Adolescent Girls In Ethiopia Research Articles

Measuring adolescent girls' agency.

The last decade has experienced a surge of interventions focused on improving adolescent girls' agency. Yet measuring adolescent girls' agency continues to be a challenge, limiting the ability to track impact. This study addresses this evidence gap by constructing and validating a multidimensional measure of agency among adolescent girls in Ethiopia. This study utilized cross-sectional data from 3033 in school adolescent girls aged 10-12 years and 15-17 years and their adult female caregivers collected as part of the Gender and Adolescent: Global Evidence study in 2017-2018 in Ethiopia. This study constructed a measure of agency among the sample and evaluated both known group and convergent validity of the scale. Twenty-two indicators across three domains (decision-making, voice, and mobility) were used to characterize adolescent girls' agency. The data was randomly divided into two halves for exploratory and confirmatory factor analyses separately. While six factors of agency emerged from the initial exploratory analysis, two factors (decision-making and mobility factors) defined adolescent girls' agency from the confirmatory factor analysis. Known-groups validity of the agency scale was confirmed-the scores on the two domains (decision-making and mobility) and the overall agency scale was higher for older girls compared to younger girls and for girls in urban households compared to those in rural households. Convergent validity of the scale was not confirmed. This study advances adolescent girls' agency measurement by providing a validated multidimensional measure that can be used to support future policy and research.

Disordered eating attitude and associated factors among late adolescent girls in Gondar city, northwest Ethiopia: a community-based cross-sectional study.

Disordered eating attitudes are characterized by abnormal beliefs, thoughts, and feelings regarding food and weight control. Dieting, intentional weight loss, and weight control affect 41-62% of girls worldwide. However, there is limited information related to disordered eating attitudes and associated factors among late adolescent girls in Ethiopia, including in the study area. Thus, the study aimed to assess disordered eating attitudes and associated factors among late adolescent girls in Gondar city, northwest Ethiopia. For this community-based cross-sectional study, which was conducted from 26 June to 26 July 2022, in Gondar city, Ethiopia, 1,188 adolescent girls were included. Multistage stratified sampling followed by a systematic random sampling technique was applied to recruit participants for the study. Data were collected using an interviewer-administered questionnaire containing the Eating Attitudes Test-26 (EAT-26). Anthropometric measurements were also taken. Bivariable and multivariable logistic regressions were employed to identify factors associated with disordered eating attitudes. In the final model, variables with a p-value of < 0.05 were considered statistically significant. A total of 1,158 late adolescent girls (a response rate of 97.5%) participated in the study. The prevalence of disordered eating attitudes among late adolescent girls was 9.7% [95% confidence interval (CI): 7.96, 11.4%]. Having a mother who was unable to read and write [adjusted odds ratio (AOR): 3.88 (95% CI: 1.07, 14.11)], having a mother who could read and write [AOR: 4.31: (95% CI: 1.14, 16.24)], having a father who only attended primary school [AOR: 3.78 (95% CI: 1.33, 10.78)], having severe anxiety [AOR: 3.26 (95% CI: 1.42, 7.49)], and severe usage of social media [AOR: 2.80 (95% CI: 1.22, 6.46)] were factors significantly associated with disordered eating attitudes among late adolescent girls. This study revealed that disordered eating attitudes among late adolescent girls were relatively high. The educational status of parents, anxiety, and severe usage of social media were positively associated with disordered eating attitudes. Therefore, nutritional education for parents of adolescents who are vulnerable to unhealthy behavior is imperative. The finding also implied the importance of an inclusive strategy to mitigate the emerging problem of targeting vulnerable groups.

Understanding associations between the COVID-19 pandemic and menstrual hygiene management among adolescent girls in Ethiopia: findings from a mixed-methods longitudinal study

ObjectiveTo understand the relationship between the COVID-19 pandemic and menstrual hygiene management (MHM) among adolescent girls in Ethiopia and to explore which girls were most affected by pandemic disruptions.DesignTwo rounds...

Spatial distribution of pregnancy and early motherhood among late adolescent girls in Ethiopia using data from the Ethiopia Demographics and Health Survey 2019: Spatial and multilevel analyses.

Various governmental and non-governmental organizations in Ethiopia are striving to decrease adolescent pregnancy by enacting laws against early marriage, developing a national youth and adolescent reproductive health strategy, legalizing abortion, and developing an HIV/AIDS policy for youth; however, the issue of teenage pregnancy& early motherhood remains a major concern. Data were obtained from the Ethiopian Demographics and Health Survey (EDHS) in 2019. A total sample of 2210 adolescents was included in our study. Spatial autocorrelation, hotspot analysis, and spatial interpolation were used to observe significant spatial variation and clustering and to predict the prevalence of pregnancy in an unsampled area among adolescent girls in Ethiopia; a multilevel binary logistic regression model was fitted to identify factors associated with the outcome variable. The adjusted odds ratio was calculated with a 95% confidence interval, and the variables with a p-value 0.05 in the multivariable multilevel logistic regression were determined to be statistically significant. Global spatial autocorrelation analyses showed that the spatial distribution of late-adolescent pregnancy and early motherhood varied across Ethiopia (the Global Moran's Index I value showed GMI = 0.014, P 0.001). The spatial distribution revealed a high cluster (hot spot) of late-adolescent pregnancy and early motherhood in most parts of Gambella, Afar, Benishangul-Gumuz, the eastern part of Oromia, and Somalia. In the multivariable multilevel analysis, being 17 years old (AOR = 3.43; 95% CI: 1.54-7.59), 18 years old (AOR = 14.92; 95% CI: 6.78-32.8), and 19 years old (AOR = 8.44; 95% CI: 4.06, 17.56), married (AOR = 25.38; 95% CI: 15.33, 42.02), having completed primary, secondary, and higher education (AOR = 0.45; 95% CI: 0.21-0.95), and being at Gambela (AOR = 3.64; 95% CI: 1.04, 12.75) were significant predictors of late adolescent pregnancy and early motherhood. Overall, the prevalence of late-adolescent pregnancy and early motherhood was found to be high. At the individual level, marital status, educational attainment, and age of adolescents were significant predictors of pregnancy and early motherhood, and regions were found at a community level associated with pregnancy and early motherhood among late adolescents. Therefore, late-adolescent girls should be educated about menstruation, sexual intercourse, pregnancy, and contraceptives before they reach early adolescence.

Feasibility and impact of school-based nutrition education interventions on the diets of adolescent girls in Ethiopia: a non-masked, cluster-randomised, controlled trial.

Adolescence is a critical period of physical and psychological development, especially for girls, because poor nutrition can affect their wellbeing as well as that of their children. We aimed to assess the feasibility and impact of a package of nutrition education interventions delivered through public primary schools on the diets of adolescent girls in Ethiopia. In this non-masked, cluster-randomised, controlled trial, primary schools (clusters) in the Southern Nations, Nationalities, and People's Region and Somali region of Ethiopia were randomly allocated to the intervention group (nutrition information provided during flag ceremonies, classroom lessons, school club meetings, peer group mentoring, BMI measurement and counselling, and parent-teacher meetings) or the control group (standard academic curriculum on health and nutrition) by use of computer-generated pseudo-random numbers. Duration of the school-based interventions was 4 months, and the key messages were related to dietary diversity (eating a variety of foods), energy adequacy (eating breakfast and healthy snacks), and healthy food choices (avoiding junk foods). Adolescent girls were eligible for participation if aged 10-14 years and enrolled in grades 4-8 in a study school. Data were collected with two independent cross-sectional surveys: baseline before the start of implementation and endline 1·5 years later. The primary outcome of impact was dietary diversity score, defined as the number of food groups (out of ten) consumed over the previous 24 h using a list-based method, and minimum dietary diversity, defined as the proportion of girls who consumed foods from at least five of the ten food groups, in the intention-to-treat population. We also assessed intervention exposure as a measure of feasibility. We estimated intervention effects using linear regression models for mean differences at endline, with SEs clustered at the school level, and controlled for adolescent age, region, household food security, and wealth. The trial is registered with ClinicalTrials.Gov, NCT04121559, and is complete. 27 primary schools were randomly allocated to the intervention group and 27 to the control group. Between March 22 and April 29, 2021, 536 adolescent girls participated in the endline survey (270 in the intervention group and 266 in the control group), with median age of 13·3 years (IQR 12·1-14·0). At endline, the dietary diversity score was 5·37 (SD 1·66) food groups in the intervention group and 3·98 (1·43) food groups in the control group (adjusted mean difference 1·33, 95% CI 0·90-1·75, p<0·0001). Increased minimum dietary diversity was also associated with the intervention (182 [67%] of 270 in the intervention group vs 76 [29%] of 266 in the control group; adjusted odds ratio 5·37 [95% CI 3·04-9·50], p<0·0001). 256 (95%) of 270 adolescent girls in the intervention group were exposed to at least one of the five in-school intervention components. Integrating nutrition interventions into primary schools in Ethiopia was feasible and increased dietary diversity incrementally among adolescent girls, but could be limited in changing other food choice behaviours, such as junk food consumption, based on nutrition education alone. Bill & Melinda Gates Foundation.

Agency and role models: do they matter for adolescent girls’ sexual and reproductive health?

Despite recent declines in early childbearing in Ethiopia, improved sexual and reproductive health continues to elude many adolescent girls, partially due to constrained agency and role models. This study examined the relationship between agency, role models and two sexual and reproductive health outcomes, ideal age at childbirth and attitude towards gender-differentiated parental control, among adolescent girls in Ethiopia. Agency and role model presence were positively associated with ideal age at childbirth (β = 0.23, p < .01 and β = 0.77, p < .001, respectively). Having family members, friends or famous individuals as role models was significantly associated with an increase of 1.45 years (p < .01), 1.32 years (p < .05) and 1.01 years (p < .01) in ideal age at childbirth, respectively, compared to having no role model. Agency was positively associated with attitude towards gender-differentiated parental control of adolescent behaviors (OR = 1.18, p < .001). This study highlights the need for interventions aimed at increasing agency and providing role models for adolescent girls.

Communication self-efficacy and contraceptive use at sexual debut among rural adolescent girls in Ethiopia

Introduction Girls with early sexual debuts are exposed to risky sexual behaviours such as unintended pregnancy and contracting sexually transmitted infections. Communication self-efficacy is vital for protecting girls from unwanted pregnancy by educating them about the use of contraceptives. This study aimed to investigate the relationship between communication self-efficacy and contraceptive use at sexual debut in a rural Ethiopian setting. Methods A total of 394 adolescent girls between the age of 13 - 17, who self-reported their sexual debut, were included in the analysis. Communication self-efficacy was measured using two items: adolescents who discussed contraceptives with their partners, and adolescents who discussed contraceptives with to other people. The association between contraceptive use at sexual debut and communication self-efficacy was examined using a multivariable logistic regression model that accounted for a complex sample survey design. Results The mean age of sexual debut was 14.5 years (95% CI 14.38, 14.69) and the proportion of contraceptive use at sexual debut was 17.37% (95% CI 12.75, 22.95). Contraceptive use at sexual debut was higher among girls who talked to their partner about contraceptives (adjusted odds ratio (AOR) = 1.94, 95% CI [0.98 - 3.8]) and those who discussed contraceptives with others (AOR = 2.45, 95% CI [1.56 - 5.55]. Conclusions Contraceptive use at sexual debut was low among young rural adolescent girls. Adolescent girls who had communication self-efficacy were likely to use contraceptives at sexual debut. Life skills interventions that improve communication and negotiation are recommended to enhance contraceptive use.

Human papillomavirus vaccine acceptance among adolescent girls in Ethiopia: a systematic review and meta-analysis

BackgroundCervical cancer is the fourth most common cancer affecting females. Human papillomavirus vaccination of adolescent girls is the primary strategy for cervical cancer prevention but in Ethiopia, it lacks emphasis. Despite different studies done and found a highly variable level of vaccine acceptance; however, there was no summarized evidence on the issues as a nation. Thus this systematic review and meta-analysis aimed to assess the pooled prevalence of human papillomavirus vaccine acceptance by adolescent girls and its associated factors in Ethiopia.MethodA systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in PubMed, Google Scholar, and African Online Journal databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q-test and I2 statistics were computed to assess heterogeneity among studies. Funnel plot and Eggers test were done to assess publication bias. Review manager software was used to identify factors associated with vaccine acceptance.ResultOverall, 157 articles were retrieved and finally 7 articles were included in this review. The pooled prevalence of adolescent human papillomavirus vaccine acceptance was 46.52% (95%CI; 30.47-62.57%). Subgroup analysis showed that adolescent vaccine acceptance was highest in the Oromia region and lowest in Addis Ababa. Knowledge about human papillomavirus vaccination (AOR = 3.89, 95% CI: (2.85–5.32)) and attitude (AOR = 2.65, 95% CI: (2.03– 3.44)) were significantly associated with adolescent’s vaccine acceptance.ConclusionHuman papillomavirus vaccine acceptance of adolescent girls in Ethiopia was low. Knowledge about the vaccine and attitude to vaccination were positively associated with their vaccine acceptance. Therefore, policymakers and program planners should target school-aged adolescents in increasing their awareness and changing their attitudes to enhance their vaccine acceptance in order to prevent and control cervical cancer.

P17-020-23 Coverage, Adherence Level and Lessons From Weekly Iron and Folic Acid Supplementation Program for Adolescent Girls in Ethiopia: Results From an Implementation Research

P17-020-23 Coverage, Adherence Level and Lessons From Weekly Iron and Folic Acid Supplementation Program for Adolescent Girls in Ethiopia: Results From an Implementation Research

Dietary Diversity and Associated Factors among Adolescent Girls in Rural Community of Doyogena District, Kembata Tembaro Zone, Southern Ethiopia, 2020

Background: Optimal nutrition for adolescent girls is critical for growth, development, and long-term health. Dietary diversity is a crucial component of feeding strategies. In resourcepoor countries, undiversified diets and low-quality monotonous diet feeding habits are frequent. This leads to poor nutritional status, particularly micronutrient deficiencies, which has an impact on adolescent females' current and future lives, as well as their kids. However, data on the magnitude of dietary diversity and associated determinants among adolescent girls in resource-poor settings such as Ethiopia, which include the research area, is sparse. Methods: A community-based cross-sectional study design was conducted among 603 adolescent girls from randomly selected adolescent girls in Ethiopia using a multistage sampling method. The data were collected through face-to-face interviews by using a pretested structured questionnaire and entered into Epi-data 4.2.0.0 version and exported to SPSS version 20 for analyses. Multicollinearity between independent variables and model goodness fit test was checked. Bivariable and multivariable logistic regression analysis were used to determine the degree of relationship between independent and dependent variables. At a p-value of less than 0.05, the odds ratio was declared, along with the 95 percent confidence interval and the level of statistical significance. Results: The prevalence of dietary diversity among adolescent girls was 43.8% (95% CI: 39.7%- 48.0%). having secondary and above level of education and primary education, [AOR = 4.0, 95% CI: (1.89-8.32)], being in food secure households [AOR = 6.99, 95% CI: (4.34-11.23)], skipping practice of meals [AOR = 0.54, 95% CI: (0.33-0.88)], currently being on the menstruation [AOR = 0.42, 95% CI: (0.26-0.66)] and having good knowledge about nutrition [AOR = 2.20, 95% CI: (1.32-3.56)] were significantly associated with dietary diversity among adolescent girls. Conclusion: The prevalence of dietary diversity among adolescent girls was low in the study area. Therefore, attention should be given to fathers with no formal education, and efforts should be made to improve household food security, adolescent girls knowledge about nutrition, and minimize skipping of meals to increase adolescent girls dietary diversity and to break the vicious cycles of malnutrition.

Dietary practice and nutritional status and the respective effect of pulses-based nutrition education among adolescent girls in Northwest Ethiopia: a cluster randomized controlled trial.

Thinness and stunting are the most severe public health problems among adolescent girls in Ethiopia. An inadequate intake of protein-source foods is the most critical cause, mainly due to the non-affordability of animal-origin foods. However, research into what extent improving pulses-based food consumption could contribute to decreasing the magnitude of protein-energy undernutrition is limited. This trial aimed to evaluate the effectiveness of pulses-based nutrition education in reducing the proportion of thinness among adolescent girls. A two-arm cluster randomized controlled trial was conducted among adolescent girls in Northwest Ethiopia from December 2021 to June 2022. A total of 602 adolescent girls from four schools were enrolled in the trial. Schools were assigned to intervention and control groups using the stratified cluster randomization method. Pulses-based nutrition education was the intervention, whereas the usual dietary practice of adolescent girls was the comparator. The education was delivered over 4 weeks on a 45-60-min session per week basis. Thinness was the primary outcome of the trial, measured by anthropometry. An intention-to-treat analysis method was used. A log-binomial regression model was fitted to the data. Relative risk with the respective confidence interval and value of p was calculated. A value of p < 0.05 was used to declare statistical significance. Stata 16 software was used for the analysis. About 89.37% of the participants in the intervention group and 92.36% in the control group completed the trial. The pulses-based nutrition education intervention did not show a significant difference in reducing the proportion of thinness among the participants in the intervention group compared to the participants in the control group even though a significant difference was observed in terms of the consumption of pulses-based food. The present trial was statistically non-significant in reducing thinness among adolescent girls. Similar studies that utilize objective methods for ascertaining pulses-based food consumption need to be conducted.Clinical trial registration: https://pactr.samrc.ac.za/Search.aspx, the trial was registered in the Pan African Clinical Trials Registry (PACTR202111605102515) on November 12, 2021.

Trends and factors associated with thinness among late adolescent girls in Ethiopia: Multivariate decomposition and multilevel analysis.

Undernutrition among adolescent girls is still a major public health problem in low- and middle-income countries (LMICs). Even though the global prevalence of thinness among adolescent girls declined over time, it remains steady in LMICs including Ethiopia. Therefore, this study aimed to assess the trends and factors associated with thinness. A logit-based multivariate decomposition analysis for a non-linear response model was fitted to identify factors that contributed to the change in thinness over time. For the associated factors, a multilevel binary logistic regression model was employed. The intra-class correlation coefficient (ICC) and likelihood ratio (LR) test were used to assess the presence of the clustering effect, and deviance was used for model comparison. Statistical significance was declared at p < 0.05. Thinness among late adolescent girls declined significantly from 34.4% (95% CI: 32.8%, 36.0%) in 2000 to 24.9% (95% CI: 23.4%, 26.5%) in 2016 with an annual average reduction rate of 1.73%. About 84% of the decrement in thinness was attributed to the change in the effect of the characteristics. The place of residence and marital status were significantly associated with a change in thinness due to the change in coefficients. The compositional changes in the age of the adolescents, religion, and types of toilet facilities were also significantly associated with the change in thinness. From the multilevel binary logistic regression, higher age of adolescents (AOR = 0.83; 95% CI: 0.77, 0.90), improved toilet facility (AOR = 0.45; 95% CI: 0.31, 0.65), middle wealth index (AOR = 1.45; 95% CI: 1.10, 1.90), and female head of the household (AOR = 0.77; 95% CI: 0.61, 0.98) were significantly associated at an individual level, whereas being from Somali (AOR = 2.14; 95% CI:1.76, 3.10) and SNNP region (AOR = 0.35; 95% CI: 0.18, 0.68), they had a statistically significant association with thinness at community level. Thinness among late adolescent girls declined substantially, but it remains a major public health concern. Nutritional interventions targeting thinness reduction among late adolescent girls should base on the identified factors. Age, residence, marital status, type of toilet facility, religion, wealth index, sex of head of the household, and region were all associated with thinness in this study.

Earning pocket money and girls’ menstrual hygiene management in Ethiopia: a systematic review and meta-analysis

BackgroundMany adolescent girls in Ethiopia and elsewhere missed school during their monthly cycles due to a lack of affordable menstrual absorbent materials or money to buy sanitary pads. So far, few studies have looked into the relationship between earning pocket money and maintaining good menstrual hygiene. Hence, this systematic review and meta-analysis aimed to synthesize the best available evidence regarding the association between earning pocket money and menstrual hygiene management among adolescents in Ethiopia.MethodsWe systematically searched PubMed, Hinari, Science Direct, Cochrane Library, ProQuest, POPLINE, African Journal Online, Direct of Open Access Journals, and Google Scholar for studies examining the association between earning pocket money and menstrual hygiene management among adolescent girls in Ethiopia, without restriction in a publication year. The Joanna Briggs Institute quality assessment tool for the cross-sectional studies was used to assess the quality of included studies. A prefabricated checklist, including variables: first author, publication year, sample size, type of questionnaire, and the region was used to extract data from the selected articles. A random-effect meta-analysis model was used to estimate the pooled odds ratio (OR) of the association between earning pocket money and menstrual hygiene management. The heterogeneity and publication bias was assessed by using I2 test statistics and Egger’s test, respectively.ResultsData from nine studies involving 4783 adolescent girls were extracted. The meta-analysis revealed that adolescent girls who earned pocket money from their parents or relative had 1.64 times higher odds of having good menstrual hygiene management than their counterparts [pooled OR = 1.64, 95% CI: 1.16–2.34, I2:66.7%, n = 7 (number of studies)]. Similarly, the likelihood of having good menstrual hygiene management was lower by 49% among adolescent girls who did not receive any pocket money from their parents compared to their counterparts (pooled OR = 0.51, 95% CI: 0.35–0.74, I2:48.4%, n = 2).ConclusionsThe findings revealed that adolescent girls who earned pocket money were more likely to practice good menstrual hygiene management. Progress toward better menstrual hygiene will necessitate consideration of this factor.

School-Based Nutrition Interventions Had Impacts on Dietary Diversity and Meal Frequency of Adolescent Girls in Ethiopia

ObjectivesAdolescence is a critical period of physical and psychological development, especially for girls as poor nutrition can affect their well-being as well as the well-being of their children. In Ethiopia, where the population is very young, evidence on the nutrition of adolescent girls and their determinants is scant. We tested the impact of a package of nutrition interventions delivered primarily through schools and implemented by Alive & Thrive (A&T) on the diet of adolescent girls. MethodsA cluster-randomized trial design compared 27 primary school clusters in A&T areas to 27 clusters in non-A&T areas in the SNNP and Somali regions. We surveyed adolescent girls (n = 536) aged 10–14 years and enrolled in primary school grades 4–8, following at least one school semester (approximately 4 months) of implementation in March-April 2021. Using linear regression models, we tested for differences between program groups on dietary diversity, meal frequency, and consumption of unhealthy foods. In adjusted models, we controlled for age, household food security and wealth, and region. ResultsWe observed significant impacts on dietary diversity score (1.4 food groups) and minimum dietary diversity (OR: 5.2). Among the food groups, there was significantly higher consumption of 5 groups in A&T areas: pulses, meats, eggs, vitamin A-rich fruits and vegetables, and other fruits. There was also a significant impact on meal frequency of 0.9 meals/snacks in the previous 24 hours, with girls in A&T areas consuming 4.0 meals/snacks out of 6 eating times compared to 3.2 in control areas. There was no significant impact on consumption sweets, baked sweets, sweetened beverages, and fried and salty foods among girls, but there was lower consumption of sweets in the previous 24 hours in A&T (14%) versus control areas (23%). ConclusionsIntegrating nutrition interventions into primary schools in Ethiopia was feasible and achieved a significant impact on girls’ dietary diversity and meal frequency. Reinforcing messages about eating better and more often resulted in incremental behavior change related to dietary diversity and meal frequency; however, telling adolescents not to eat junk foods that they crave or enjoy without changing their food environments may be less successful in curbing consumption. Funding SourcesBill & Melinda Gates Foundation, through A&T, managed by FHI Solutions.

Spatial distributions and determinants of anaemia among adolescent girls in Ethiopia: a secondary analysis of EDHS 2016 – a cross-sectional study

ObjectiveThis study aimed to investigate the spatial distributions and determinants of anaemia among adolescent girls in Ethiopia. Exploring the spatial epidemiology of anaemia and identifying the risk factors would inform...

Prevalence and associated factors of anemia among adolescent girls in Ethiopia: A systematic review and meta-analysis.

BackgroundAnemia is the reduction of red blood cells in size and numbers and an indicator of both poor nutrition and poor health. It is a major global public health problem. Anemia in adolescents and young adults can have negative effects on their cognitive performance and growth. In Ethiopia, previous studies yielded variable prevalence. This review aimed to determine the pooled prevalence of adolescent girls’ anemia and associated factors in Ethiopia.MethodsWe searched for studies reporting anemia and associated factors among adolescent girls as reported in peer reviews publications in Ethiopia from 1988 to 2021 from PubMed, Google Scholar, Web of Science, Science Direct, Cochrane Library, and Worldwide Science database. The search strategy identified 309 cross-sectional studies. After screening for potentially eligible articles, we identified 37 publications for full text review, following which 10 publications were included in the final review. Using data from the review, we performed meta-analysis to produce pooled estimates and assess the prevalence of anemia and associated risk factors. Data were extracted using a standardized data extraction format prepared in Microsoft Excel™ and transferred to Stata ™ Version 14.0 for management and further analysis. To identify the source of heterogeneity, subgroup analysis using sample size and study setup was computed, and I2 test was used to declare the presence or absence of significant heterogeneity during subgroup analysis. A random-effect meta-analysis model was used to estimate the pooled prevalence of adolescent girls’ anemia. Moreover associated factors for adolescent anemia were assessed too.ResultsThe overall pooled prevalence of anemia among adolescent girls’ in Ethiopia was 23.02% (95% CI: 17.21to 28.84). In the subgroup analysis, studies that have a higher sample size than mean have a higher pooled prevalence (27.35%) (95% CI: 21.42 to 33.28) compared to their counterparts. Age being 15–19 (OR: 2.13; 95% CI: 1.52 to 2.96), living in rural areas (OR: 2.05; 95% CI: 1.66 to 2.54), and low dietary diversity (OR: 1.35; 95% CI: 1.00 to 2.34), were the identified factors associated with anemia among adolescent girls’.ConclusionThe pooled prevalence of anemia among adolescent girls in Ethiopia was moderately high. Being in 15–19 years, rural residence, and low dietary diversity score were found to be the significant factors of anemia among adolescent girls in Ethiopia.

Menstrual hygiene practice among adolescent girls in Ethiopia: A systematic review and meta-analysis.

Adolescent girls face several challenges relating to menstruation and its proper management. Lack of adequate sanitary products, inadequate water supply, and privacy for changing sanitary pads continue to leave adolescent girls with limited options for safe and proper menstrual hygiene in many low-income settings, including Ethiopia. These situations are also compounded by societal myths, stigmas surrounding menstruation, and discriminatory social norms. This systematic review and meta-analysis aimed to estimate the pooled proportion of safe menstrual hygiene management among adolescent girls in Ethiopia using the available studies. We searched PubMed, Google Scholar, African Journal Online (AJOL), Hinari, Science Direct, ProQuest, Direct of Open Access Journals, POPLINE, and Cochrane Library database inception to May 31, 2021. Studies reporting the proportion of menstrual hygiene management among adolescent girls in Ethiopia were considered. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. Since the included studies revealed considerable heterogeneity, a random effect meta-analysis model was used to estimate the pooled proportion of menstrual hygiene management (MHM). Of 1,045 identified articles, 22 studies were eligible for analysis (n = 12,330 participants). The pooled proportion (PP) of safe MHM in Ethiopia was 52.69% (95%CI: 44.16, 61.22). The use of commercial menstrual absorbents was common 64.63% (95%CI: 55.32, 73.93, I2 99.2%) followed by homemade cloth 53.03% (95%CI: 22.29, 83.77, I2 99.2%). Disposal of absorbent material into the latrine was the most common practice in Ethiopia 62.18% (95%CI: 52.87, 71.49, I2 98.7%). One in four girls reported missing one or more school days during menstruation (PP: 32.03%, 95%CI: 22.65%, 41.40%, I2 98.2%). This study revealed that only half of the adolescent girls in Ethiopia had safe MHM practices. To ensure that girls in Ethiopia can manage menstruation hygienically and with dignity, strong gender-specific water, sanitation, and hygiene (WASH) facilities along with strong awareness creation activities at every level are needed.

Menstrual abnormality, maternal illiteracy, and household factors as main predictors of anemia among adolescent girls in Ethiopia: Systematic review and meta-analysis.

Adolescent girls are more likely to develop anemia as a result of physical and physiological changes that place a greater strain on their nutritional needs. Primary studies, on the other hand, may not be sufficient to provide a complete picture of anemia in adolescent girls and its major risk factors. The study aimed to describe the pooled prevalence of adolescent girls' anemia and the factors that contribute. We conducted a systematic review of observational studies using the databases CINAHL (EBSCO), PubMed, Science Direct, Cochrane Library, and Google Scholar. The Newcastle-Ottawa Scale was used to assess the quality of the articles, and studies of fair to good quality were included. We pooled anemia prevalence among adolescents and odds ratio estimates for risk factors. Subgroup analysis employing sample size and study setup was computed to determine the source of heterogeneity, and the I2 test was used to identify the existence or absence of substantial heterogeneity during subgroup analysis. The pooled prevalence of adolescent girls' anemia was calculated using a random-effects meta-analysis model. The overall pooled prevalence of anemia among adolescent girls in Ethiopia was 23.03% (95% confidence interval: 17.07, 28.98). Low dietary diversity (odds ratio: 1.56; 95% confidence interval: 1.05, 2.32), illiterate mothers (odds ratio: 1.45; 95% confidence interval: 1.13, 1.86), household size greater than five (odds ratio: 1.65; 95% confidence interval: 1.14, 2.38), food-insecure households (odds ratio: 1.48; 95% confidence interval: 1.21, 1.82), and menstrual blood flow more than 5 days (odds ratio: 6.21; 95% confidence interval: 1.67, 23.12) were the identified factors associated with anemia among adolescent girls. The pooled prevalence of anemia among adolescent girls in Ethiopia was moderately high. Therefore, to combat the burden of anemia among adolescent girls offering nutritional education is crucial. Iron supplementation is also recommended for adolescent females who have a menstrual cycle that lasts longer than 5 days.

Dietary diversity score and associated factors among high school adolescent girls in a selected school of Yeka Sub-city, Addis Ababa.

Introduction:Adequate dietary intake is critical for modification of eating behavior and provides nutrients required for growth particularly among adolescents. The evidence revealed the variation and unrelated data on the prevalence of dietary diversity among adolescent girls in Ethiopia.Objective:To assess the magnitude of dietary diversity and associated factors among high school adolescent girls at the selected school of Yeka Sub-city, Addis Ababa, Ethiopia 2021.Methods:A cross-sectional study was conducted in high schools of the Yeka sub-city. Self-administered questionnaires were used to collect data. Data were analyzed using SPSS and the characteristics of the study participants were reported using descriptive statistics. A logistic regression model was fitted to identify factors associated with dietary diversity.Result:The mean score of dietary diversity was 4.9 ± 1.47 with a response rate of 97.2% among a proposed number of participants. The dietary diversity score is high in 56.7% and low among 43.3% of adolescents. Stayed a long time on social media (adjusted odds ratio = 2.6), school type (adjusted odds ratio = 6.5), educational status of mother (adjusted odds ratio = 8.7), consuming more sweet food (adjusted odds ratio = 3.6), occupation of the mother (adjusted odds ratio = 2.3), household security (adjusted odds ratio = 2.3), and fear of obese/worried about shape (adjusted odds ratio = 5.0) were statistically associated with low dietary diversity score.Conclusion:The finding of the study revealed that the magnitude of low dietary diversity among adolescent girls was found to be high. Long time social media usage, school type, educational status of the mother, consuming more sweet food, occupation of mother, household food security, and fear of obese/worried about shape were statistically associated with dietary diversity score.

Associations of early marriage and early childbearing with anemia among adolescent girls in Ethiopia: a multilevel analysis of nationwide survey

BackgroundEarly marriage and early childbearing are common practices in Ethiopia. Girls who get married and give birth at a very young age are more likely to experience several health problems including anemia among others. However, the effects of early marriage and early childbearing on anemia status of adolescent girls have not been quantified in previous studies. In this study, we assessed whether early marriage and early childbearing measured at both individual and community levels are associated with adolescent anemia.MethodsWe analyzed data from the 2016 demographic and health survey of Ethiopia. Our study focused on 3172 late female adolescents (15–19 years). We used the chi-squared test and spearman correlation coefficients for bivariate analysis. The relationship between early marriage and childbearing with anemia was evaluated using multilevel binary logistic regression models while controlling other determinants.ResultsOverall prevalence of anemia among female adolescents was 23.8% (95% CI; 22.3–25.2). Our multivariable multilevel analysis showed that individual-level marital status (AOR = 1.53, 95% CI = 1.06–2.02) and community-level childbearing status (AOR = 2.80, 95% CI 1.25–6.29) were positively associated with anemia among female adolescents.ConclusionOur findings show the presence of significant association between early marriage & early childbearing with adolescent anemia. Therefore, there is a need for effective policies and programs to end the practice of early child marriage and the consequent adolescent pregnancy in Ethiopia. This will help to improve nutritional status of adolescent girls as well as nutritional outcomes of their children.