge, positive attitude and poor practice among health professionals. The overall estimated good level of knowledge, positive attitude and poor practice towards COVID-19 was found to be 79.4% (95% CI: 73.5%-85.2%; I2 = 96%), 73.7% (95%CI: 63.09%-84.4%; I2 = 98.3%) and 40.3% (95%CI: 31.1%-49.6%; I2 = 97.1%) respectively. CONCLUSION: Study findings showed that there were significant gaps in COVID-19 related knowledge, attitude and practice with respect to World Health Organization recommendations on COVID-19 management and personal protection practices. This study therefore recommends that institutions provide with immediate effect accurate and up-to-date information on COVID-19 and training that encourages improved knowledge, attitude and practice to mitigate this pandemic.

Seroprevalence of hepatitis c virus infection among blood donors in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Blood transfusion is one of the routine therapeutic interventions in hospitals that can be lifesaving. However, this intervention is related to several transfusion-related infections. Hepatitis C viral infection is one of the most common causes of transfusion-related hepatitis. Subsequently, this systematic review and meta-analysis was aimed to estimate the seroprevalence of hepatitis C virus infection among blood donors in Ethiopia. METHODS: PubMed, Google Scholar, Health InterNetwork Access to Research Initiative (HINARI), Excerpta Medica database (EMBASE), and Cochrane library, the web of science, African journal of online (AJOL), and Google Scholar was searched. The data were extracted using Microsoft Excel and analyzed by using STATA version 14. Publication bias was checked by funnel plot, contour-enhanced funnel plots, trim and fill analysis and more objectively through Egger's regression test, with P <  0.05 considered to indicate potential publication bias. The heterogeneity of studies was checked using I2 statistics. Pooled analysis was conducted using a weighted inverse variance random-effects model. Subgroup analysis was done by region and study period. A sensitivity analysis was employed. RESULT: A total of 25 studies with 197,172 study participants were used to estimate the seroprevalence of hepatitis c virus among blood donors. The overall seroprevalence of hepatitis C virus was 0.819% (95% CI: 0.67-0.969; I2 = 92.3%). Regional sub-group analysis showed that the pooled prevalence of hepatitis c virus infection among blood donors found to be 0.563% in Somali, 1.08% in Oromia, 0.847% in Amhara, and 0.908% in south nations nationalities and peoples region. CONCLUSION: The pooled seroprevalence of hepatitis C virus infection among blood donors in Ethiopia found to be low. Moreover, there should be systematic strategies that enhance donor screening and retention of safe regular donors.

Prevalence and determinants of uterine rupture in Ethiopia: a systematic review and meta-analysis.

Uterine rupture is a serious public health concern that causes high maternal and perinatal morbidity and mortality in the developing world. Few of the studies conducted in Ethiopia show a high discrepancy in the prevalence of uterine rupture, which ranges between 1.6 and 16.7%. There also lacks a national study on this issue in Ethiopia. This systematic and meta-analysis, therefore, was conducted to assess the prevalence and determinants of uterine rupture in Ethiopia. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic review and meta-analysis of studies. All observational published studies were retrieved using relevant search terms in Google scholar, African Journals Online, CINHAL, HINARI, Science Direct, Cochrane Library, EMBASE and PubMed (Medline) databases. Newcastle-Ottawa assessment checklist for observational studies was used for critical appraisal of the included articles. The meta-analysis was done with STATA version 14 software. The I2 test statistics were used to assess heterogeneity among included studies, and publication bias was assessed using Begg's and Egger's tests. Odds ratio (OR) with a 95% confidence interval (CI) was presented using forest plots. A total of twelve studies were included in this study. The pooled prevalence of uterine rupture was 3.98% (95% CI 3.02, 4.95). The highest (7.82%) and lowest (1.53%) prevalence were identified in Amhara and Southern Nations, Nationality and Peoples Region (SNNPR), respectively. Determinants of uterine rupture were urban residence (OR = 0.15 (95% CI 0.09, 0.23)), primipara (OR = 0.12 (95% CI 0.06, 0.27)), previous cesarean section (OR = 3.23 (95% CI 2.12, 4.92)), obstructed labor(OR = 12.21 (95% CI 6.01, 24.82)), and partograph utilization (OR = 0.12 (95% CI 0.09, 0.17)). Almost one in twenty-five mothers had uterine rupture in Ethiopia. Urban residence, primiparity, previous cesarean section, obstructed labor and partograph utilization were significantly associated with uterine rupture. Therefore, intervention programs should address the identified factors to reduce the prevalence of uterine rupture.

The Intention on Modern Contraceptive Use and Associated Factors among Postpartum Women in Public Health Institutions of Sodo Town, Southern Ethiopia 2019: An Institutional-Based Cross-Sectional Study.

BACKGROUND: The postpartum period is an important transitional time for couples to put the decision on family planning utilization. However, women in Ethiopia are usually uncertain about the use of family planning during this period. This cross-sectional study was, therefore, aimed at determining the intention of modern contraceptive use and associated factors among postpartum women attending the immunization clinic in Sodo town, Ethiopia. METHOD: This institution-based cross-sectional study was conducted among 416 study participants from May 25 to June 20, 2019. The data were collected by using a systematic random sampling technique of interviewer-administered questionnaires. Descriptive analysis was done, and results were presented in texts and tables. Variables at bivariate analysis with a p value < 0.2 were moved to the multivariate logistic regression model to control potential confounding variables. Statistical tests at p value < 0.05 during multivariate analysis were considered as a cutoff point to determine statistical significance. RESULTS: A total of 416 postpartum women participated in the study yielding a response rate of 98.1%. The prevalence of intention on modern contraceptive use among study participants was 70%. The odds of intention on modern contraceptive use was higher among study participants who had secondary school education (AOR = 2.052, 95% CI: 1.064-3.958), antenatal care visit (AOR = 1.74; 95% CI: 1.02-2.95), knowledge on modern contraceptive use (AOR = 2.54; 95% CI: 1.50-4.28), menses resumption (AOR = 2.05; 95% CI: 1.14-3.68), and husband approval to use contraceptives (AOR = 2.395, 95% CI: 1.501-5.458). CONCLUSION: The intention of modern contraceptive use among postpartum women was low. Family planning providers should emphasize reducing barriers of intention like lack of education, knowledge, male partner approval, antenatal care visit, and advise the impact of menses on fertility.

Corrigendum to "Utilization of Long-Acting Contraceptive Methods and Associated Factors among Female Health Care Providers in East Gojjam Zone, Northwest Ethiopia, in 2018".

[This corrects the article DOI: 10.1155/2019/5850629.].

Utilization of Long-Acting Contraceptive Methods and Associated Factors among Female Health Care Providers in East Gojjam Zone, Northwest Ethiopia, in 2018.

INTRODUCTION: Sub-Saharan Africa, including Ethiopia, faces serious population and reproductive health challenges, indicated by a higher unmet need for family planning, especially for long-acting contraceptive methods, higher fertility, and population growth rates. The utilization of long-acting reversible contraceptive methods in Ethiopia and in particular in the study area is low. OBJECTIVE: This study aimed to assess the utilization of long-acting reversible contraceptive methods among female health care workers in the reproductive age group in East Gojjam Zone, Northwest Ethiopia, in 2018. METHODS: Institutional-based cross-sectional study was conducted from 1 to 30 March 2018. A total of 392 female health care workers have participated. Data were collected by a structured, pretested, and self-administered questionnaire, then entered into Epi-info Version 7, and analyzed by SPSS Version 21. Bivariable and multivariate binary logistic regression analyses were carried out. p value <0.05 was considered to declare statistically significant variables. RESULT: The current utilization of long-acting contraceptive methods among female health workers was found to be 22.7%. Supportive attitude of their husbands/partners (AOR at 95% CI 4.62 (1.52-14.09)), having <5000 EBrr monthly family income (AOR at 95% CI 2.813 (1.04-7.57)), supportive attitude towards the utilization of long-acting contraceptive methods (AOR at 95% CI 5.13 (2.03-12.95)), and the desire to have 0-2 children (AOR at 95% CI 5.34 (1.80-15.80)) were positively associated factors towards the utilization of long-acting contraceptive methods. CONCLUSION: The current utilization of long-acting contraceptive methods was found low. Husbands/partners' supportive attitude, the number of children they want to have, attitude, and monthly family income were identified as significant factors. The East Gojjam Zonal Health Department and other stakeholders should work on the promotion of partners/husbands' involvement in the utilization of long-acting contraceptive methods among reproductive age women, including health care workers.

Utilization of preconception care and associated factors among reproductive age group women in Debre Birhan town, North Shewa, Ethiopia.

BACKGROUND: Preconception care refers to things women can do before and between pregnancies to increase the chance of having a healthy baby and being a healthy mother. Unfortunately, millions of women in the world do not have access to pre-pregnancy, pregnancy health services and childbirth with suitable quality. Therefore, addressing this significant gap and coming up with the necessary information is helpful to improve maternal and child health in our country. So, this study was aimed to assess the utilization of preconception care and associated factors among reproductive age group women in Debre Birhan Town, North Shewa, Ethiopia. METHODS: A mixed method of community based cross-sectional study was employed from March 1st to 30; 2017. Systematic sampling technique was used to select a total of 424 reproductive age women. The data were collected using pre-tested and structured questionnaire and eight in-depth interviews were done using an interview guide. The collected data were coded and entered into Epi data 3.5.1 and exported to SPSS version 21 for cleaning and analysis. Logistic regression was run to look for the association between dependent and explanatory variables; and using variables which have p-value ≤0.25 binary logistic regression was fitted. Association presented in Odds ratio with 95% confidence interval and significance determined at P-value less than 0.05. RESULT: A total of 410 subjects were participated with a response rate of 96.7%. The overall utilization of Preconception care was 13.4%. Woman's age, marital status, knowledge and availability of unit for preconception care were significantly associated with utilization of preconception care with (AOR: 3.567; 95% CI: 1.082, 11.758), (AOR: 0.062; 95% CI: 0.007, 0.585), (AOR = 6.263; 95% CI: 2.855, 13.739) and AOR: 13.938; 95% CI: 3.516, 55.251) respectively. CONCLUSIONS: The finding of this study showed that women's utilization of preconception care is relatively low. A woman's age, marital status, educational status, knowledge about preconception care services and availability of unit for preconception care were factors affecting utilization of preconception care. Therefore, establishing preconception care strategies which can address all the components of the care will be essential when designing effective implementation strategies for improving the uptake of preconception care.

Exclusive Breastfeeding Practice and Associated Factors among Mothers in Boditi Town, Wolaita Zone, Southern Ethiopia, 2018: A Community-Based Cross-Sectional Study.

BACKGROUND: Exclusive breastfeeding tops the table of life-saving interventions for newborns. A child who is exclusively breastfed is 14 times less likely to die in the first six months compared to its counterpart. Approximately 18,000 children globally still die every day and if current trend continues, some 60 million children under age 5 will die between 2017 and 2030, and half of them will be newborns. Five countries, including Ethiopia, accounted for half of all newborn deaths in the world. OBJECTIVE: To assess the prevalence and associated factors of exclusive breastfeeding practice among mothers who have infants 6-12 months of age in Boditi Town, Wolaita Zone, Southern Ethiopia, 2018. METHODS: Community-based cross-sectional study was conducted among 412 randomly selected mothers having 6 to 12 month infants from April 1 to 14, 2018. A pretested interviewer administered questionnaire was used for data collection. The data were entered using Epi Data version 3.1 and analyzed using SPSS version 20. Descriptive statistics was made. Bivariate and multivariate logistic regression was also carried out to see the effect of each independent variable on the dependent variable. RESULTS: Of 412 mother-infant pairs sampled, 403 were participated, which made a response rate of 97.8%. Prevalence of EBF computed using since birth dietary recall method was 64.8% (95% C.I= 60.0, 69.0). From multivariable analysis, child birth attended by health care provider (AOR = 5.303, 95% C.I = 1.613, 17.436), postnatal care utilization (AOR = 1.91, C.I = 1.083, 3.370), and mothers who did not report any breast related problem for the first six months after child birth (AOR = 1.864, C.I = 1.090, 3.189) were factors positively associated with exclusive breastfeeding practice. CONCLUSION: Although the prevalence of exclusive breastfeeding practice in this study was relatively high, more effort to meet World Health Organization (WHO) recommendations is still necessary to benefit from its intervention. There is a need to promote child births to be attended by health care providers and postnatal care utilization. Further, women should be educated on what to do and where to seek care if breast problem occurs after child birth.