ANC Follow-up Research Articles

Modern Family Planning Use and its Relationship with the Nutritional Status of Women of Child Bearing Age at Tena District, Arsi Zone Oromia Regional State, Ethiopia 2013: A Community based Case Control Study

Background: The healthy future of society depends on the health of the children of today and their mothers, who are guardians of the future. Spacing pregnancies at least two years apart and limiting the total number of pregnancies improves the survival chances and health outcomes of women including their nutritional status. Method: A community based unmatched case control complemented by qualitative study was conducted at Tena district, Arsi Zone, Oromiya region in 2013. Prior to the study family planning users (MFPM) and non-users for at least one year were identified and registered. A total of 360 (180 in each groups for cases and controls) sampled subjects were enrolled using systematic random sampling. Result: The prevalence of current modern family planning utilization was 65% and injectable was the most utilized type in both cases and control women, followed by pills and Norplant. The major factors associated with modern family planning use were religion, women and husband education status, radio possession, number of children, ANC follow-up during pregnancy and decision to go health facility. The proportion of respondents with weight ≤ 45 kg, BMI below 18.5 kg/m2 and MUAC below 21 cm was higher among controls than cases and the difference noted was significant (p-value<0.05). Conclusions and recommendation: Educational status, numbers of children, ANC follow up were strong determinant of ever modern family planning. The prevalence of underweight was significantly higher among women who did not use family planning than family planning users. Continuous supply of modern family planning with different range is important for improvement of women’s nutritional and health status. Other than this, increasing awareness of the benefits of modern family planning and empowering women is important.

English

&nbsp; Ethiopia&rsquo;s Health Extension Program is an innovative community-based health care service delivery system that emphasizes the construction of health posts at village level and assignment of trained Health Extension Workersto improve the prevailing high disease burden and mortality that Ethiopians suffer from. The main objective of the study was to assess the socio-cultural factors that affect the implementation of HEP in rural communities focusing on Family Health and Hygiene and Environmental sanitation packages of HEP. A cross sectional survey was conducted in randomly selected 416 households of rural kebeles found in Jimma Zone. Even though 57% of the mothers did ANC follow-up in health posts, none of them reported for delivery in health posts. Home delivery was practiced by 82.5% of the mothers. From the 61.5% FP service beneficiaries only 15% were clients of health posts. TT coverage was 90% and 87% of the under 5 children have vaccination cards. Though 90% of the households have constructed pit latrines, 49% lackedshading and 10% have practiced open field defecation. Wash-hand basin and soap or mud was not seen around 95% of the latrines. Unprotected streams were sources of water supply for about 10% of the households. Almost half of the households studied disposed solid wastes in open fields. Generally, health posts were underutilized by the community. Above all, attention was not given to the cultural assets of the community that are suggested in the HEP guidelines as a means to increase community&rsquo;s participation. &nbsp; Key words: Health extension programs, innovative and Socio-cultural factors.

Prevention of Mother-to-Child Transmission (PMTCT) of HIV services in Adama town, Ethiopia: clients’ satisfaction and challenges experienced by service providers

BackgroundThe coverage and uptake of prevention of mother-to-child transmission (PMTCT) of HIV services has remained very low in Ethiopia. One of the pillars of improving quality of health services is measuring and addressing client satisfaction. In Ethiopia, information about the quality of PMTCT services regarding client satisfaction is meager.MethodsA facility-based cross-sectional study using quantitative methods was conducted in Adama town. We interviewed 423 pregnant women and 31 health providers from eight health facilities. Satisfaction of clients was measured using a standard questionnaire adapted from the UNAIDS best practices collection on HIV/AIDS. Bivariate and multivariate logistic regression analyses were used to identify factors associated with clients’ satisfaction.ResultsAbout three-fourth (74.7%) of clients reported that they were satisfied with the PMTCT services provided by the health facilities. However, a much lower proportion (39%) of the total respondents (pregnant women who underwent an ANC follow-up session), said they received and understood the messages related to mother-to-child transmission (MTCT) of HIV and PMTCT. The main challenges reported by service providers were lack of training, lack of feedback on job performance and inadequate pay. Clients’ satisfaction with PMTCT service was found to be associated with liking the discussion they had with their counselor, non-preference to a different counselor with regards to sex and/or age and not seeing the same ANC counselor before and after HIV test.ConclusionAlthough 74.7% of clients were satisfied, the majority did not have a good understanding of the counseling on MTCT and PMTCT. We recommend more efforts to be exerted on improving provider-client communication, devising ways of increasing clients’ satisfaction and designing an effective motivation strategy for service providers to enhance the status of PMTCT services.

Timely Initiation of Complementary Feeding Practice and Associated Factors among Mothers of Children Aged from 6 to 24 Months in Axum Town, North Ethiopia

Introduction: Appropriate complementary feeding is critical for the achievement of a healthy growth and development and mere survival of young children. Lack of appropriate breast-feeding and complementary feeding practice are the main cause of under nutrition. An estimated 32% of children under five years in developing countries are stunted and 10% are wasted. Objective: To assess timely initiation of complementary feeding practice and associated factors among mothers of children aged from 6 to 24 months living in Axum town, North Ethiopia. Methods: Community based cross- sectional study was conducted from April to May 2013. A sample of 422 subjects was selected by using systematic random sampling technique. Data were collected using pre-tested interviewer administered structured questionnaires. The data were cleaned, coded, entered in to EPI-INFO version 3.5.1, and transferred and analysed using SPSS version 20. Results: Out of 422 study participants, 223 (52.8%) have started complementary feeding practices to their child timely. Married women [AOR=2.490; 95% CI: (1.170, 5.301)] and attended ANC follow up [AOR=3.874; 95% CI: (1.805, 8.314)] were positively associated with timely initiation of complementary feeding. On the other hand, mothers whose husband cannot read and write [AOR=0.358; 95% CI :( 0.148, 0.863)], household size of 4-6 (AOR=0.34; 95%CI: 0.16, 0.74) and mothers who delivered at home (AOR=0.338; 95%CI: 0.12, 0.99) were negatively associated with timely initiation of complementary feeding. Conclusion and recommendation: Timely initiation of complementary feeding practice was relatively low in the study area. Mother’s marital status, husband education, family size, mother’s ANC follow-up, and mother’s place of delivery were significantly associated with timely initiation of complementary feeding. Nutritional counseling, promoting ANC follow up, nutrition education & enhancing institution delivery were recommended to the concerned bodies.