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BACKGROUND: Pregnant mothers are a risky population group for COVID-19 and pregnant mothers with COVID-19 are at increased risk of hospitalization, intensive-care unit admission, invasive ventilation support, and maternal mortality. Vaccination is an essential tool in stopping the effect of the pandemic on maternal and child health. However, there are only limited studies in Ethiopia on the intention to take the COVID-19 vaccine among pregnant women. Thus, this study aimed to assess intention to take the COVID-19 vaccine and associated factors among pregnant women in Bahir Dar city, Northwest Ethiopia. METHODS: Facility based cross-sectional study was conducted among 590 pregnant women from 23 May to 07 July 2022. The study participants were selected using a systematic sampling technique. Interviewer administrative questionnaire with epicollect5 application was used to collect the data. Both bi-variable and multivariable binary logistic regression analysis was performed. Statistical significance was defined at a 95% CI with a p-value < 0.05. RESULT: Overall, 19.8% (95% CI: 16.60-23.06%) of pregnant women intend to take the COVID-19 vaccine. Being urban residence (AOR = 3.40, 95% CI: 1.71-6.78), third trimester of gestational age (AOR = 3.11, 95% CI: 1.61-6.03), multipara (AOR = 2.30, 95% CI: 1.33-3.97), knowledge of COVID-19 vaccine (AOR = 2.33, 95% CI: 1.44-3.77) and having good attitude towards COVID-19 vaccine (AOR = 2.68, 95% CI: 1.65-4.33) were significantly associated with intention to take COVID-19 vaccine. CONCLUSION: In conclusion, the pregnant women's intention to take the COVID-19 vaccine in this study area was very low. It was significantly associated with residency, gestational age, parity, knowledge, and attitude toward the vaccine. Therefore, strengthening interventions that improve knowledge and attitude about the COVID-19 vaccine, predominantly among those primipara mothers and mothers from rural residences, may raise the intention to take it.
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COVID-19 , Cuidado Pré-Natal , Criança , Gravidez , Feminino , Humanos , Gestantes , Vacinas contra COVID-19 , Intenção , Etiópia/epidemiologia , Estudos Transversais , Paridade , Instalações de SaúdeRESUMO
BACKGROUND: The government of Ethiopia has been implementing compassionate, respectful, and caring strategies to increase institutional delivery and decrease maternal mortality in recent years. There is limited evidence on respectful delivery care and associated factors in low-income countries like Ethiopia. Therefore, this study aimed to assess the proportion of respectful delivery care and associated factors among mothers delivered in the health facilities of Dessie city, Northeast Ethiopia. METHODS: A health facility-based cross-sectional study was conducted among a total of 390 mothers from April 16 to May 30, 2018. A pretested structured interviewer-administered questionnaire was used to collect the data. The data were entered into Epidata and analyzed using Stata/SE 14. Binary logistic regression analysis was used to identify associated factors. Variables having P-value less than 0.2 in the bivariable regression were selected as a candidate for multi-variable regression. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was estimated to measure the strength and direction of the association respectively. RESULTS: The proportion of respectful delivery care among mothers delivered in public health facilities of Dessie city was 43.4%, 95% CI (39.1%, 47.6%). It was found to be 34.9% in hospital and 74.1 in health center. Respectful delivery care was associated with day time delivery [AOR = 2.23, 95% CI (1.30, 3.82)], any maternal and/or fetal complications [AOR = 0.50, 95% CI (0.27, 0.94)], gave birth in health center [AOR = 3.22, 95% CI (1.61, 6.46)] and educated mothers [AOR = 2.87, 95% CI (1.18, 7.01)]. CONCLUSIONS: The proportion of respectful delivery care in the study area was low as compared to the government emphasis and other works of literature. This study indicated that any maternal and/or newborn complications, daytime delivery, giving birth in a health center, and maternal education were associated with respectful delivery care. Women empowerment through education could be a recalled intervention for respectful care.
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Instalações de Saúde , Mães , Estudos Transversais , Etiópia , Feminino , Humanos , Recém-Nascido , Gravidez , Cuidado Pré-NatalRESUMO
BACKGROUND: Despite numerous national and international efforts to alleviate child growth faltering, it remains a global health challenge. There is a growing body of literature that recognizes the importance of women's empowerment in a wide range of public health topics, such as the utilization of maternal healthcare services, agricultural productivity, and child nutrition. However, in Ethiopia, the relationship between women's empowerment and child nutritional status is not studied at the national level. This study aimed to determine the association between women's empowerment and growth faltering in under-5 children in Ethiopia. METHODS: The data source for this analysis is the 2016 Ethiopian Demographic and Health Survey (EDHS): a nationally representative household survey on healthcare. The EDHS employed a two-stage stratified cluster sampling technique. We computed standard women's empowerment indices, following the Survey-based Women's emPowERment index approach. A multilevel logistic regression model that accounted for cluster-level random effects was used to estimate the association between women's empowerment and child growth faltering (stunting, wasting and underweight). RESULTS: Attitude to violence, social independence, and decision-making were the three domains of women's empowerment that were associated with child growth faltering. One standard deviation increase in each domain of empowerment was associated with a reduction in the odds of stunting: attitude towards violence (AOR = 0.92; 95% CI 0.88-0.96; p < 0.001), social independence (AOR = 0.95; 95% CI 0.89-0.99; p = 0.049), and decision-making (AOR = 0.93; 95% CI 0.87-0.99; p = 0.023). Similarly, each standard deviation increase in attitude towards violence (AOR = 0.93; 95% CI 0.89-0.98; p = 0.008), social independence (AOR = 0.91; 95% CI 0.86-0.97; p = 0.002), and decision-making (AOR = 0.92; 95% CI 0.86-0.99; p = 0.020) were associated with a decrease in the odds of having underweight child. CONCLUSIONS: Ensuring women's empowerment both in the household and in the community could have the potential to decrease stunting and underweight in a rapidly developing country like Ethiopia. Policymakers and health professionals need to consider women's empowerment in this unique context to improve nutritional outcomes for children and alleviate growth faltering.
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Empoderamento , Características da Família , Criança , Etiópia/epidemiologia , Feminino , Instalações de Saúde , Inquéritos Epidemiológicos , HumanosRESUMO
BACKGROUND: Low birth weight (LBW) is closely associated with foetal and neonatal mortality and morbidity, inhibite growth and cognitive development and resulted chronic diseases later in life. Many factors affect foetal growth and thus, the birth weight. These factors operate to various extents in different environments and cultures. The prevalence of low birth weight in the study area is the highest in the country. To the investigator's knowledge in Bale Zone, no study has yet been done to elucidate the risk factors for low birth weight using case control study design. This study was aimed to identify the risk factors of low birth weight in Bale zone hospitals. METHODS: A case-control study design was applied from April 1st to August 30th, 2013. A total of 387 mothers (136 cases and 272 controls) were interviewed using structured and pretested questionnaire by trained data collectors working in delivery ward. For each case, two consecutive controls were included in the study. All cases and controls were mothers with singleton birth, full term babies, no diabetes mellitus and no hypertensive. The data were entered and analyzed using SPSS version 16.0 statistical package. The association between the independent variables and dependent variable (birth weight) was evaluated through bivariate and multiple logistic regression analyses. RESULT: Maternal age at delivery <20 years (adjusted odds ratio (AOR) = 3; 95% confidence interval (CI) = 1.65-5.73), monthly income <26 United States Dollarr (USD) (AOR = 3.8; 95% CI = 1.54-9.41), lack of formal education (AOR = 6; 95% CI = 1.34-26.90), being merchant (AOR = 0.1; 95%CI = 0.02-0.52) and residing in rural area (AOR = 2.1; 95% CI = 1.04-4.33) were socio-economic variables associated with low birth weight. Maternal risk factors like occurrence of health problems during pregnancy (AOR = 6.3; 95% CI = 2.75-14.48), maternal body mass index <18 kg/m2 (AOR = 6.7; 95% CI = 1.21-37.14), maternal height <1.5m (AOR = 3.7; 95% CI = 1.22-11.28), inter-pregnancy interval <2 years (AOR = 3; 95% CI = 1.58-6.31], absence of antenatal care (OR = 2.9; 95% CI = 1.23-6.94) and history of khat chewing (AOR = 6.4; 95% CI = 2.42-17.10) and environmental factors such as using firewood for cooking (AOR = 2.7; 95% CI = 1.01-7.17), using kerosene for cooking (AOR = 8.9; 95% CI = 2.54-31.11), wash hands with water only (AOR = 2.2; 95% CI = 1.30-3.90) and not having separate kitchen room (AOR = 2.6; 95% CI = 1.36-4.85) were associated with low birth weight. CONCLUSION: Women who residing in rural area, faced health problems during current pregnancy, had no antenatal care follow-up and use firewood as energy source were found to be more likely to give low birth weight babies. Improving a mother's awareness and practice for a healthy pregnancy needs to be emphasized to reverse LBW related problems.
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Hospitais/estatística & dados numéricos , Recém-Nascido de Baixo Peso , Complicações na Gravidez/epidemiologia , Adulto , Intervalo entre Nascimentos/estatística & dados numéricos , Estatura , Índice de Massa Corporal , Estudos de Casos e Controles , Escolaridade , Etiópia/epidemiologia , Feminino , Humanos , Recém-Nascido , Idade Materna , Razão de Chances , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Fatores de Risco , Condições Sociais , Fatores Socioeconômicos , Adulto JovemRESUMO
BACKGROUND: Women's autonomy in health-care decision is a prerequisite for improvements in maternal and child health. Little is known about women's autonomy and its influencing factors on maternal and child health care in Ethiopia. Therefore, this study was conducted to assess women's autonomy and identify associated factors in Southeast Ethiopia. METHOD: A community based cross-sectional study was conducted from March 19th until March 28th, 2011. A total of 706 women were selected using stratified sampling technique from rural and urban kebeles. The quantitative data were collected by interviewer administered questionnaire and analyzed using SPSS for window version 16.0. Descriptive statistics, bivariate and multiple logistic regression analyses were carried out to identify factors associated with women's autonomy for health care utilization. RESULT: Out of 706 women less than half (41.4%) had higher autonomy regarding their own and their children's health. In the multiple logistic regression model monthly household income >1000 ETB [adjusted odds ratio(AOR):3.32(95% C.I: 1.62-6.78)], having employed husband [AOR: 3.75 (95% C.I:1.24-11.32)], being in a nuclear family structure [AOR: 0.53(95% C.I: 0.33-0.87)], being in monogamous marriage [AOR: 3.18(95% C.I: 1.35-7.50)], being knowledgeable and having favorable attitude toward maternal and child health care services were independently associated with an increased odds of women's autonomy. CONCLUSION: Socio-demographic and maternal factors (knowledge and attitude) were found to influence women's autonomy. Interventions targeting women's autonomy with regards to maternal and child health care should focus on addressing increasing awareness and priority should be given to women with a lower socioeconomic status.
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Serviços de Saúde da Criança/estatística & dados numéricos , Tomada de Decisões , Serviços de Saúde Materna/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Autonomia Pessoal , Direitos da Mulher/estatística & dados numéricos , Adolescente , Adulto , Pré-Escolar , Estudos Transversais , Emprego/estatística & dados numéricos , Etiópia , Características da Família , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Renda/estatística & dados numéricos , Lactente , Modelos Logísticos , População Rural , Fatores Socioeconômicos , Cônjuges/estatística & dados numéricos , População Urbana , Adulto JovemRESUMO
An innovative electronic Maternal and Child Health (eMCH) application was developed to support operational and clinical decision-making in maternal and child health services. End-user-based evaluation of eHealth application is a critical step to ascertain how successfully users can learn and use it, and improve the technology. Therefore, this study aimed to evaluate the eMCH tool usability, feasibility, and acceptability among healthcare providers (HCPs) in the Amhara region, Ethiopia. A cross-sectional study was conducted among HCPs working in six public healthcare facilities. The usability evaluation was done on 24 HCPs across three professional categories using the ISO 9241-11 usability guideline. One hundred nine HCPs were participated in the feasibility and acceptability study. Data were collected using a standard usability tool, think-aloud protocol, a self-administered approach, and Open Broadcaster Software Studio version 26.1.1 video recorder. Descriptive statistics were used to describe the data. A Kruskal-Wallis test was used to measure the association between mean scores and categories of HCPs. The recorded videos were used for the log file analysis method. None of the HCP categories were able to complete all the tasks without errors. The average number of errors and restarts were 7.5 and 2.8, respectively. The average number of restarts was directly proportional to the average number of errors. The participants successfully completed more than 70% of the tasks without requiring any assistance or guidance. Forty-seven comments or errors were identified from the think-aloud analysis and 22 comments from the usability metrics analysis. Overall, statistically significant performance differences were observed among the three HCP groups across the majority of the usability evaluation metrics. Fifty-seven percent of HCPs scored higher than the mean on the feasibility study. Slightly higher than half, 56 (51.4%), of the HCPs scored higher than the mean score on the acceptability study. The usability evaluation identified vital comments and usability flaws that were essential for the eMCH tool to be upgraded. The tool was feasible and acceptable as reported by end-users. Therefore, the errors and usability flaws of the tool should be fixed before deployment to other healthcare settings.
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BACKGROUND: Although breast cancer has a markedly higher incidence in developed countries, seven out of ten deaths occur in developing countries, including Ethiopia. However, there is a limited information on the quality of life (QoL) among breast cancer patients in Ethiopia, notably in the Amhara region. Therefore, this study aimed to assess the QoL and its associated factors among patients with breast cancer in the Amhara Region, Ethiopia. METHODS: An institutional based cross-sectional study was conducted from 25th March 2019 to 7th July 2019. A systematically selected sample of 256 breast cancer patients were participated in the study. A standardized interviewer-administered Amharic version questionnaire was used to collect the data. We used the European Organization for Research and Treatment of Cancer quality of life questionnaire core 30 (EORTC QLQ C30) and breast cancer supplementary measure (QLQ-BR23) to measure QoL. The data were analyzed by SPSS version 23. A binary logistic regression model was fitted to identify the predictors of QoL. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported to show the strength of the association. RESULTS: Sixty-eight percent of breast cancer patients had poor QoL (68.4%; 95% CI: 62.5-73.8). The mean score of QoL was 70.6 (standard deviation (SD) ±13.9; 95% CI: 69.0-72.4). All functional component scores were less than 75 on the symptom scale. Diarrhea (11.6), constipation (17.5), and dyspnea (24.7) were less noticeable symptoms. Being out of marriage (AOR = 2.59, 95% CI: 1.32-5.07), being poor (AOR = 2.39, 95%CI: 1.32-5.03), being non-housewife (AOR = 3.25, 95% CI: 1.16-7.22), and being complaints of dyspnea (AOR = 3.48, 95% CI: 1.79-6.79), and insomnia (AOR = 2.03, 95% CI: 1.05-3.91) were significantly associated with QoL. CONCLUSIONS: The proportion of poor QoL among breast cancer patients was high. Health care professionals should give attention to breast cancer patients who are out of marriage, poor and non-housewife while offering the recommended treatment courses.
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Neoplasias da Mama , Qualidade de Vida , Humanos , Etiópia/epidemiologia , Feminino , Neoplasias da Mama/psicologia , Neoplasias da Mama/epidemiologia , Estudos Transversais , Pessoa de Meia-Idade , Adulto , Inquéritos e Questionários , IdosoRESUMO
Background: Population-based research on the prevalence and determinants of dementia, Alzheimer's disease, and cognitive impairment is scarce in East Africa. Objective: To provide an overview of community- and population-based studies among older adults on the prevalence of dementia and cognitive impairment in East Africa, and identify research gaps. Methods: We carried out a literature search using three electronic databases (PubMed, Scopus, Google Scholar) using pertinent search terms. Results: After screening 445 publications, we identified four publications on the population-based prevalence of dementia, and three on cognitive impairment. Prevalence rates varied from 6- 23% for dementia, and 7- 44% for cognitive impairment, among participants aged≥50-70 years. Old age and a lower education level were risk factors for dementia and cognitive impairment. Physical inactivity, lack of a ventilated kitchen, and history of central nervous system infections and chronic headache were associated with increased odds of dementia. Female sex, depression, having no spouse, increased lifetime alcohol consumption, low income, rural residence, and low family support were associated with increased odds of cognitive impairment. Potential misclassification and non-standardized data collection methods are research gaps that should be addressed in future studies. Conclusions: Establishing collaborative networks and partnering with international research institutions may enhance the capacity for conducting population-based studies on dementia and cognitive impairment in East Africa. Longitudinal studies may provide valuable insights on incidence, as well as potential risk and protective factors of dementia and cognitive impairment, and may inform the development of targeted interventions including preventive strategies in the region.
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Disfunção Cognitiva , Demência , Humanos , Demência/epidemiologia , África Oriental/epidemiologia , Prevalência , Disfunção Cognitiva/epidemiologia , Fatores de Risco , Feminino , Idoso , MasculinoRESUMO
Background and Aims: Neonatal period is the most vulnerable time in which children face the greatest risk of death. Worldwide, each year, millions of newborns died in the first month of life. Sub-Saharan Africa, Ethiopia, in particular, is largely affected. However, there is a dearth of information regarding the survival status of neonates and determinants of their mortality in the study area. Therefore, this study was aimed at investigating neonatal mortality and its predictors in Jabitehnan district, Northwest Ethiopia. Method: A single-arm community-based retrospective cohort study was conducted in March 2021 among 952 neonates born between August 2020 and February 2021. Data were collected by a semi-structured questionnaire, and a multistage stratified sampling technique was employed to select one urban and 10 rural kebeles from the district. Then, the total sample size was proportionally allocated to these selected kebeles. Neonatal death was ascertained by community diagnosis. Kaplan-Meier curve was used to estimate survival time. Cox regression was used to identify factors, the hazard ratio was estimated, and a p-value < 0.05 was considered statistically significant. Results: The neonatal mortality rate was 44 (95% confidence interval [CI]: 33-60) per 1000 live births; and the incidence rate was 1.64 (95% CI: 1.21-2.23) per 1000 neonate days. Three-quarters of deaths occurred in the first week of life. Medium household wealth index (adjusted hazard ratio [AHR] = 3.54; 95 CI: 1.21-10.35), increased number of pregnancies (AHR = 1.22; 95%CI: 1.01-1.47), being male (AHR = 2.45, 95% CI: 1.12-5.35) and not starting breastfeeding in the first hour of life (AHR = 4.00; 95% CI: 1.52-11.10) were found to be predictors of neonatal mortality. Conclusion: Neonatal mortality was high compared to the national target. Wealth, number of pregnancies, sex of the neonate, and breastfeeding initiation were factors associated with neonatal death. Hence, strengthening interventions such as providing sexual education in the population, considering households with a medium wealth index in the exemption service, and counseling mothers about early breastfeeding initiation would improve neonatal survival.
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Introduction: Ethiopia has made significant efforts to enhance family planning services despite variations in the community's use of modern contraception in different parts of the country. Various studies have reported the proportion and determinant factors of adolescents' contraceptive uptake in Ethiopia. These studies are not consistent in terms of size, scope, and geographic coverage, and the results need to be systematically collated to inform policies. Therefore, this review was aimed at analyzing the findings of those primary studies to obtain more representative evidence of adolescents' contraceptive uptake in Ethiopia. Methods: Five databases (MEDLINE via PubMed, Google Scholar, Scopus, ScienceDirect, and CINAHL) were searched for papers published from January 2000 up to June 2022 in English. Of thirty eligible studies, eight papers were included in this meta-analysis. Between-study heterogeneity was evaluated by the forest plot and inconsistency index (I 2). A random-effects model was used to calculate the pooled estimates of adolescents' contraceptive uptake. Results: The overall pooled proportion of adolescents' contraceptive uptake was 40% (I 2 = 99.70, p ≤ 0.001; 95%CI = 19, 61). Adolescents' usage of contraception was influenced by a number of factors: individual-, sociocultural-, knowledge- (about contraceptive methods), and healthcare service-related factors. Individual-related factors include the educational status of adolescents, being of young age, and the income status of adolescents' families. Sociocultural-related factors comprise discussion with the family/relatives, parent disapproval and pressure from partners, and being married or having a partner. Healthcare service-related factors include the availability of youth clubs and inconvenient service hours for SRH services. Knowing contraceptive methods and SRH services was also positively associated with adolescents' contraceptive utilization. Conclusions: The proportion of adolescents who used contraception in Ethiopia was 40%. Adolescents' use of contraceptives was influenced by a variety of factors: individual-, sociocultural-, healthcare-, and knowledge-related factors. Hence, integrated interventions targeted at tackling barriers to contraceptive uptake may be helpful to improve adolescents' contraceptive utilization in Ethiopia.
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Anticoncepção , Anticoncepcionais , Adolescente , Comportamento Contraceptivo , Etiópia , Serviços de Planejamento Familiar , HumanosRESUMO
BACKGROUND: Maternity waiting home (MWH) is a direct strategy to improve newborn and maternal survival. The utilization of MWH, however, remains very low in Ethiopia. Men involvement in maternal health programs is a key strategy to increase utilization of maternal health services, including MWH. This study defines men involvement in-terms of men's participation in deciding to admit their spouse to an MWH, accompanying their spouse to an MWH, providing financial support, availing food at an MWH, and taking care of the home or children. Thus, the current study aims to identify factors affecting men's involvement in MWH utilization. METHODS: A community-based cross-sectional study was conducted from October 1st to December 30th, 2018. Four hundred three men were involved in the study. Data were analyzed by the statistical package for social science (SPSS) version 23. Independent predictors were identified by a multivariable logistic regression model. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. RESULTS: Men's involvement in MWH was 55.6% (50.71, 60.45). Age (AOR = 0.86, 95% CI = 0.82-0.94), knowledge about MWH (AOR = 4.74, 95% CI = 2.65-8.49), decision-making power (AOR = 4.00, 95% CI = 1.38-11.57), and receiving counseling about MWH during spousal antenatal care visits (AOR = 9.15, 95% CI = 3.34-25.03) had statistically significant associations with men's involvement in MWH utilization. CONCLUSIONS: Nearly, half of the male partners were involved in MWH utilization. Men's age, MWH knowledge, decision-making power, and receiving counseling were factors affecting their involvement in MWH utilization. Interventions targeting to improve male involvement in MWH utilization should focus on building men's knowledge about MWH, increasing male involvement in ANC with an appropriate level of counseling about MWH, and changing patriarchal thinking in society with appropriate behavioral interventions such as community-based health education.
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Homens/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Apoio Comunitário , Estudos Transversais , Etiópia , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Saúde Materna , Serviços de Saúde Materna , Pessoa de Meia-Idade , Gravidez , Análise de RegressãoRESUMO
BACKGROUND: Being-street mother is a challenging life situation for both the mothers and their children. However, the lived experiences of motherhood in street families are not explored very well in Ethiopia in general. Hence, this study explored street mothers' well-being, perception of street life, and motivation to leave street life in Bahir Dar city, Ethiopia. METHODS: A phenomenological study was conducted on 10 street mothers from July 13, 2021 to July 17, 2021. The mothers were selected using purposive sampling technique. Data were collected using face-to-face in-depth interview method. Data were analyzed using framework approach. RESULTS: Four themes emerged from the data: well-being of mothers and their children with four subthemes (physical, social, mental, and spiritual wellbeing), perception of street life, motivations to leave street life and efforts to end street life. Nearly all of the street mothers perceived that living on the street was terrible for them and their kids. They described it as an absolutely revolting, bitter, awful, horrible, and difficult life. Generally, street mothers had the motivation to leave street life, but only some had exerted tangible efforts to end the street life. CONCLUSION: Street mothers had a very poor status in almost all dimensions of well-being. The perception of mother about their street life was negative. The mothers had strong motivation to end street life but were unable to make strong tangible efforts showing that they need assistance mechanisms before they change to street extended families under misery.
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Mães , Motivação , Criança , Feminino , Humanos , Etiópia , Estudos Transversais , DepressãoRESUMO
INTRODUCTION: Various studies have identified different factors that affect adolescent contraceptive uptake in different parts of Ethiopia. However, varying results were reported across primary studies and those results need to be systematically collated to inform policies. Therefore, this systematic review aimed to synthesize the findings of those primary studies to obtain more robust and representative evidence about adolescent contraceptive uptake in Ethiopia. METHODS: Five databases (MEDLINE via PubMed, Google Scholar, Scopus, Science Direct and CINAHL) were searched for papers published from January 2000 up to June 2021 in English. We limited our search to start on January 2000 as the health of adolescents have been given more attention after this period and to avoid time-lapsed biases. Seven studies were included in this systematic review. We used the Newcastle-Ottawa Scale and the Mixed Methods Appraisal Tool for quality assessment of the selected studies. RESULTS: Determinants of adolescent contraceptive utilization were focused on four levels: individual, socio-cultural, healthcare service and knowledge related factors. Individual-related factors that influence adolescents' contraceptive uptake include; being in the age group of 10-15 years, not currently enrolled in school and being from low-income families, while socio-cultural factors include: lack of discussion with family members, arranged marriage, pressure from a partner, harmful traditional practices, discussion with peer groups and sexual partners. Healthcare service-related factors include; lack of information about contraceptives during health facility visits, lack of privacy during service provision and inconvenient service hours at health facilities, and not visiting health facilities, whereas, knowledge related factors include; having knowledge of contraceptive methods and being heard about contraceptives from media. Also, the proportion of adolescent contraceptive uptake ranged from 12 to 79%. CONCLUSIONS: In this systematic, individual, socio-cultural, health-care-related, and knowledge-related characteristics have all been identified as influencing adolescents' contraceptive uptake in Ethiopia. Hence, integrated interventions aimed at overcoming barriers to adolescent contraceptive uptake would be beneficial to improving adolescent contraceptive utilization in Ethiopia.
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Background: Most of the COVID-19 fatal cases and severe illnesses like acute respiratory distress syndrome occur in older adults and other people who have underlying medical comorbidities. Understanding patients with chronic disease' knowledge, attitudes, and intention to take the COVID-19 vaccine and related factors are necessary to control the mortality of COVID-19 infection. Therefore, this study aimed to assess knowledge, attitudes, and intention to take the COVID-19 vaccine among patients with chronic disease in Southern Ethiopia. Methods and materials: A facility-based cross-sectional study was conducted among 409 patients with chronic diseases having a follow-up at the hospitals of the Southern region of Ethiopia from November 14, 2021, to December 24, 2021. A structured, interviewer-administered questionnaire was used to collect data. Bivariate and multivariable logistic regression was conducted to show the association of variables with knowledge, attitude, and intention to take the COVID-19 vaccine. The associations of variables were declared with the use of a 95% CI and P-value < 0.05. Results: Overall, 79.2, 70.9, and 58.2% of participants had good knowledge, favorable attitude, and intent to take the COVID-19 vaccine, respectively. Age ≥49 years old (AOR = 1.643; 95% CI = 1.008-3.060) and college and above level of education (AOR = 3.002; 95% CI = 1.897-5.021) were found to be significantly associated with knowledge about COVID-19 vaccine. College and above level of education (AOR = 1.510; 95% CI = 1.002-3.975) and good knowledge (AOR = 3.560; 95% CI = 1.481-6.120) were found to be significantly associated with intention to take COVID-19 vaccine. Conclusion and recommendation: Intention to take the COVID-19 vaccine was low among patients with chronic diseases to achieve herd immunity. Therefore, a holistic and multi-sectoral partnership is necessary for a successful COVID-19 vaccination campaign. Further health education and communication are very crucial methods to improve vaccine acceptance and lastly to achieve herd immunity.
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COVID-19 , Intenção , Idoso , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Doença Crônica , Estudos Transversais , Etiópia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-IdadeRESUMO
Countries like Ethiopia have had to make difficult decisions to balance between the demands of the COVID-19 pandemic and maintaining the essential health service delivery. We assessed the effect of preventive COVID-19 measures on essential healthcare services in selected health facilities of Ethiopia. In a comparative cross-sectional study, we analyzed and compared data from seven health facilities over two periods: the pre-COVID-19 period before the first reported COVID-19 case in the country and during the COVID-19 period. Data were summarized using descriptive statistics and the independent t test. During the COVID-19 period the average number of monthly patient visits in the emergency department, pediatrics outpatient, and adult outpatient dropped by 27%, 30%, and 27%, respectively compared with the pre-COVID-19 period. Family planning; institutional delivery; childhood immunization; antenatal care-, hypertension- and diabetic patient follow-up, did not vary significantly between pre-COVID-19 and during COVID-19. Moreover, the monthly average number of tuberculosis (TB) and HIV patients who visited health facilities for drug refill and clinical evaluation did not vary significantly during the two periods. In conclusion, the study highlights that the effect of public restrictions to mitigate the COVID-19 pandemic on essential care systems should be considered.
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COVID-19/prevenção & controle , Serviços de Saúde/normas , Atenção Primária à Saúde , Atenção Terciária à Saúde/estatística & dados numéricos , Assistência Ambulatorial/estatística & dados numéricos , COVID-19/epidemiologia , COVID-19/psicologia , Estudos Transversais , Etiópia/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Atenção Primária à Saúde/estatística & dados numéricos , Tuberculose/epidemiologiaRESUMO
Ensuring access to improved water and sanitation remains a public health challenge in Ethiopia. Exploring access to improved drinking-water supply and sanitation will help to track the progress towards achieving the Sustainable Development Goals. The aim of this study was to explore geographical variations and inequalities in access to improved drinking water and sanitation in Ethiopia. A total of 16,650 households from 643 enumeration areas of the recent Ethiopian Demographic and Health Survey 2016 data were extracted and included in the analysis. World Health Organization recommended definitions were used to measure indicators of improved drinking water and sanitation at enumeration areas. SaTScan™ software was used for spatial analysis using enumeration areas as centers for exploring geographical variations of improved water and sanitation. Absolute and relative inequalities were used to quantify regional inequalities in access to improved water and sanitation. Nationwide access to improved drinking water and sanitation in Ethiopia was 49.6% (95% CI: 48.4-50.7) and 6.3% (5.8-6.8), respectively, with large variations between and within regions (using the categories and definitions that were in effect for monitoring coverage in 2016). Access to improved drinking water ranged from 28.5% in Somali Region to 95.3% in Addis Ababa city whereas access to improved sanitation ranged from 1.7% in Amhara Region to 24% in Dire Dawa city. Households lacking access to improved water and sanitation were clustered in northern (Amhara Region) and southern (Southern Nations, Nationalities, and Peoples' Region) parts of Ethiopia. Most enumeration areas had very low level of access to improved drinking water and/or sanitation. This analysis demonstrated the existence of geographical variations and inequalities in access to improved drinking water and sanitation in Ethiopia. Therefore strategies to improve access for safe drinking water and sanitation should consider geographical variations and inequalities at a subnational scale.
RESUMO
BACKGROUND: Though skin-to-skin care (SSC) is becoming an important newborn care package at both facility and community levels in Ethiopia, there is a lack of evidence to monitor the progress at each level. Therefore, this study is aimed at quantifying the proportion of SSC at both national and regional levels and identifying factors that affect SSC uptake in Ethiopia. METHOD: We used the 2016 Ethiopia Demographic and Health Survey data. The survey employed a multistage cluster sampling method. We included 7,488 live births in the analysis. The factors influencing SSC practice were identified using a multivariable logistic regression model. We reported adjusted odds ratios (AORs) with 95% confidence intervals (CIs). RESULTS: In Ethiopia, 24.3% of mothers practiced SSC for their newborns (95% CI = 23.3, 25.2). The highest proportion was in Addis Ababa (63%), and the lowest was in the Somali region (14.5%). Attending 1-4 antenatal care (AOR = 1.51, 95%CI = [1.08, 2.12], giving birth at health facility (AOR = 4.51, 95%CI = [2.16, 9.44], and having female births (AOR = 1.24, 95%CI = [1.01, 1.54]) were associated with more odds of practicing SSC. However, giving birth by the cesarean section had resulted in lower odds of practicing SSC (AOR = 0.37, 95%CI = [0.22, 0.63]). Regions with reduced odds of SSC practice include Amhara (AOR = 0.57, 95%CI = [0.40, 0.82]), Somali (AOR = 0.51, 95%CI = [0.31, 0.83]), and Southern Nations, Nationalities, and People (AOR = 0.64, 95%CI = [0.43, 0.94]). CONCLUSIONS: The SSC practice was low in Ethiopia with a high level of variation between regions. In Ethiopia, maternal health service uptake affects the SSC of the newborns. Well-tailored community-level interventions are needed to increase skin-to-skin care practice among home delivery mothers.
Assuntos
Inquéritos Epidemiológicos , Serviços de Saúde Materna , Higiene da Pele , Adolescente , Adulto , Parto Obstétrico , Etiópia , Feminino , Parto Domiciliar , Humanos , Gravidez , Adulto JovemRESUMO
BACKGROUND: Though exclusive breastfeeding (EBF) for the first six months is recommended, it remains a debatable issue in both developed and developing countries. Thus, this study investigated the effect of EBF cessation time on childhood morbidity and adverse nutritional outcome in Ethiopia. METHODS: We used the 2011 and 2016 Ethiopian Demographic and Health Surveys. The study involved 2,433 children under six months of age. Logistic regression model was applied to determine the effect of EBF cessation time on outcome variables. Population Attributable Fraction was calculated to evaluate the public health impacts of EBF termination in the population. RESULTS: Discontinuing EBF at 0-3 months (adjusted odds ratio (AOR): 1.95, 95% confidence interval (CI): 1.08, 3.53)) and 4-6 months (AOR: 3.57, 95% CI: 2.19, 5.83) increased diarrhea occurrence compared to children who continued EBF up to 6 months. Children who had terminated EBF at 4-6 months had increased odds of fever (AOR: 1.73, 95% CI: 1.11, 2.68) and acute respiratory illnesses (ARIs) (AOR: 2.74, 95% CI: 1.61, 4.65). Cessation of EBF earlier than 4 months or between 4-6 months was associated with increased odds of having at least one childhood morbidity. Termination of EBF at 0-3 months and at 4-6 months were associated with increased occurrence of wasting (AOR: 2.32, 95% CI: 1.45, 3.74) and underweight (AOR: 2.30, 95% CI: 1.36, 3.91), respectively. Exclusive breastfeeding can avert 42% of diarrhea, 27% of ARI, 21% of fever, 26% of wasting and 23% of underweight burden among children under six months of age. CONCLUSIONS: Termination of EBF before six months was associated with increased occurrence of diarrhea, fever and ARIs. It was also linked with increased occurrence of childhood wasting and underweight. The finding emphasized EBF for the first six months to reduce childhood morbidity and adverse nutritional outcomes.
Assuntos
Aleitamento Materno , Transtornos da Nutrição do Lactente/epidemiologia , Estado Nutricional , Adulto , Aleitamento Materno/estatística & dados numéricos , Demografia , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Transtornos da Nutrição do Lactente/etiologia , Recém-Nascido , Masculino , Morbidade , Avaliação de Resultados em Cuidados de Saúde , Fatores de Risco , Adulto JovemRESUMO
OBJECTIVE: Sexual and reproductive health rights are the rights of all people regardless of their age, sex and other characteristics to make choices about their own sexuality and reproductive issues. However, little is known about the knowledge and attitude towards SRH rights in Ethiopia. Therefore, this study aimed to assess knowledge and attitude towards SRH rights and associated factors among Adet Tana Haik college students in northwest Ethiopia. RESULTS: Overall, about 59.6% students were knowledgeable and more than half (53.4%) had favorable attitude towards SRH rights. In this study, students attending third-year class (AOR = 2.20;95% CI 1.29, 3.33), discussion with parents (AOR = 3.35;95% CI 1.61, 6.96), respondent's mothers attended secondary/above school (AOR = 3.01; 95% CI 1.28, 7.13), participation in RH clubs (AOR = 1.72; 95% CI 1.09, 2.70) and favorable attitude towards SRH rights (AOR = 2.41; 95% CI 1.56, 3.74) were significantly associated with knowledge of participants. On the other hand, knowledge of students (AOR = 2.33; 95% CI 1.36, 7.07), participation in RH clubs (AOR = 1.41;95% CI 1.09, 2.20) and discussion with parents (AOR = 2.50; 95% CI 1.15, 5.47) were the predictors for the attitude of students towards SRH rights. Hence, strengthening women's education, encouraging discussions with parents and participation in RH clubs may improve the knowledge and attitude of students towards SRH rights.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Saúde Reprodutiva , Direitos Sexuais e Reprodutivos , Saúde Sexual , Estudantes/estatística & dados numéricos , Adulto , Estudos Transversais , Etiópia , Feminino , Humanos , Masculino , Universidades , Adulto JovemRESUMO
OBJECTIVES: The study was designed to evaluate the accuracy of maternally perceived baby birth size assessments as a measure of birth weight and examine factors influencing the accuracy of maternal size assessments. STUDY DESIGN: Cross-sectional study. SETTING: The study is based on national data from the 2016 Ethiopian Demographic and Health Survey. PARTICIPANTS: We included 1455 children who had both birth size and birth weight data. MAIN OUTCOME MEASURES: Predictive accuracy of baby birth size for low birth weight. Level of discordance between maternally perceived birth size and birth weight including factors influencing discordance. RESULTS: Mother-reported baby birth size had low sensitivity (57%) and positive predictive value (41%) to indicate low birth weight but had high specificity (89%) and negative predictive values (94%). The per cent of agreement between birth weight (<2500 g vs ≥2500 g) and maternally perceived birth size (small size vs average or above) was 86% and kappa statistics indicated a moderate level of agreement (kappa=0.41, p<0.001). Maternal age, wealth index quintile, marital status and maternal education were significant predictors of the discordance between birth size and birth weight. CONCLUSIONS: Maternal assessment of baby size at birth is an inaccurate proxy indicator of low birth weight in Ethiopia. Therefore, a mother's recall of birth size should be used as a proxy indicator for low birth weight with caution and should take maternal characteristics into consideration.