Antenatal Care Follow-up Research Articles

Nutritional-Related Predictors of Anemia among Pregnant Women Attending Antenatal Care in Central Ethiopia: An Unmatched Case-Control Study.

Background Anemia is a major public health problem in both developed and developing countries especially among pregnant women. Nearly half of pregnant women in Ethiopia have anemia which has both health and economic impacts. Therefore, this study is aimed at identifying nutritional-related predictors of anemia among pregnant women attending antenatal care in Central Ethiopia, 2019. Methods An unmatched case-control study was conducted at public hospitals in Central Ethiopia from February to April 2019. The consecutive sampling technique was used to select study participants. Data were collected by a structured questionnaire, and the collected data were entered into Epi Info version 7 and SPSS version 23 for analysis. Binary and multiple logistic regression analyses were computed to identify predictors of anemia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05 was used to determine the presence of an association. Result A total of 426 pregnant women (142 cases and 284 controls) had participated in this study. Taking tea/coffee immediately after food (AOR = 2.35, 95% CI: 1.39-3.99), mid-upper arm circumference (MUAC) of mothers of <23 centimeters (AOR = 3.83, 95% CI: 2.26-6.49), the presence of forbidden food during pregnancy (AOR = 2.21, 95% CI: 1.24-3.88), not taking additional food (AOR = 1.99, 95% CI: 1.17-3.40), unable to take fruit (AOR = 4.05, 95% CI: 1.3-15.47), loss of appetite (AOR = 2.28, 95% CI: 1.28-4.09), low dietary diversity score (DDS) (AOR = 3.29, 95% CI: 1.83-5.90), and medium DDS (AOR = 2.88, 95% CI: 1.46-5.70) were found to be determinants of anemia. Conclusions Taking tea or coffee immediately after food, MUAC of mothers, the presence of forbidden food, not taking additional food, frequency of taking fruit, and dietary diversity were predictors of anemia among pregnant women. Therefore, interventions targeted at prevention of anemia among pregnant mothers should emphatically consider those identified determinants. This finding also highlights the need for strong nutritional counseling to prevent anemia among pregnant mothers during antenatal care follow-ups along with other interventions.

Burden of Uterine Rupture and Its Determinant Factors in Ethiopia: A Systematic Review and Meta-analysis

Background. Uterine rupture is a life-threatening obstetrical emergency, which results in serious undesired maternal and perinatal complications in resource-limited countries, mainly in Ethiopia. The prevalence, determinants, and outcomes of uterine rupture described by different studies were highly inconsistent in Ethiopia. Therefore, this systematic review and meta-analysis is aimed at estimating the pooled prevalence, determinants, and adverse outcomes of uterine rupture in Ethiopia. Methods. Studies were searched from international databases (PubMed/MEDLINE, HINARI, Cochrane library, Google Scholar, and web of science) and Ethiopian universities’ digital libraries (Addis Ababa University, University of Gondar, and Harameya University). All observational studies were included. A total of 15 studies that fulfill the inclusion criteria were included in this meta-analysis. Data were extracted by two reviewers and exported to STATA version 11 for analysis. The I 2 statistics were used to assess heterogeneity across the studies. Publication bias was examined by using Egger’s test and funnel plot. The pooled prevalence of uterine rupture and its outcomes were estimated by using a random effects model. The associations between determinants and uterine rupture were evaluated by using both random and fixed-effect models. Results. In this meta-analysis, a total of 15 studies with 92,394 study participants were involved. The pooled prevalence of uterine rupture was 2.37% in Ethiopia. Obstructed labor ( OR = 3.03 ; 95 % CI = 2.52 , 3.63 ), lack of antenatal care follow-up ( OR = 5.79 ; 95 % CI = 2.47 , 13.61 ), duration of labor &gt; 24 hours ( OR = 3.75 ; 95 % CI = 2.24 , 6.29 ), grand multipara ( OR = 10.79 ; 95 % CI = 4.77 , 24.40 ), and being rural residency ( OR = 7.17 ; 95 % CI = 3.90 , 13.16 ) were significantly associated with uterine rupture. Conclusion. The overall prevalence of uterine rupture was high in Ethiopia. Obstructed labor, lack of antenatal care follow-up, duration of labor &gt; 24 hours, grand multipara, and rural residency were determinants of uterine rupture. This study implies the need to develop plans and policies to improve antenatal care follow-up and labor and delivery management at each level of the health system.

Level of Happiness and Its Associated Factors Among Pregnant Women in South Gondar Zone Hospitals, North Central Ethiopia.

BackgroundHappiness is the most indicator of good quality of life particularly for pregnant women. Reduced happiness of pregnant women can result in reduced maternal health services utilization and can result in adverse newborn and maternal outcomes. Assessing the level of happiness and its factors are important for pregnant women and the next generation. Hence, the current research paper aimed to assess the level of happiness and its associated factors among pregnant women who attended antenatal care follow-up in South Gondar Zone Hospitals.MethodsInstitution-based cross-sectional study was carried out from September 2018 to February 2019 among 1606 expectant pregnant women in the last 6 months. The Oxford Happiness Questionnaire (OHQ) was used as a measure of the degree of happiness and used four as average person score. Besides, bivariate, multivariable logistic analyses were deployed to identify associations.ResultsA total of 1606 pregnant women were participating in this study. The prevalence of low level of pregnancy happiness in this study was 24% (95% CI: 20.7 −26.6). Mothers who exposed to unintended pregnancy (AOR; 1.94, CI 95% 1.86–4.52), reported intimate partner violence (AOR; 2.42, 95% CI 1.67–3.54) and being in the third trimester (AOR; 1.89 95% CI 1.19–3.01) were the most predictor variables with the low level of happiness.ConclusionApproximately one-fourth of the pregnant women had a low level of pregnancy happiness. Mothers who were exposed to unintended pregnancy encountered intimate partner violence, who were in the third trimester were the most significant variables associated with a low level of happiness. Governmental and non-governmental organizations work on women’s reproduction rights and the zonal health department with local health offices should educate on the prevention of intimate partner violence and unintended pregnancy and its consequences and also empower women to cope with changes and challenges of pregnancy and childbirth.

Food taboos and related misperceptions during pregnancy in Mekelle city, Tigray, Northern Ethiopia.

Most communities, rural or urban, have taboos regarding foods to avoid during pregnancy, and most have local explanations for why certain foods should be avoided. Such taboos may have health benefits, but they also can have large nutritional and health costs to mothers and fetuses. As such, understanding local pregnancy food taboos is an important public health goal, especially in contexts where food resources are limited. Despite this, information regarding food taboos is limited in Ethiopia. Therefore, this study assessed food taboos, related misconceptions, and associated factors among pregnant women in Northern Ethiopia. A cross-sectional study of 332 pregnant women in antenatal care (ANC) follow-up at selected private clinics in Mekelle city, Tigray, Ethiopa, recruited between April and May, 2017. Using a semi-structured questionnaire, we assessed whether respondents' observed food taboos, what types of foods they avoided, their perceived reasons for avoidance, diversity of respondents' diets during pregnancy, and respondents' socio-demographic characteristics. After reporting frequency statistics for categorical variables and central tendencies (mean and standard deviation) of continuous variables, bivariate and multivariable logistic regression analyses were conducted to identify the socio-demographic factors and diet diversity associated with food taboo practices. Around 12% of the pregnant women avoided at least one type of food during their current pregnancy for one or more reasons. These mothers avoided eating items such as yogurt, banana, legumes, honey, and "kollo" (roasted barley and wheat). The most common reasons given for the avoidances were that the foods were (mistakenly) believed to cause: abortion; abdominal cramps in the mother and newborn; prolonged labor; or coating of the fetus's body. Maternal education (diploma and above) (AOR: 4.55, 95% CI: 1.93, 10.31) and marital status (single) were found to be negatively associated (protective factors) with observances of pregnancy food taboos. Approximately 79% of respondents had pregnancy diets that were insufficiently diverse, although we did not find any statistical evidence that this was associated with adhering to food taboos. The misconceptions related to pregnancy food taboos should be discouraged insofar as they may restrict women's consumption of nutritious foods which could support maternal health and healthy fetal development. Health providers should counsel pregnant women and their husbands about appropriate pregnancy nutrition during ANC visits.

Prevalence and Associated Factors of Self-Medication among Pregnant Women on Antenatal Care Follow-Up at University of Gondar Comprehensive Specialized Hospital in Gondar, Northwest Ethiopia: A Cross-Sectional Study.

Background Self-medication is being prevalent throughout the globe. Although pregnant women are among the most vulnerable group of the population for drug-induced adverse effects on their fetus and themselves, many pregnant women use self-medication without adequate safety precautions. Objective This study was aimed at assessing the prevalence and associated factors of self-medication among pregnant women on antenatal care follow-up at University of Gondar Comprehensive Specialized Hospital. Methods A cross-sectional study was employed among 400 pregnant women attending antenatal care clinic at the University of Gondar Comprehensive Specialized Hospital between February 01 and May 30, 2019. A structured interviewer-administered questionnaire was used for data collection. Data were analyzed using SPSS® (IBM Corporation) version 22. Descriptive statistics were presented using frequency and proportion. Binary logistic regression was used to identify factors associated with self-medication with a 95% confidence level and p value of 0.05. Results Among 400 respondents, the prevalence of self-medication during the current pregnancy was 44.8% (95% CI = 40.5-50). Among all respondents (400), 38.0% (95% CI = 33.3-42.8) and 12.5% (95% CI = 9.5-15) used herbal and conventional medicine, respectively. Self-medication showed a significant association with a previous history of self-medication and monthly income. Conclusions The prevalence of self-medication among pregnant women is considerably high. The previous history of self-medication and monthly income showed a significant association with self-medication. Awareness creation should be done for reproductive-age women on the potential risks of self-medication.

Determinants of Maternal Satisfaction with Existing Delivery Care at Wolaita Sodo University Teaching and Referral Hospital, Ethiopia.

Background Assessing maternal satisfaction on delivery service has significant public health importance to measure the quality of maternal and child care services in a country. Therefore, the objective of this study was to further investigate the determinants of maternal satisfaction on delivery service provided at the Woliata Sodo University Teaching and Referral Hospital, Ethiopia. Methods An institutionally based cross-sectional study was employed at the Wolaita Sodo University Hospital, Ethiopia. All mothers who gave birth between March and May 2018 were included in the study. Data were collected through using a pretested and structured interviewer-administered questionnaire. Both bivariate and multivariable logistic regression analyses were performed. A P value of <0.05 was used to declare statistical significance. Result A total of 398 delivered mothers were included in the study. The rate of maternal satisfaction on existing delivery care was found to be 67.3%. Being less educated (AOR = 5.06, [2.22-11.53]), primigravida (AOR = 3.59, [1.17-11.04]), planned and wanted pregnancy (AOR = 2.74, [1.21-6.18]), having antenatal care follow-up for current pregnancy (AOR = 4.48, [2.04-9.83]), ever used family planning service (AOR = 3.83, [1.95-67.52]), labor duration of less than 6 hours (AOR = 5.96, [2.61-13.57]), and spontaneous vaginal delivery (AOR = 2.82, [1.07-7.42]) were factors significantly associated with maternal satisfaction. Conclusion In this study setting, maternal satisfaction was lower compared to other studies. Unreserved effort should be considered for future interventions.

Determinant factors, trend and outcomes of cesarean delivery in Debre Berhan referral hospital, North Shewa Zone, Ethiopia.

Cesarean Section (CS) refers to the delivery of a fetus, placenta and membrane through the abdominal and uterine incision after 28 weeks of gestation. Unless used appropriately, the potential risk to the mother and baby becomes more than the vaginal delivery. Therefore, this study is designed to assess the determinant factors, trends and outcomes of caesarean delivery. Hospital based cross-sectional study was conducted from January 2015 to December 2016. All cesarean deliveries performed after period of viability (28 weeks) were included. The data was collected by using checklist and pretested questionnaire. The data was entered into EpiData and analyzed by SPSS version 21. There were 2587 deliveries in 2015 and 3423 deliveries in 2016, from those 440 and 660 were delivered by CS in each year respectively. The rate of CS in 2015 and 2016 was 17% and 19.3% respectively. The most common indication of CS was fetal distress. Mothers who had no antenatal care (ANC) follow-up had 3.16 times more risk for fetal death than mothers having ANC follow-up. We can conclude that the cesarean delivery rate is greater than WHO recommendation. ANC follow-up, parity, duration of labor, gestational age, types of CS and types of anesthesia are the main risk factors for CS and influence maternal and fetal outcomes.

Association between Helicobacter pylori Infection and Occurrence of Anemia among Pregnant Women Attending Antenatal Care in Kulito Health Center, Halaba Zone, South Ethiopia, 2018.

Background Anemia in pregnancy is defined as a hemoglobin (Hb) concentration of less than 11 grams (gm)/deciliter (dl) in venous blood. Globally, it affects 1.62 billion people. In developing countries, anemia is a major cause of maternal and child morbidity and mortality. Globally, anemia contributes to 20% of all maternal deaths. Nearly 50% of the world's population is estimated to be infected with Helicobacter pylori (HP). High prevalence of HP among pregnant women was also reported in developing countries than developed ones. The association between HP infection and occurrence of anemia is not well known in Ethiopia. Therefore, the aim of this study was to determine the association between anemia and Helicobacter pylori infection among pregnant women attending antenatal care follow-up in Kulito Health Center, Halaba Zone, South Ethiopia. Methods Institution-based cross-sectional study was employed. Systematic random sampling procedure was employed to select 236 pregnant women who attended antenatal care at Kulito Health Center. An interviewer-administered questionnaire supplemented by laboratory tests was used to obtain the data. The collected data were analyzed by using SPSS version 20.0. Results The prevalence of anemia among antenatal care attendant pregnant women of Kulito Health Center was 27.5% with 36 (15.2%) of mild, 29 (12.3%) of moderate, and no severe cases of anemia. The overall prevalence of HP infection among study participants was found to be 129 (54.7%) (95% CI: 47.9–61.4). Factors significantly associated with anemia were presence of HP infection (AOR = 3.064, 95% CI: 1.336 7.027), low interpregnancy gap (AOR = 2.863, 95% CI: 1.245–6.582), being on the third trimester (AOR = 6.457; 95% CI: 1.276–32.729), and mid-upper arm circumference (MUAC) level <21 cm (AOR = 2.595, 95% CI: 1.044–6.450). Conclusion This study revealed that anemia and HP infection were highly prevalent among pregnant women attending the antenatal follow-up clinic in Kulito Health Center. HP infection, low interpregnancy gap, being on the third trimester, and MUAC less than 21 cm were the independent factors associated with anemia. Recommendation. Pregnant women should be aware that anemia is a problem that can be prevented by early prevention and treatment of HP infection and undernutrition, using family planning to widen the interpregnancy gap. Further experimental studies are warranted to determine the cause and effect of the association between anemia and HP infection.

Women’s satisfaction with existing labour and delivery services in Ethiopia: a systematic review and meta-analysis

ObjectiveTo estimate the pooled prevalence of women’s satisfaction with existing labour and delivery services in Ethiopia.DesignSystematic review and meta-analysis.MethodsMEDLINE/PubMed, Scopus, Hinari, Google Scholar and web of science electronic databases were...

Factors Associated with the Unplanned Pregnancy at Suhul General Hospital, Northern Ethiopia, 2018.

Background Unplanned pregnancy is a fundamental concept that is used to recognize the fertility of populations and the unmet need for contraception and family planning. Unplanned pregnancy happened mainly due to the results of not using contraception or inconsistent or incorrect use of effective methods. Reducing the number of unplanned pregnancy endorses reproductive health mainly by reducing the number of times a woman is exposed to the risk of pregnancy and childbearing. Objective This study is aimed at assessing the magnitude of unplanned pregnancy and associated factors among pregnant mothers attending antenatal care at Suhul General Hospital, Northern Ethiopia. Methods A facility-based cross-sectional study design was conducted among pregnant mothers visiting antenatal care follow-up from February to April 2018 at Suhul General Hospital, Shire, and Northern Ethiopia. The study participants were selected using a systematic sampling method, and the data was collected using a pretested structured questionnaire through face-to-face interviews. Bivariate and multivariate logistic regression analyses were done to determine the association of each independent variable with the dependent variable. Result The magnitude of unplanned pregnancy among 379 pregnant mothers was 20.6%. Unmarried women [AOR: 4.73, 95% CI: (1.56, 14.33)], age above forty [AOR: 4.17, 95% CI: (1.18, 14.6)], had no history of unplanned pregnancy [AOR: 3.26 95% CI: (1.65, 6.44)], and unemployed [AOR: 6.79; 95% CI: (2.05, 22.46)] were the variables significantly associated with the magnitude of unplanned pregnancy. Conclusion and Recommendation. The findings of this study showed that the magnitude of unplanned pregnancy was high and age, marital status, occupation, and history of unplanned pregnancy were statistically associated with an unplanned pregnancy. There is seeming necessity to plan strategies of communication within couples or individuals on reproductive especially on fertility and promote family planning methods.

Missed antenatal care follow-up and associated factors in Eastern Zone of Tigray, Northern Ethiopia.

Focused antenatal care improves the survival and health of the mother as well as the babies. However, there are real challenges in keeping the subsequent antenatal care follow up in Ethiopia. Hence, the aim of this study was to assess missed antenatal care follow up and associated factors in the Eastern zone of Tigray. Hospital based cross-sectional study was conducted among systematically selected 548 women who came for delivery services from March to April 2016. The data were collected using pre-tested and structured questionnaire through face to face exit interview. Data entry and analysis were made using EPI info version 7 software and SPSS version 20 respectively. Both binary and multiple logistic regression was performed. This study revealed that 33.4% of participants were missing their Antenatal care follow-up. Having no formal education [AOR=1.778 (1.102, 2.869)], attending primary education [AOR= 1.756 (1.040, 2.964)], self-employee [AOR=1.589 (1.030, 2.452)], government employee [AOR=0.503 (0.503, 0.953)], being unmarried [AOR=2.36 (1.11, 5.04)], didn't informed about institutional delivery [AOR=3.34 (1.44, 7.78)], and travel distance more than two hours to hospital [AOR=1.93 (1.08, 3.44)] were factors significantly associated with missed Antenatal care follow-up. The proportion of missed antenatal care follow-up was lessened as compared to local and national evidences. Nevertheless, still a coordinated effort on tracking of pregnant women who missed their antenatal care appointment is required by health policy implementers so as to increase the uptake of four complete visits.

Magnitude of home delivery and associated factors among child bearing age mothers in Sherkole District, Benishangul Gumuz regional state-Western-Ethiopia

BackgroundThe World Health Organization estimates that globally only 43% of women have access to skilled care during deliveries and the rest are exposed to unskilled delivery service. A recent Ethiopian Demographic and Health Survey report stated that maternal death was 412 per 100,000 in 2016.This still indicates that maternal health remains a major public health problem in Ethiopia irrespective of the government’s measure to institutional delivery. Therefore, the aim of this study was to assess the magnitude of home delivery and associated factors among women of child bearing age in Sherkole district, Western Ethiopia.MethodsA community based cross sectional study was conducted among women aged 15–49 years in Sherkole district, Benishangul Gumuz region from January to June 2018. A total of 451 randomly selected women were included in the study. Stratified sampling followed by simple random sampling technique was used to select the study participants. Data were collected using pretested and structured questionnaires. Bivariate and multivariate logistic regression models were fitted to identify factors associated with home delivery among women in the child bearing age. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance.ResultsThe magnitude of home delivery was 353 (80%) and were assisted by non-skilled birth attendants. Mothers whose husband chooses the place of delivery [AOR: 5.6, 95% CI (2.1–15.2), Mothers’ occupation ([AOR: 0.21 95% C I (0.08–0.57), ANC visit [AOR: 95 CI: 5.1(1.6–15.8), decision making [AOR: 95 CI: 0.3(0.01–0.7)] and traditional remedies [AOR: 95%CI: 0.03 (0.01–0.09)] were significantly associated with home delivery.ConclusionsBased on the findings of the survey, it was concluded that the overall magnitude of home delivery was found to be high. Therefore, it is recommended that the promotion of antenatal care follow-up with maternal and child health information particularly on delivery complications or danger signs needs due attention and remedial actions. In addition, it is indispensable introducing defaulter tracing mechanisms in ANC services, by learning from experiences of settings that have already adopted it.

Women\u2019s knowledge towards neonatal danger signs and its associated factors in Ethiopia: a systematic review and meta-analysis

IntroductionReducing neonatal mortality is an essential part of the third Sustainable Development Goal, to end preventable child deaths. Neonatal danger signs are the most common cause of neonatal mortality and morbidity. In Ethiopia, most babies are born at home or are discharged from the health institutions in the first 24 h, as a result enhancing women’s knowledge towards neonatal danger signs and its complication might reduce neonatal morbidity and mortality. Therefore, this systematic review and meta-analysis aimed to assess the women knowledge towards neonatal danger signs in Ethiopia.MethodMEDLINE/PubMed, Scopus, Hinari, Google scholar, web of science electronic databases and grey literature from repository were searched for all the available studies. Fourteen cross sectional studies were included in this systematic review and meta-analysis. Subgroup analysis was conducted for the evidence of heterogeneity. Cochrane I2 statistics were used to check the heterogeneity of the studies. Egger test with funnel plot were used to investigate publication bias.ResultFourteen cross-sectional studies with a total of 6617 study participants were included for this study. The overall pooled prevalence of women’s knowledge towards neonatal danger sign was 40.7% (95%CI, 25.72, 55.67). Having higher educational status of the women (AOR = 3.86, 95%CI: 2.3–6.5), having higher educational status of the husband (AOR = 4.57, 95%CI: 3.29–6.35), access to mass media (AOR = 1.69, 95%CI: 1.17–2.23), having antenatal care visits (AOR = 2.63, 95%CI: 1.13–4.67), having postnatal care follow up (AOR = 2.55, 95%CI; 1.72–3.79) and giving birth at health institutions (AOR = 2.51, 95%CI:1.68–3.74) were factors associated with knowledge of the women towards danger sign of the neonate.ConclusionIn this systematic review and meta-analysis the pooled prevalence of maternal knowledge towards neonatal danger sign was low. Educational status of the mother, educational status of the husband, access to mass media, antenatal care follow-up, postnatal care follow-up and place of delivery were factors associated with knowledge of the mother towards danger sign of the newborn. Promoting antenatal care, postnatal care follow-up and community-based health information dissemination about neonatal danger signs should be strengthened.Systematic review registrationPROSPERO CRD42019132179.

Predictors of optimal breastfeeding practices in Worabe town, Silte zone, South Ethiopia.

BackgroundStudies in sub-Saharan Africa indicated the overall prevalence of optimal breast feeding ranged between a lowest of 17.63% in East Africa and a highest of 46.37% in West Africa. It’s estimated that 823,000 deaths of children could be prevented every year through optimal breastfeeding practices. However optimal breastfeeding practices is low in most setting of Ethiopia. Therefore, this study aimed to assess optimal breastfeeding practices and associated factors in Worabe town.MethodA community-based analytical cross-sectional study was conducted from April 15th–25th, 2018. A systematic sampling technique was applied on 347 sampled mothers who had children greater than or equal to 2 years old. The data was entered into EpiData (version 3.1) and subsequently exported to SPSS Statistics (version 22) for analysis. Descriptive statistics were used for presenting summary data using tables and graph. Bivariate and multi variable logistic regression analysis to identify were used to identify associated factors. The statistical significance was declared at P<0.05.ResultOptimal breastfeeding was exhibited by 42.1% of mothers. Government employees (AOR = 8.0; 95% CI: 1.7, 36.4), families with a household income of 1,500–3,000 Ethiopian birr (AOR = 4.6; 95% CI: 1.0, 20.1), individuals knowledgeable about optimal breastfeeding practices (AOR: 5.5 95% CI: 1.6, 18.1), individuals counselled about breastfeeding practices during postnatal follow-ups (AOR = 4.940, 95% CI: 1.313, 10.195), and individuals that had a caesarean section delivery (AOR = 4.2, 95% CI: 1.2, 14.1) had a higher chance of practicing optimal breastfeeding. However, mothers who did not attend or have access to antenatal care follow-ups (AOR = 0.1, 95% CI: 0.04, 0.5) were less likely to practice optimal breastfeeding.ConclusionsLess than half of mothers breastfed their children optimally. Factors that influenced this included knowledge of optimal breastfeeding practices, total household income, the woman's occupation, access to breastfeeding counselling during postnatal care follow-ups, access to antenatal care follow-ups, and mode of delivery. It is strongly recommended that optimal breastfeeding awareness programs through health education be done in collaboration with health extension workers, and zonal health offices.

Mothers’ knowledge and their health seeking behavior about neonatal danger signs and associated factors in Fiche town, Oromia region, Ethiopia

ObjectiveThe aim of this study was to assess the risk factors associated with knowledge and health seeking behavior of mothers about neonatal danger signs. MethodsA community based cross-sectional study was conducted among mothers living in Fiche town from November 1, 2018 to October 30, 2019. Data were analyzed using SPSS version 24. Crude and adjusted odds ratios (95% CI) were calculated and all results were deemed to be statistically significant when p < 0.05. ResultAmong the 360 participants, 186 (51.7%) of mothers were found to have a good knowledge about neonatal danger signs. Having antenatal care follow-up [AOR = 6.35, 95% CI: 4.084, 17.206] and having college and above level of education [AOR = 2.071, CI: 1.311–14.690] were significantly associated with a good knowledge of neonatal danger sign and getting post-natal care was a predictor of good health seeking behavior [AOR = 3.720, 95%CI: 2.876, 13.377]. ConclusionAntenatal care follow-up and mother's level of education were contributing factors for good knowledge of neonatal danger sign and post-natal care was a significant factor for health seeking behaviors of mothers. Therefore, the antenatal and post natal health care workers should educate mothers on various reproductive health issues.

Age-appropriate vaccination coverage and its determinants for the polio containing vaccine 1-3 and measles-containing vaccine doses in Zhejiang province, China: A community-based cross-sectional study

ABSTRACT Background: This study aimed to evaluate the age-appropriate coverage and its associated risk factors for the primary vaccination of Polio containing vaccine (PCV) and measles-containing vaccine (MCV) through the secondary use of the 2018 Zhejiang provincial coverage survey among children aged 12–23 months. Methods: Data were collected through structured pre-tested Chinese version questionnaire by face-to-face interview among 770 mothers whose children aged 12–23 months. Age-appropriate vaccination coverage was measured using Chinese vaccination schedule recommendation. Bivariate and multivariate logistic regression models were adopted to identify determinants of the age-inappropriate vaccination. Results: The age-appropriate vaccination coverage of PCV1, PCV2, PCV3, and MCV was 88.8%, 80.8%, 73.6%, and 75.7%, respectively. The risk factors associated with the age-inappropriate vaccination of PCV 1–3 dose and MCV included child’s gender, birthplace, living area, maternal education level, immigration status, monthly household income, participation of the pregnant women’s seminar, antenatal care follow-up, knowledge on vaccination. Conclusion: The proportions of age-appropriate vaccination coverage were low compared with the up-to-date coverage. Modifiable factors were associated with age-inappropriate vaccinations. Vaccination interventions should consider identified modifiable factors to improve age-appropriate vaccination coverage.

Exclusive breastfeeding for the first six months of life and its associated factors among children age 6-24 months in Burao district, Somaliland

BackgroundAdequate nutrition during early childhood ensures growth and development of children and breast milk is better than any other products given to a child. However, studies on exclusive breastfeeding practice are limited in Somaliland. Therefore, this study was aimed to assess exclusive breastfeeding for the first 6 months of life and its associated factors among children 6–24 months of age in Burao district, Somaliland.MethodsA community-based cross-sectional study was conducted from 26 August to 10 October 2018, in Burao district among randomly, selected 464 mothers with children 6–24 months of age. Data were collected through face-to-face interview using pretested structured questionnaire.ResultsThe prevalence of exclusive breastfeeding was 20.47% (95% CI 18.84, 23.63%). Exclusive breastfeeding practice was associated with: having female child (AOR 0.48; 95% CI 0.29, 0.80)), lack of formal education (AOR 0.32; 95% CI 0.19, 0.53), household monthly income 100$-200$ (AOR 0.35;95% CI 0.18, 0.68), lack of husband’s support (AOR 0.32; 95% CI 0.19, 0.53), and mothers who were not counselled on breastfeeding during antenatal care (AOR = 0.33; 95% CI 0.16, 0.66).ConclusionsExclusive breastfeeding practice was very low as compared to recommendations of infant and young child practice (IYCF) which recommends children to exclusively breastfeed for the first 6 months of life. Exclusive breastfeeding practice was associated with a mother’s lack of formal education, monthly income less than 100$, being a female child, lack of advice on exclusive breastfeeding during antenatal care and lack of husband support. The promotion of education for women, husband’s engagement, encouraging antenatal care follow-up and counseling of exclusive breastfeeding during antenatal care was recommended to improve exclusive breastfeeding practice.

HIV testing, test results and factors influencing among infants born to HIV positive mothers in public hospitals of Mekelle City, North Ethiopia: a cross-sectional study

BackgroundTimely infant testing for HIV is critical to ensure optimal treatment outcomes among exposed infants. While world health organization recommends HIV exposed infants to be tested between 4 to 6 weeks of age, in developing countries like Ethiopia, access to timely infant testing is still very limited. The study is intended to assess timely infant testing, testing for HIV at the 18th month, test results and factors influencing HIV positivity among infants born to HIV positive mothers in public hospitals of Mekelle, Ethiopia.MethodsA cross-sectional study design was employed on 558 HIV exposed infants, using consecutive sampling technique. A checklist was used to extract 4 years (January 2014–December 2017) secondary data, collected from January–April 2018. Data were analyzed using SPSS version 20, and binary logistic regression model was used to examine the association of independent variables with the outcome variables.ResultsTimely infant testing for HIV accounted for 346(62.0%). Mothers who attended antenatal care (AOR: 2.77; 95% CI: 1.17, 6.55) and who were counselled on feeding options (AOR: 2.01; 95% CI: 1.11, 3.65) were strongly associated with timely infant testing. Poor maternal adherence status was associated with infants’ HIV positivity at the 18th month of antibody test (AOR: 15.93; 95% CI: 2.21, 94.66). Being rural resident (AOR: 4.0; 95% CI: 1.23, 13.04), being low birth weight (AOR: 5.64; 95% CI: 2.00, 16.71) and not receiving ARV prophylaxis (AOR: 4.70; 95% CI: 1.15, 19.11) were positively associated with the overall HIV positivity.ConclusionsA considerable proportion of exposed infants did not undergo timely testing for HIV. Antenatal care follow-up and counselling on feeding options were associated with timely infant testing. Mother’s poor adherence status was associated with infant’s HIV positivity at the 18th month of antibody testing. Being rural resident, being low birth weight, and not receiving ARV prophylaxis were the factors that enhance the overall HIV positivity. Timely infant testing, counselling on feeding options and adherence should be intensified, and prevention of mother-to-child transmission program in rural settings need to be strengthened.

Determinants of adverse birth outcome in Tigrai region, North Ethiopia: Hospital-based case-control study

BackgroundAdverse birth outcome which attributes to most perinatal deaths is an important indicator of child health and survival. Hence, this study aims to identify determinants of adverse birth outcome among mothers who gave birth in public hospitals of Tigrai region, North Ethiopia.MethodsHospital based case-control study was conducted in Tigrai region, Ethiopia between December 2015 and January 2016 among 405 (135 cases and 270 controls) consecutively selected mothers who gave birth in four randomly selected public Hospitals. Mothers with adverse birth outcome (preterm birth; < 37 gestational weeks at birth, low birth weight; < 2.5 kg at birth, or still birth) were the cases while mothers without adverse birth outcome (live birth, birth weight ≥ 2.5 kg and of ≥37 gestational weeks at birth) were the controls. Data were collected by interview and reviewing medical records using structured questionnaire. The collected data were entered into database using EPI info version 3.5.1 then exported to SPSS version 21 for analysis. Finally, multivariate logistic regression was used to identify determinants of adverse birth outcomes at P value < 0.05.ResultThe mean age of cases and controls was 27.3 (SD = 6.6) and 26.14 (SD = 4.9) years, respectively. In a multivariate analysis; less than four antenatal care visits [AOR = 4.35, 95% CI: 1.15–13.50], not receiving dietary counseling [AOR = 11.24, 95% CI: 3.92–36.60], not using family planning methods [AOR = 4.06, 95% CI:1.35–17.34], less than 24 months inter pregnancy interval [AOR = 5.21, 95% CI: 1.89–13.86], and less than 11 g/dl hemoglobin level [AOR = 4.86, 95% CI: 1.83–14.01] were significantly associated with adverse birth outcomes.Conclusion and recommendationThe number of antenatal care visits, ever use of family planning methods, not receiving dietary counseling during antenatal care follow up visits, short inter-pregnancy interval, and low hemoglobin level were identified as independent determinants of adverse birth outcome. A concerted effort should be taken improve family planning use, and antenatal care follow-up with special emphasis to maternal nutrition to prevent adverse birth outcomes.

Risk Factors of Birth Asphyxia Among Neonates Born in Public Hospitals of Tigray, Northern Ethiopia.

IntroductionBirth asphyxia is defined by the World Health Organization as not initiating and maintaining default breathing at birth. Approximately 24% of neonatal deaths occurred annually worldwide due to birth asphyxia. About 3% of the 120 million neonates born each year acquire asphyxia in third world countries. Long-term survivors may experience cerebral palsy, delay in growth, vision, hearing and intellectual deficiency, epilepsy, difficulties with communication and behavior. Thus, this study aims to determine the risk factors of birth asphyxia among neonates who were delivered at public hospitals of Tigray, Ethiopia.Materials and MethodsHospital-based unmatched case-control study design was implemented on 390 samples from January to February 2018. Data were collected by interviews using a structured questionnaire and checklist. The collected data were coded and entered using EpiData version 3.1 statistical software and transported to statistical package for social science (SPSS) version 20 software for analysis. Cross-tabulation and odds ratio with 95% confidence interval were computed. Bivariate logistic regression and multivariable logistic regression were done. Multicollinearity was checked. Goodness of fit was checked by the Hosmer–Lemeshow test.ResultsA total of 260 controls and 130 cases were enrolled in the study. Multivariable logistic regression showed that Primi-parity [AOR 5.5 (CI: 2.5, 12.3)], pre-eclamcia/pregnancy-induced hypertension [AOR12.4 (CI: 4.17, 37.15)], post-term pregnancy [AOR 2.73 (CI: 1.00, 7.55)] meconium-stained liquor [AOR 29.2 (CI: 12.0, 71.1)], cord entangled [AOR 5.67 (CI: 1.66,19.3)] and non-vertex presentation [AOR 5.49 (CI: 2.20,13.7)] were found to be risk factors for perinatal birth asphyxia.Conclusion and RecommendationsIntrapartum factors and neonatal factors in the index pregnancy have an association with perinatal birth asphyxia. The research finding suggests effective antenatal care follow-up and follow-up of labor progress using partograph after labor initiation.