Utilisation of growth monitoring and promotion services and associated factors among mothers of children younger than 2 years in Gondar Zuria District, northwest Ethiopia: a community-based, cross-sectional study.

OBJECTIVE: The study aimed to assess the utilisation of growth monitoring and promotion services and the associated factors among mothers of children under 2 years old in Gondar Zuria District, northwest Ethiopia. DESIGN: Community-based, cross-sectional study. SETTING: The study was conducted in Gondar Zuria District, Central Gondar Zone. Data collection was conducted from 10 March to 5 April 2022. PARTICIPANTS: 576 mother-child pairs, recruited via a multistage, stratified random sampling technique. OUTCOME MEASURES AND ANALYSIS: Utilisation of growth monitoring and promotion services was the outcome of the study. Data were entered into Epi Info V.7 and exported to Statistical Package for the Social Sciences V.24.0 for further analysis. Both bivariable and multivariable logistic regression analyses were used to identify factors associated with utilisation of growth monitoring services. A p value less than 0.05 was considered significant for the outcome variable. RESULTS: The utilisation of growth monitoring and promotion services among children aged 0-23 months was 26.6% (95% CI 22.9, 30.2). Health centre delivery (adjusted OR (AOR)=1.56; 95% CI 1.02, 2.68), postnatal care visits (AOR=3.13; 95% CI 1.99, 4.90), regular growth monitoring and promotion sessions (AOR=6.53; 95% CI 2.43, 9.34), and wealth status (AOR=5.98; 95% CI 3.09, 10.58) were significantly associated with utilisation of growth monitoring and promotion services. CONCLUSION: Less than one in three children aged 0-23 months saw utilisation of growth monitoring and promotion services in the study setting. Birthplace, postnatal care follow-up, regular growth promotion and monitoring sessions, and wealth status were associated with utilisation of growth monitoring and promotion services. Enhancing skilled birth delivery, promoting postnatal care follow-up and expanding the availability of growth monitoring and promotion outreach sites could be useful to improve the utilisation of growth monitoring and promotion services.

Practical contribution of women development army on growth monitoring and promotion service at Dembya and Gondar Zuria districts, Central Gondar Zone, North West Ethiopia: a community based mixed study.

BACKGROUND: The United Nations' Sustainable Development Goal (SDG)-2 aims to eliminate child hunger or end all forms of child malnutrition by 2030. To achieve this goal the cost-effective method is the implementation of growth monitoring and promotion service with the contribution of Women Development Army (WDA) as community volunteers. However, According to the data, the program's implementation varies throughout the country and lack of evidence on the practical contribution of the WDA to enhancing child nutritional care outcomes. Therefore this study aimed to determine practical contribution of WDA and associated factors on growth monitoring and promotion service in two rural districts of central Gondar zone, Northwest Ethiopia. METHODS: A community based mixed study was conducted from March 6 to April 7, 2022 among 615 Women Development Army. Multistage sampling technique was used to select study participants. A structured questionnaire was used to collect quantitative data and in-depth interview were used to generate qualitative information. Qualitative data were coded and grouped and discussed using identified themes. Binary logistic regression was fitted, odds ratio with 95% confidence interval was estimated to identify factors of practical contribution of WDA and qualitative data was analyzed using thematic analysis. RESULTS: In this study practical contribution of WDA on growth monitoring was 31.4% (95% CI: 28.0-35.3%). Having GMP training (AOR = 4.2, 95%CI: 1.63, 10.58), regular community conversation (AOR = 6.0, 95%CI: 3.12, 11.54), good knowledge about GMP (AOR = 2.1, 95%CI: 1.17, 3.83) and not having regular schedule of GMP service in the area (AOR = 0.04, 95%CI: 0.02, 0.09), were statistically significantly associated with practical contribution of growth monitoring. During in-depth interview, lack of training, low motivation or commitment among WDA and low communication between WDA and health extension workers were mentioned among the problems faced during growth monitoring service. CONCLUSION: In this study, practical contribution of growth monitoring among WDA was low. GMP training regular community conversation, knowledge about GMP and regular schedule of GMP service in the local area were significantly associated for practical contribution of growth monitoring service. Lack of training, low motivation or commitment among WDA and low communication between WDA and health extension workers were reasons for did not contribute effectively for GMP service. Therefore, giving training for WDA and improving community conversation at kebeles level are important to improve GM service. .

Prevalence and correlates of stunting and thinness among adolescent students in Lideta subcity, Addis Ababa, Ethiopia: a cross-sectional study.

OBJECTIVES: To determine the prevalence of stunting and thinness and associated factors among adolescents attending public schools in Lideta subcity, Addis Ababa, Ethiopia, in 2021. DESIGN: Cross-sectional. SETTING: Public schools in Lideta subcity, Addis Ababa, Ethiopia. ELIGIBILITY: Adolescents from grades 5-12 in public schools and students whose parents gave consent for participation. DATA ANALYSIS: Bivariate and multivariable logistic regression analyses were used to examine the association between the independent variables and stunting and thinness. Using a 95% CI and adjusted OR (AOR), factors with a p value of less than 0.05 were determined to have a significant association. OUTCOME MEASURES: The prevalence of stunting and thinness, as well as the factors associated with stunting and thinness, were secondary outcomes. RESULTS: The overall prevalence of stunting and thinness was 7.2% (95% CI: 5.3% to 9.3%) and 9% (95% CI: 6.8% to 11.4%), respectively. Stunting was associated with a larger family size (AOR=3.76; 95% CI: 1.58 to 8.94), low dietary diversity (AOR=2.87; 95% CI: 1.44 to 5.74), food insecurity (AOR=2.81; 95% CI: 1.38 to 5.71) and a lower wealth index (AOR=3.34; 95% CI: 1.51 to 7.41). On the other hand, thinness was associated with maternal education in those who were unable to read and write (AOR=2.5; 95% CI: 1.97 to 8.11), inadequate dietary diversity (AOR=4.81; 95% CI: 2.55 to 9.07) and larger family size (AOR=2.46; 95% CI: 1.14 to 5.29). CONCLUSION: Adolescent stunting and thinness were common in Addis Ababa's public schools. Family size, dietary diversity and food security were the main factors associated with both thinness and stunting. Therefore, to solve the problem of adolescent stunting and thinness, the administration of Addis Ababa city should prioritise minimising food insecurity while boosting productivity to enhance adolescent nutritional diversity. Moreover, nutritional education should be strengthened by healthcare providers working at public schools as well as health extension workers.

Renal outcomes of diabetic patients treated with combination therapy of ACE inhibitors plus either thiazide diuretics or calcium channel blockers: comparative retrospective cohort study in Northwestern Ethiopia.

OBJECTIVE: The study determined the comparative renal functions on patients with diabetes treated with ACE inhibitors (ACEIs) plus either thiazide diuretics or calcium channel blockers (CCBs) in Northwestern Ethiopia. DESIGN: Retrospective cohort study design was employed to collect the data from medical records of patients with diabetes followed for 1-5 years (N=404). SETTING: The medical records of patients in chronic diabetic follow-up clinics of the hospital. PARTICIPANTS: All the patients with diabetes medical records in Northwestern Ethiopian specialised hospital. MAIN OUTCOME MEASURES: Exposures were ACEIs plus thiazide diuretics or CCBs collected from March to June 2020. Outcomes were defined as declining in estimated glomerular filtration rate (eGFR) values by ≥30% from the baseline recorded from 2015 to 2019. Descriptive and analytical statistics were illustrated to compare the study groups. Kaplan-Meier with log- rank test was used to plot the survival analyses curve. Potential factors substantially associated to renal events were examined using cox proportional hazards model. RESULT: About 20% of patients developed renal events and significant numbers were from hydrochlorothiazide (HCT) users. The mean eGFR levels were significantly higher in patients on CCBs users over the follow-up years compared with HCT-based users. The CCBs users had an 18.8 mL/min/1.73 m2 higher in eGFR levels at the end of the follow-up period than HCT users (p<0.001). HCT users had shorter survival probability overtime to develop the outcomes compared with CCBs users (p=0.003). The CCBs-based regimen prevented risks of declining in renal function by 56.4% than HCT (p=0.001). Hazards of declining in eGFR levels were 93% higher for the patients with initial systolic blood pressure (SBP) levels were more than 150 mm Hg (p=0.006). CONCLUSION: Compared with HCT, patients on CCBs had significantly prevented risks of renal events. However, both groups appeared with the same cardiovascular events. HCT-based regimen and higher initial SBP levels were significantly associated with eGFR reductions.

Goiter and Its Associated Factors among Adolescent High School Girls at Tach Armachiho District, Northwest Ethiopia: An Institution-Based Cross-Sectional Study.

INTRODUCTION: In Ethiopia, iodine deficiency disorder (IDD) is a major public health problem. The most visible effect of IDD is the appearance of goiters, and 28 million people are affected by goiter. Therefore, this study aimed to assess the prevalence and associated factors of goiter among high school adolescent girls at Tach Armachiho district, Northwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted from October to November 2018. A total of 620 high school adolescent girls were selected using the simple random sampling technique, and structured questionnaires having observational check-list were used for data collection. The presence of goiter was estimated using criteria set by World Health Organization. Iodine content of the salt was estimated by using spot testing kits. Both bivariable and multivariable logistic regressions were used to identify associated factors. The degree of association between independent and dependent variables was assessed by using odds ratio with 95% confidence interval. Those variables having p value of less than 0.05 in the multivariable analysis were considered as significant factors for goiter. RESULTS: A total of 614 adolescent girls gave a complete response. The prevalence of goiter among adolescent girls was 24.1%. In the multivariable logistic regression analysis, age of adolescent girls (adjusted odds ratio (AOR) = 1.57, 95% CI: 1.01-2.46), residence (AOR = 1.91, 95% CI: 1.04-3.51), family history (AOR = 4.96, 95% CI: 3.19, 7.72), low dietary diversity (AOR = 8.39, 95% CI: 4.36-16.14), and medium dietary diversity (AOR = 2.26, 95% CI: 1.36-3.77) were significantly associated with adolescent girls goiter. CONCLUSIONS: Goiter among high school adolescent girls in this study was high. Age of adolescent, residence, family history of goiter, and dietary diversity were statistically significant factors for goiter. Therefore, more emphasis will be given for late adolescent age, having family history of goiter, low dietary diversity, and rural residence to improve the burden of adolescent goiter.

Sustainable under nutrition reduction program and dietary diversity among children's aged 6-23 months, Northwest Ethiopia: Comparative cross-sectional study.

INTRODUCTION: Adequate dietary diversity is vital for the survival, growth and development of infants and children. Inadequate dietary diversity is the major cause of micronutrient deficiency in Sub-saharan Africa, including Ethiopia, where only less than one-fourth of the children aged 6-23 months obtain adequate diversified diet. Thus country implemented a strategy known as the Sustainable Undernutrtion Reduction (SUR) programs to alleviate the problem. However, empirical evidences are scarce on the impact of the program on children aged 6-23 months. Therefore, this study aimed to compare the level of dietary diversity among children aged 6-23 months in districts covered and not covered by SURE program in West Gojjam zone. METHODS: A community based comparative cross-sectional study was conducted in three districts of West Gojjam zone, Ethiopia, from February 29 to April 20, 2019. A total of 832 mother and child pairs were selected by the simple random sampling technique. A pretested and structured interviewer-administered questionnaire was used to collect data. A binary logistic regression model was fitted to identify factors associated with dietary diversity. Crude odds and adjusted odds ratios with 95% confidence intervals (CI) were calculated to assess the strength of associations and significance of the identified factors for dietary diversity score. RESULT: The overall proportion of adequate dietary diversity among children aged 6-23 months was 29.9% (95% CI: 27.0-33.0), whereas in SURE covered and uncovered districts it was 33.4% (95%CI: 29.0-38.and 26.4%(95% CI: 22.0, 31.0), respectively. ANC (Antenatal care) (AOR = 1.7; 95% CI: 1.16, 2.55) and postnatal care services (AOR = 2.1; 95% CI: 1.38, 3.28), participating in food preparation programs (AOR = 1.9; 95% CI: 1.19, 2.96), GMP (AOR = 2.74,95%CI:1.80, 4.18), vitamin A supplementation (AOR = 2.10,95%CI:1.22, 3.61) and household visits by health extension workers (AOR = 2.0; 95% CI: 1.25, 3.21) were significantly associated with dietary diversity. CONCLUSION: The proportion of adequate dietary diversity was higher among children in the program than those out of the program. ANC visits, PNC follow-ups, women's participating in food preparation programs and household visits by health extension workers were significantly associated with dietary diversity. Therefore, and strengthening and scaling up the program to non covered districts and providing health and nutrition counseling on Infant and Young Child Feeding (IYCF) during ANC and PNC services are recommended for achieving the recommended dietary diversity.

Poor child complementary Feeding Practices in northwest Ethiopia: Finding from the Baseline Survey of Nutrition Project, 2016.

BACKGROUND: Improving infant and young child feeding practices is critical to improved nutrition, health, and development of children. Ethiopia adopted the WHO recommendations of child feeding practices and developed the national guideline. In spite of this fact, only few children start and received appropriate complementary feeding based on the recommendation. Therefore, the study aimed to determine dietary diversity score and its associated factors among under five children at Dabat Health and Demographic Surveillance System site (HDSS), northwest Ethiopia. METHODS: A cross-sectional community based study was carried out from February to June 2016. All children aged 6-59 months old who lived in HDSS site were included in the survey. Odds ratio (OR) with the corresponding 95% confidence interval (CI) was calculated to show the strength of association. Finally, variables with a P-value of < 0.05 were considered statistically significant.. RESULTS: In this study, a total of 3433 children were included. About 34.87% (95%CI: 33.27, 36.49%) of the children received adequately diversified diet. The odds of receiving adequately diversified diet was higher among children whose mother had secondary and above education (AOR = 6.51; 95%CI: 4.95, 8.56), had antenatal care (AOR = 1.90; 95%CI: 1.60, 2.26) and postnatal care visits (AOR = 1.31; 95%CI: 1.00, 1, 72), and children who feed with their family (AOR = 1.39; 95%CI: 1.17, 1.65). However, a lower dietary diversity score was observed among younger children; 6-11 months old (AOR = 0.59; 95%CI: 0.41, 0.85), and children from food insecure household (AOR = 0.76; 95%CI: 0.63, 0.92). CONCLUSIONS: Diversified diet feeding practice is low in Dabat HDSS site. Age of the child, maternal education, antenatal and postnatal care visits, and household food insecurity were significantly associated with dietary diversity of children. Hence, ensuring household food security and enhancing the coverage of maternal health care utilization are recommended to increase dietary diversity of children.

Stunting and Its Determinants among Adolescent Girls: Findings from the Nutrition Surveillance Project, Northwest Ethiopia.

Under nutrition among adolescents is a major public health problem in Ethiopia and its causes are under investigated. Therefore, this study aimed to assess the prevalence of stunting and its determinants among adolescent girls in Dabat district. A total of 1556 adolescent girls were included in the study. The WHO's Anthro-plus software was used to generate the height for age z-scores. Variables having a p-value<0.2 in the simple logistic regression were entered into multiple logistic regression and a p-value < 0.05 were considered statistically significant. About 47.4%(95%CI; 45.0, 49.6%) of adolescent girls were stunted. Being in the early (AOR = 0.027, 95%CI: 0.08, 0.09) and middle age (AOR = 0.21, 95%CI: 0.06, 0.71) were less likely to be stunted compared with the late adolescent. The odds of stunting were found to be higher among adolescent of rural area (AOR = 1.45; 95%CI: 1.01, 2.10) and from household food in-secured (AOR = 1.33; 95%CI: 1.02, 1.73)families. Higher numbers of adolescent girls are stunted in Dabat district, suggesting severe public health importance of the problem. Age, residence and food security were associated with adolescent stunting. Thus, improving food security strategies targeting rural and food insecure households is recommended. Abbreviations: AOR= Adjusted Odd Ratio,CI= Confidence Interval, COR= Crude Odd Ratio, ENSSPI=Establishing Nutrition Surveillance System and Piloting Interventions HAZ=Height for Age, HDSS=Health and Demographic Surveillance System, HFSS=Household Food Security Status, INDEPTH=International Network of Demographic Evaluation of Population and Their Health, IQR=Inter Quartile Range, NNP=National Nutrition Program, NSHFP=National School Health and Feeding Program, SPSS=Statically Package for Social Science, WHO= World Health Organization.

Prevalence of growth monitoring practice and its associated factors at public health facilities of North Gondar zone, northwest Ethiopia: an institution-based mixed study.

BACKGROUND: Growth monitoring is used to assess the growth rate of a child by periodic and frequent anthropometric measurements in comparison to a standard. However, since the practice has been poor in Ethiopia, this study aimed to assess it and its associated factors among health workers in North Gondar zone, northwest Ethiopia. METHODS: An institution-based mixed study was conducted from April 1 to May 7, 2017, among 500 health workers. The multistage sampling technique was used to select participants. A structured questionnaire was used to collect quantitative data, while non-participant observation and in-depth interviews were used to generate qualitative information. Qualitative data were coded, grouped, and discussed using the identified themes. A binary logistic regression was fitted, odds ratio with a 95% confidence interval was estimated to identify the predictors of growth monitoring practice, and qualitative data were analyzed using thematic analysis. RESULTS: Growth monitoring practice among health workers was 50.4% (95% CI: 45, 55). Work experience (AOR = 4.27, 95%CI: 1.70, 10.72), availability of growth monitoring materials (AOR = 1.52, 95%CI: 1.05, 2.20), attitude (AOR = 0.68, 95%CI: 0.47, 0.98), midwifery occupation (AOR = 0.42, 95%CI: 0.19, 0.94), and diploma level qualification (AOR = 2.20, 95%CI: 1.09, 4.45) were statistically significantly associated with growth monitoring practice. CONCLUSION: In this study, growth monitoring practice among health workers was lower than those of most studies. Jobs, educational status, work experience, attitude, and availability of materials were significantly associated with growth monitoring practices. Therefore, giving training to health extension and less experienced staff about growth monitoring, and providing growth monitoring equipment are important to improve health workers growth monitoring practices.

Prevalence and associated factors of anemia among adult human immune deficiency virus positive patients on anti-retroviral therapy at Debre tabor Hospital, Northwest Ethiopia.

OBJECTIVE: Anemia is the most common hematological complication of HIV infection that has a significant impact on the quality of life and clinical outcomes. Therefore, the aim of this study was to assess the prevalence and associated factors of anemia among adult HIV positive patients on Anti-retroviral therapy at Deber Tabor hospital, northwest Ethiopia. An institution based cross-sectional study was conducted on 365 HIV/AIDS patients on ART selected using the systematic random sampling technique. Blood samples were analyzed using the Cell-DYN 1800 automated hematology analyzer to measure hemoglobin. Bivariable and multivariable binary logistic regression analyzes were employed to find the predictors at p-value < 0 .2 and 0.05, respectively. RESULTS: The overall prevalence of anemia was 34.0%[95% CI (29.0, 39.0)]; taking Zidovudine based antiretroviral regimen (AOR: 5.9, 95% CI 1.04, 13.86), CD4 count < 200 cells/mm3 (AOR: 4.8 95%, CI 1.14, 12.42), inability to read and write (AOR: 3.2, 95% CI (1.24,8.40), inadequate dietary diversity (AOR: 2.2, 95% CI 1.15, 4.26), and female sex (AOR: 1.9, 95% CI 1.06, 3.69) were significantly associated with increased odds of anemia. Therefore, routine screening of hemoglobin level, proper treatment of respondents on zidovudine based ART regimen and increasing productivity to improve dietary diversity are essential to prevent anemia.

Factors associated with adherence to iron folate supplementation among pregnant women in West Dembia district, northwest Ethiopia: a cross sectional study.

OBJECTIVE: In Ethiopia, iron folate tablets are prescribed for all pregnant mothers during their antenatal visits and given for free; however, only limited data are available on their adherence. Therefore, the aim of this study was to assess adherence to iron folate supplementation and its associated factors among pregnant women in West Dembia district, northwest Ethiopia. An institution based cross-sectional study was conducted on 348 pregnant women that had at least one antenatal care visit. Bivariate and multivariate logistic regressions were employed to identify the predictors at p-value < 0.2 and 0.05 respectively. RESULTS: Adherence to iron folate supplementation in this study was 52.9% [95% CI (47.7, 58.0%)]. Women who had good knowledge about anemia (AOR: 2.63, 95% CI 1.51, 4.59), knowledge about iron folate supplementation (AOR: 2.82, 95% CI 1.52-5.23), four and more ANC visits (AOR: 6.97, 95% CI 3.25, 14.96), and anemia history during current pregnancy (AOR: 13.87, 95% CI 3.75, 51.35) were significantly associated with adherence to iron folate supplementation. Therefore, preventing prenatal anemia, improving knowledge of women about anaemia and iron folate supplementation, and increasing ANC services are essential to increase adherence.