Birth In Ethiopia Research Articles

Prevalence, underlying causes, and determinants of maternal near miss in Ethiopia: a systematic review and meta-analysis.

Maternal near miss (MNM) is one of the newly adopted assessment parameters to gauge the quality of maternity care. In Ethiopia, several studies have been conducted to investigate the incidence, underlying causes, and determinants of MNM. However, the findings from those studies vary greatly and are largely inconsistent. Thus, this review aims to more robustly estimate the pooled prevalence, identify underlying causes, and single out determinants of MNM in Ethiopia. Studies were searched from international databases (PubMed/ Medline, Cochrane Library, and Embase databases) and other potential sites. All observational studies were included. Heterogeneity between studies was checked using Cochrane Q test statistics and I2 test statistics and small study effects were checked using Egger's statistical test at a 5% significance level. Outcome measures were overall and specific underlying causes (obstetrics hemorrhage, hypertensive disorder pregnancy, pregnancy-related infection) rates of MNMs per 10,000 live births. The meta-analysis included 43 studies consisting of 77240 MNM cases. The pooled prevalence MNM per 1000 live births in Ethiopia was 54.33 (95% CI: 33.93 to 85.89). Between-study heterogeneity was high (I2 = 100%, P < 0.0001), with the highest rate observed in Amhara region (384.54 per 1000). The prevalence of obstetrics hemorrhage (14.56 per 1000) was higher than that of hypertensive disorder pregnancy (12.67 per 1000) and pregnancy-related infections (3.55 per 1000) were identified as underlying causes. Various factors, including socio demographic characteristics, previous medical and obstetrics history as well as access to and quality of care obtained, were associated with MNM. Almost six women encounter near miss among a hundred live births in Ethiopia. Obstetric hemorrhage and hypertensive disorder pregnancy were the most common underlying causes of MNM. Both individual and facility level determinants were found to be associated with MNM. Considering the magnitude and identified factors, tailored measures should be taken at every stage of the continuum of care. https://www.crd.york.ac.uk/prospero/, identifier CRD42023395259.

Magnitude of preterm birth and associated factors Among mothers who gave birth in Debre Berhan comprehensive specialized hospital.

Premature deliveries are a major public health issue, with high health, economic, and productivity costs associated with lengthy hospitalizations in neonatal critical care units. The goal of this study was to determine the number of premature births in Ethiopia's Debre Berhan Comprehensive Specialized Hospital and the factors that influence them. The Debre Berhan Comprehensive Specialized Hospital conducted an institution-based cross-sectional study between February and April 2020. A total of 325 study participants were selected using systematic random sampling. Face-to-face interviews using a pre-tested semi-structured questionnaire were used to collect data. For data entry and analysis, Epi data version 3.1 and SPSS version 20 were used. At a P-value of 0.2, bivariate logistic regression analysis was used to categorize candidate variables to the next level, and variables in multivariate logistic regression models with a p-value of 0.05 were considered statistically significant. Preterm births accounted for 16.1% of all births at Debre Berhan Comprehensive Specialized Hospital. Cesarean section [AOR = 2.412; 95% CI (1.154, 5.0370)], twin pregnancy [AOR = 3.524; 95% CI (1.114, 11.150)], and maternal anemia during pregnancy [AOR = 3.124; 95% CI (1.417, 6.887)] were statistically significant associations with the outcome variable in the final logistic regression model. Preterm birth was found to be greater in the study area than in the Global Action Report for Sub-Saharan Africa and a few other countries. Efforts should be made to prevent maternal health issues that lead to caesarean section, and all pregnant mothers should be supplemented with iron and folic acid as soon as feasible. This study suggests that there is still a gap in the field in terms of health service intervention.

The magnitude and associated factors of immediate postpartum anemia among women who gave birth in Ethiopia: systematic review and meta-analysis, 2023

BackgroundThe immediate postpartum period is a very crucial phase for both the life of the mother and her newborn baby. Anemia is the most indirect leading cause of maternal mortality. However, anemia in the immediate postpartum period is a neglected public health problem in Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the pooled magnitude of immediate postpartum anemia and the pooled effect size of associated factors in Ethiopia.MethodsSearching of published studies done through PubMed, Medline, Cochrane, African index Medicus, List of Reference Index, Hinari, and Google Scholar. This systematic review and meta-analysis follow the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) godliness. The quality of studies was assessed by using a Newcastle- Ottawa Scale (NOS) assessment tool. Analysis was performed using a random effect model by using STATA 17 version software. Egger’s weighted regression and I2 test were used to evaluate publication bias and heterogeneity respectively.ResultsIn this systematic review and meta-analysis, a total of 6 studies were included. The pooled magnitude of immediate postpartum anemia in Ethiopia was 27% (95%CI: 22, 32). Instrumental mode of delivery (OR = 3.14, 95%CI: 2.03, 4.24), mid-upper arm circumference (MUAC) measurement < 23 cm (OR = 3.19, 95%CI: 1.35, 5.03), Antepartum Hemorrhage (OR = 4.75, 95%CI: 2.46, 7.03), postpartum hemorrhage (OR = 4.67, 95%CI: 2.80, 6.55), and no iron/foliate supplementation (OR = 2.72, 95%CI: 1.85, 3.60) were the identified factors associated with developing anemia in the immediate postpartum period.ConclusionThe overall pooled magnitude of anemia in the immediate postpartum period among Ethiopian women was still a moderate public health problem. Instrumental mode of delivery, mid upper arm circumference (MUAC) measurement < 23 cm, antepartum hemorrhage, postpartum hemorrhage, and no iron/foliate supplementation were the identified factors associated with higher odds of developing anemia among immediate postpartum women in Ethiopia. Therefore, midwives, and doctors, shall focus on prevention of maternal hemorrhage, nutritional advice and counseling including iron /foliate supplementation, and avoid unnecessary instrumental delivery to prevent and reduce anemia related maternal mortality and morbidity in Ethiopia.PROSPERO registrationCRD42023437414 with registration date on 02/08/2023.

Spatial patterns and determinants of low utilization of delivery care service and postnatal check-up within 2 months following birth in Ethiopia: Bivariate analysis.

Home delivery is a nonclinical childbirth practice that takes place in one's home with or without traditional birth attendants and postnatal care is the care given to the mother and her newborn baby; according to world health organization (WHO), the postnatal phase, begins one hour after birth and lasts six weeks (42 days). This paper aimed to study the spatial pattern and determinant factors of low utilization of delivery care (DC) services and postnatal check-up (PNC) after live births in Ethiopia. This study used the 2016 Ethiopian Demographic and Health Survey data as a source. A total weighted samples of 11023 women-children pairs were included. The bivariate binary logistic regression analyses with spatial effect were modeled using SAS version 9.4 and ArcGIS version 10.8 was used for mapping. The spatial distribution of low utilization of delivery care service and postnatal check-up were significantly clustered in Ethiopia (Moran's I statistic 0.378, P-value < 0.001 and 0.177, P-value < 0.001 respectively). Among 11023 children-women pair, the prevalence of home delivery and no postnatal check-up within two months following birth were 72.6% and 91.4% respectively. The Liben, Borena, Guji, Bale, Dolo and Zone 2 were predicted to have high prevalence of home delivery and part of Afder, Shabelle, Korahe, Dolo and Zone 2 were high risk areas of no postnatal checkup. Lack of occupation, region, large family size, higher birth order, low utilization of antenatal care visit, unable to access mass media, big problem of health facility distance and the spatial variable were found to be jointly significant predictors of low utilization of DC and PNC in Ethiopia. Whereas older age, being reside in rural area and low wealth status affects delivery care service utilization. We suggest health providers, policy makers and stakeholders consider those variables with priority given to Liben, Borena, Guji, Bale, Dolo, Zone 2, Afder, Shabelle and Korahe, where home delivery and no PNC were predicted relatively high. We also recommend researchers to conduct further studies using latest survey data set.

Predicting the potential impact of scaling up four pneumonia interventions on under-five pneumonia mortality: A prospective Lives Saved Tool (LiST) analysis for Bangladesh, Chad, and Ethiopia.

Pneumonia remains the leading cause of mortality in under-five children outside the neonatal period. Progress has slowed down in the last decade, necessitating increased efforts to scale up effective pneumonia interventions. We used the Lives Saved Tool (LiST), a modelling software for child mortality in low- and middle-income settings, to prospectively analyse the potential impact of upscaling pneumonia interventions in Bangladesh, Chad, and Ethiopia from 2023 to 2030. We included Haemophilus influenzae type B (Hib) vaccination, pneumococcal conjugate vaccine (PCV), oral antibiotics, pulse oximetry, and oxygen as pneumonia interventions in our analysis. Outcomes of interest were the number of pneumonia deaths averted, the proportion of deaths averted by intervention, and changes in the under-five mortality rate. We found that 19 775 lives of children under-five could be saved in Bangladesh, 76 470 in Chad, and 97 343 in Ethiopia by scaling intervention coverages to ≥90% by 2030. Our estimated reductions in pneumonia deaths among children under five range from 44.61% to 57.91% in the respective countries. Increased coverage of oral antibiotics, pulse oximetry, and oxygen show similar effects in all three countries, averting between 18.80% and 23.65% of expected pneumonia deaths. Scaling-up PCV has a prominent effect, especially in Chad, where it could avert 14.04% of expected pneumonia deaths. Under-five mortality could be reduced by 1.42 per 1000 live births in Bangladesh, 22.52 per 1000 live births in Chad, and 5.48 per 1000 live births in Ethiopia. This analysis shows the high impact of upscaling pneumonia interventions. The lack of data regarding coverage indicators is a barrier for further research, policy, and implementation, all requiring increased attention.

Hotspot areas of tetanus-unprotected births and its associated factors in Ethiopia: Spatial analysis of EDHS data

ABSTRACT Neonatal tetanus persists as a public health problem in many developing countries including Ethiopia. Maternal tetanus toxoid vaccination is a cornerstone to prevent neonatal tetanus. However, its prevalence is low in Ethiopia, and little has been devoted to its spatial epidemiology and associated factors. Hence, this study aimed to explore the spatial pattern and factors affecting tetanus-unprotected births in Ethiopia. A further analysis of the 2016 Ethiopia Demographic and Health Survey data was conducted, and a weighted sample of 7590 women was used for analysis. Spatial analysis was done using ArcGIS and SaTScan software. A binary logistic regression model was fitted to identify factors and variables with a p-value <.05 were considered as statistically significant. About 54.13% (95% CI: 53.01, 55.25) of births were not protected against neonatal tetanus, and spatial clustering of tetanus unprotected births was observed (Moran’s I = 0.144, p-value = .028). The primary and secondary SaTScan clusters were detected in Northeastern Tigray, Eastern Amhara, and almost the entire Afar (RR = 1.34 & LLR = 66.5, p < .01), and in the Somali region, and the western border of Gambela (RR = 1.44 & LLR = 31.3, p < .01), respectively. Tetanus unprotected births were higher among women without formal education (AOR = 1.63; 95% CI: 1.29, 2.04), came from poor households (AOR = 1.27; 95% CI: 1.12, 1.45), who had no ANC contact (AOR = 6.97; 95% CI: 6.21, 7.88), and who were not exposed to the media (AOR = 1.26; 95% CI: 1.09, 1.47). Hence, tetanus-unprotected birth hotspots require priority interventions, and it is good if the targeted interventions consider the identified factors.

Association between anemia in pregnancy with low birth weight and preterm birth in Ethiopia: A systematic review and meta-analysis.

Anemia in pregnancy has been associated with a number of adverse birth outcomes, such as low birth weight (LBW) or preterm birth (PTB). However, the evidence from primary studies on anemia in pregnancy with LBW and PTB is contentious. Moreover, a systematic review and meta-analysis to summarize these findings have not been conducted for Ethiopia. This study aimed to synthesize the best available evidence and quantify the strength and direction of the association of anemia in Ethiopia. This review examined women with singleton pregnancies with low birth weight (LBW) and preterm birth (PTB). We retrieved studies from PubMed, Wiley, Cochrane databases, and Google Scholar from inception to February 2, 2024. The World Health Organization (WHO) defines anemia in pregnancy as a low blood haemoglobin (Hgb) concentration below 11 g/dl or a hematocrit level of < 33%. When the newborn's weight was below 2500 g, LBW was considered. Preterm birth refers to the birth of a baby before 37 completed weeks of gestation. Meta-analysis was conducted using fixed and random effects models. The degree of heterogeneity, publication bias, and quality of the evidence of studies was assessed. There were 35 and 8 studies, with 14,319 and 3,265 respondents included in the meta-analysis for LBW and PTB, respectively. Neonates born to women who had normal Hgb levels were less likely to be LBW [pooled odds ratio (POR) = 0.22, 95% CI: (0.17, 0.28); I2 = 80%] (low-quality evidence). Neonates born to women with normal Hgb levels had a lower risk of PTB [POR = 0.22, 95% CI: 0.18, 0.28; I2 = 19%] (very low-quality evidence). The effect size estimate remained significant after sub-group analysis based on study design and province, except in two retrospective cohort studies for LBW. The findings suggest major implications for strengthening the implementation of nutrition policies to prevent anemia during pregnancy in Ethiopia. Further research is warranted to assess interventions that are effective in combating maternal anemia to reduce rates of LBW and PTB.

Prevalence of emergency caesarean delivery and its predictors among women who give birth in Ethiopia using further analysis of EDHS 2016 data: A mixed effect model.

Emergency caesarean delivery is a surgical procedure that is decided after the labour pain has started. According to the global report of the World Health Organization, the rate of caesarean sections has risen over time. In Ethiopia, the overall caesarean delivery was 18%, which varied between 46% in the private sector and 15% in the public sector. But specifically, the magnitude of emergency caesarean delivery and its predictors are not well addressed in Ethiopia. Therefore, this study was aimed at assessing the prevalence and predictors of emergency caesarean delivery in Ethiopia using EDHS 2016. A cross-sectional study was used, and a total of 11,022 samples were included in this study. The Ethiopian Demographic Health Survey 2016 data set was used as a data source. The STATA version 17 software was used for descriptive, bi-variable, and multivariable analysis. Multilevel binary logistic regression was used to identify the significant factors at a p-value of <0.05 and a 95% confidence level. Model comparison and goodness of fit was assessed by AIC. The prevalence of emergency caesarean deliveries in Ethiopia was 1.2% (95% CI: 0.58, 1.78). History of fistula (AOR = 7.82, 95% CI: 1.59-38.4), age ≥ 35 years (AOR = 6.98, 95% CI: 3.33-14.63), and rural residence (AOR = 2.23, 95% CI: 1.25-3.21) were the predictors of emergency caesarean delivery. As compared to the previous study, the prevalence of emergency caesarean delivery was low. Women with a history of fistula, from rural residence, and age≥ 35 years were at risk for emergency caesarean delivery. Therefore, interventions need to be encouraged to give attention to rural women whose age is ≥ 35 years and fistula reduction activities, such as avoiding early marriage, to reverse the problem. Early and accurate screening of women for emergency cesarean delivery by encouraging co-services like ANC is also recommended.

Birth prevalence and risk factors of neural tube defects in Ethiopia: a systematic review and meta-analysis

ObjectiveThis study aims to estimate the prevalence of neural tube defects (NTDs) and to identify potential risk factors in the Ethiopian context.Study designSystematic review and meta-analysis.Study participantsA total of 611...

Spatial pattern and determinants of institutional delivery in Ethiopia: Spatial and multilevel analysis using 2019 Ethiopian demographic and health survey.

In Ethiopia, despite the progress that has been made to improve maternal and child health, the proportion of births occurring at health institutions is still very low (26%), Which significantly contribute to a large number of maternal death 412 deaths/100,000 live births. Therefore, this study intended to determine spatial pattern and factors affecting institutional delivery among women who had live birth in Ethiopia within five years preceding survey. Data from 2019 Ethiopian demographic and health survey were used. Taking into account the nested structure of the data, multilevel logistic regression analysis has been employed to a nationally representative sample of 5753 women nested with in 305 communities/clusters. A significant heterogeneity was observed between clusters for institutional delivery which explains about 57% of the total variation. Individual-level variables: primary education (OR = 1.8: 95% CI: 1.44-2.26), secondary education (OR = 3.65: 95% CI: 2.19-6.1), diploma and higher (OR = 2.74: 95% CI: 1.02-7.34), women who had both Radio and Television were 4.6 times (OR = 4.6; 95% CI: 2.52, 8.45), four and above Antenatal visit (AOR = 2.72, 95% CI:2.2, 3.34), rich wealth index (OR = 2.22; 95% CI: 1.62-2.99), birth interval for 18 to 33 months (OR = 1.8; 95% CI: 1.19, 2.92), and women who space birth for 33 and above months (OR = 2.02; 95% CI: 1.3, 3.12) were associated with institutional delivery. Community level variables, community high proportion of antenatal visit (OR = 4.68; 95% CI: 4.13-5.30), and Region were associated with institutional delivery. A clustered pattern of areas with low institutional delivery was observed in Ethiopia. Both individual and community level factors found significantly associated with institutional delivery theses showed the need for community women education through health extension programs and community health workers. And the effort to promote institutional delivery should pay special attention to antenatal care, less educated women and interventions considering awareness, access, and availability of the services are vital for regions. A preprint has previously been published.

Factors associated with modern contraceptives uptake during the first year after birth in Ethiopia: A systematic review and meta-analysis.

Though postpartum family planning helps women to achieve the recommended birth interval before next pregnancy, its utilization in Ethiopia is low. Understanding drivers and barriers is key to improve postpartum family planning uptake. The aim of this systematic review and meta-analysis is to analyze and summarize predictors of postpartum family planning uptake, during the first year after birth, in Ethiopia. We conducted a systematic review and meta-analysis of observational studies published in English before April 16, 2021. We searched electronic sources like PubMed, MEDLINE, CINHAL Embase, Google and supplemented it with manual search. Two reviewers appraised independently the studies using the Joanna Briggs Institute Quality Assessment Tool for the observational studies. Data synthesis and analysis were conducted using Review Manager Version 5.3. The Cochrane Q test statistic and I2 tests were used to assess the heterogeneity among the included studies. A random-effects and fixed effect model were used to calculate pooled Odds Ratio and its 95% CI. A total of 22 studies were included in the review. Better educational status of women[OR = 2.60; 95% CI: 2.15, 3.14], women's marital status [OR = 4.70; 95% CI: 1.51, 14.60], resumption of sexual intercourse [OR = 6.22; 95% CI: 3.01, 12.86], menses return [OR = 3.72; 95% CI: 1.98, 6.99], PPFP discussion with partner [OR = 2.53; 95% CI: 2.00, 3.20], women's previous PPFP information [OR = 4.93; 95% CI: 2.26, 10.76], PPFP counseling during ANC [OR = 3.95; 95% CI: 2.50, 6.23], having PNC [OR = 4.22; 95% CI: 2.80, 6.34], having experience of modern contraceptive use [OR = 2.90; 95% CI: 1.62, 5.19], facility birth [OR = 6.70; 95% CI: 3.15, 14.25], and longer interval after last delivery [OR = 0.37; 95% CI: 0.32, 0.43] were significantly associated with modern contraceptive uptake during postpartum period. Our systematic review identified modifiable factors and estimated their association with PPFP uptake. Since most of these factors are related to reproductive health characteristics and MNCH services, integrating PPFP into MNCH services particularly at primary health care unit may improve contraceptive uptake during postpartum period. Systematic review registration: PROSPERO: 2020: CRD42020159470.

Does health sector aid matter? Evidence from time-series data analysis in Ethiopia

Aims: Development assistance for health is an important part of financing health care in developing countries. In spite of the increasing volumes in absolute terms in development assistance for health, there are controversies on their effect on health outcomes. Therefore, this study aims to analyze the effect of development assistance for health on health status in Ethiopia. Methods: Using dynamic time series analytic approach for the period 1978-2013, this paper examines whether development assistance for health has contributed for health status change in Ethiopia. While life expectancy at birth was used as a measure of health status, vector error correction model was used for the analysis. Results: Development assistance for health expenditure (lagged one and two years) had a significant positive effect on life expectancy at birth in Ethiopia. Other things being equal, a 1% increase in per capita development assistance for health leads to 0.026 years improvement in life expectancy at birth (P&lt;0.001) in the immediate year following the period of assistance, and 0.008 years (P=0.025) in the immediate two years following the provision of assistance. Conclusion: This study indicates that, seemingly, development assistance for health has significant favourable effect in improving health status in Ethiopia. The policy implication of this finding is development assistance for the health should continue as an interim means to an end.

ENSEMBLE LEARNING BASED POSTPARTUM HEMORRHAGE DIAGNOSIS FOR 5G REMOTE HEALTH CARE

The fifth-generation (5G) communications enables various promising applications that were once impossible, e.g. remote healthcare with the help of fast and reliably delivery of medical data. Post-partum hemorrhage (PPH) refers to the massive blood loss after the birthing stage (within 24 hours), i.e.&gt;500ml for the vaginal delivery, and &gt;1000ml for the cesarean section. PPH is by far the most common cause of the mortality rate of pregnant women, as well as a primary cause of current pregnant mortality in China. Despite the great potential of prediction of PPH, there is currently no effective tool based on the limited raw data from the clinical trials. In the study, we retrospectively study the 3842 vaginal delivery cases in 2017 collected from Beijing Obstetrics and Gynecology Hospital, Capital Medical University. In particular, we obtain the prediction based diagnostic model relying on machine learning, and we adopt the ensemble learning to accomplish this task, by combining the results of various candidate methods. According to the experimental results, the accuracy of correct PPH diagnosis would approach 96.7%; the total disseminated intravascular coagulation (DIC) prediction accuracy approaches 90.3%. In this regard, we may conclude the proposed model based on machine learning would allow us to predict successfully the risk of PPH, and assess the critical level of PPH patient. We anticipate our study results would contribute to the reduction the mortality of pregnant women. According to the 2013 World Health Statistics, the maternal mortality rate in low-income countries were 410/100,000 live births. The majority of maternal deaths occurred mainly in Asian and African countries. Major causes of maternal deaths are similar across low-income countries, often obstetric in origin including hemorrhage, hypertensive diseases and maternal infections. 94% of births in Ethiopia are estimated to occur at home and 10% of maternal deaths are attributed to PPH. Uterine atony, or lack of effective contraction of the uterus, is the most common cause of PPH followed by infection, sub involution of the placental site, and inherited coagulation deficits. The majority of these fatal obstetric complications occur during labor and immediately after birth. In the low-income countries, more than three-quarters of maternal deaths due to the direct obstetric causes occur during and after birth. Organized diagnosis and management of PPH, including administration of uterotonic agents, controlled cord traction, and uterine massage after delivery of the placenta, are required to avoid maternal death.

Magnitude and associated factors of low birth weight among term newborns delivered in Addis Ababa public hospitals, Ethiopia, 2021

Only 14% of births had information on birth weight available at the time of birth in Ethiopia. Hence, previous studies underestimate the magnitude and associated factors of low birth weight (LBW). As a result, the goal of this study is to fill those gaps in the previous studies. An institution-based cross-sectional study was employed. Binary logistic regression was used to identify the associated factors. In this study, the magnitude of LBW was 13.06%. History of chronic medical illness (AOR = 3; 95% CI: (1.02, 9.17)), haemoglobin level during pregnancy (AOR = 0.23; 95% CI: (0.10, 0.50)), iron/folic acid supplementation (AOR = 0.27; 95% CI: (0.10, 0.72)) and extra meal during pregnancy (AOR = 3.2; 95% CI: (1.52, 7.00)) were significantly associated with LBW. The magnitude of LBW in this study was comparable to the Ethiopian Demographic and Health Survey (EDHS) report from 2016. It is better to intervene in those identified factors in order to reduce LBW. Impact Statement What is already known on this subject? Low birth weight (LBW) accounts for 60–80% of all neonatal deaths each year. In developing countries like Ethiopia, LBW is a major public health concern. Almost half of the world's infants are not weighed at birth, a figure that is especially high in sub-Saharan Africa including Ethiopia. What do the results of this study add? Only 14% of births had information on birth weight available at the time of birth in Ethiopia. Hence, previous studies underestimate the magnitude and associated factors of LBW. To meet the Sustainable Development Goals (SDGs)-2030 targets for neonatal and child mortality, sufficient evidence on the magnitude of LBW and associated factors must be important in order to contribute to the development of timely interventions. A history of chronic medical illness, haemoglobin level, iron/folic acid supplementation and extra meal during pregnancy was associated with LBW. What are the implications of these findings for clinical practice and/or further research? The findings of this study will be useful in developing better health policies to prevent LBW as well as interventions that can target the identified factors.

Spatial distribution and determinants of newbornsnot receiving postnatal check-up withintwodays after birth in Ethiopia: a spatial and multilevel analysis of EDHS 2016

BackgroundAccessibility and utilization of postnatal newborn check-ups within 2 days after delivery are critical for a child’s survival, growth, and development. However, the service delivery is not yet improved and fluctuates across the geographical locations in Ethiopia. Therefore, this study aimed to assess the spatial distribution and determinants of newborns not received postnatal check-ups within 2 days after birth in Ethiopia.MethodsA secondary data analysis of the Ethiopia Demographic and Health Survey (EDHS) 2016 was done among live births within 2 years preceding the survey. A multilevel binary logistic regression model was fitted to identify the factors associated with the outcome variable. Adjusted Odds Ratio with 95% (Confidence Interval) was calculated and used as a measure of associations and variables with a p-value < 0.05, were declared as statistically significant.ResultsA total of 4036 live newborns in Ethiopia were included in the analysis, of whom half (51.21%) were females. The mean age of the mothers was 33+ SD 1.3, and more than 60 % (61.56%) of the mothers were not educated. The national prevalence of newborns not receiving postnatal check-ups within 2 days after birth was 84.29 (95% CI: 83.10–85.41) with significant spatial variations across the study area. Mothers who had no ANC visits were 58% higher than (AOR = 0.42(0.27–0.66) mothers who had > 4 ANC visits. Mothers who gave birth at home and others were 80% (AOR = 0.02(0.01–0.29) and 25% (AOR = 0.76(0.59–0.99), higher than mothers delivered at hospital. Rural mothers were 1.90 times higher (AOR = 1.90(1.29–2.81) than urban mothers, and mothers live in administrative regions of Afar 66% (AOR = 0.34(0.16–0.69), Oromia 47% (AOR = 0.53(0.30–0.91), Somali 60% (AOR = 0.40 (0.22–0.74),Benishangul 50% (AOR = 0.50 (0.27–0.92), SNNPR 67% (AOR = 0.33(0.19–0.57), Gambela 70% (AOR = 0.30 (0.16–0.56), Harari 56% (AOR = 0.44 (0.25–0.78), and Dire Dawa70% (AOR = 0.30 (0.17–0.54) were higher than Addis Abeba for not receiving postnatal checkup of new born within the first 2 days, respectively.ConclusionsLow postnatal check-up utilization remains a big challenge in Ethiopia, with significant spatial variations across regional and local levels. Spatial clustering of not receiving postanal check-ups within 2 days was observed in Afar, Oromia, Gambela, Benishangul, SNNPR, Harari, and Dire Dawa regions. Residence, ANC visits, place of delivery, and administrative regions were significantly associated with not receiving postnatal check-ups. Geographically targeted interventions to improve ANC follow-up and institutional delivery should be strengthened.

Bayesian Shared Frailty Models for Time to First Birth of Married Women in Ethiopia: Using EDHS 2016

Introduction The primary effect of the fertility process is the birth of the first child. The ages at which women establish marital union and give their first birth depend on and result in varying demographic features. This research demonstrates how to examine the effect of numerous factors on married women's delay to first birth in Ethiopia using Bayesian parametric models with gamma shared frailty distribution. Methods This study analyzed data from the 2016 EDHS on factors related to the time of married women to first birth. A sample of 8810 married women from all parts of Ethiopia participated in the study. The Akaike information criterion (AIC) and Bayesian information criterion (BIC) were used to compare several parametric models with gamma shared frailty distributions to find the best model (BIC). Finally, when the prior data was taken into account, the chosen model was proven to be accurate (Bayesian approach). Results The median survival time for the first birth after marriage is 24 years (95% CI; 23.4, 25.3). The result shows that the place of residence, the access to media, the level of education of the mother, the education level of the husband, the use of the head of the contraceptives, and the sex of the household are statistically associated with the time to first birth of married women. The Weibull-gamma shared frailty model under the Bayesian approach was found to be the best model that fit the time to first birth data in this study. The result also showed that there is heterogeneity between regions of married women. Conclusion To slow the increase in the Ethiopian population, families must be taught how to use contraception, and rural populations must be educated on the necessity of increasing the length of the first birth gap rather than encouraging early marriage. In general, attempts to reduce fertility by raising the age of the first marriage must consider the social and cultural settings in which marriage takes place. On the other hand, the campaign against early marriage should focus on the sociocultural, physiological, and psychological effects, as well as the reduction of reproduction.

Determinants of place birth: a multinomial logistic regression and spatial analysis of the Ethiopian mini demographic and health survey data, 2019

BackgroundMaternal and neonatal health significantly improves when birth is attended at health institutions where there are quality services and skilled attendants. In contrary, home birth results in high rates of maternal and neonatal mortality. Thus, this study aimed to determine the spatial distribution of home birth and to identify determinants of place of birth in Ethiopia based on the recent national survey.MethodsEthiopian mini-DHS-2019 data was used in this analysis. A weighted sample of 5423 mothers were included. While health facility was a reference, home and health post were used as comparison categories to identify determinants of place of birth in a survey multinomial logistic regression model. An adjusted relative risk ratio, marginal effect, and a corresponding 95% confidence interval and a p-value of < 0.05 were used to declare statistical significance. The Global Moran’s I analysis was done by using ArcMap 10.8 to evaluate the clustering of home birth. The prevalence of home birth was predicted by ordinary kriging interpolation. Then, scanning was done by SaTScan V.9.6 software to detect scanning windows with low or high rates of home birth.ResultPrevalence of home birth in Ethiopia was 52.19% (95% CI: 46.49 – 57.83). Whereas, only 2.99% (95% CI: 1.68 – 5.25) of mothers gave birth in the health posts. Bigger family size, family wealth, multiparity, none and fewer antenatal visits, and low coverage of cluster level 4 + antenatal visits were predictors of home birth. Also, home birth was clustered across enumeration areas and it was over 40% in most parts of the country with > 75% in the Somali region. SaTScan analysis detected most likely primary clusters in the Somali region and secondary clusters in the rest five regions of the country.ConclusionHome birth is a common practice in Ethiopia. Among public health facilities, health posts are the least utilized institutions for labor and delivery care. Nationally, implementing the 2016 WHO’s recommendations on antenatal care for a positive pregnancy experience and providing quality antenatal and delivery care in public facilities by qualified providers and back-up systems in place could be supportive.

Home birth prevalence and associated factors in southwest Ethiopia

Background/Aim In Ethiopia, antenatal care takes a focused approach, where women are encouraged to give birth in a health facility, as there are no services that provide skilled birth attendants for home births. However, nearly half of mothers booked for antenatal care give birth at home, which is associated with a higher risk of maternal mortality and poor outcomes. This study aimed to assess the prevalence of home birth and associated factors among women in southwest Ethiopia. Methods A community-based cross-sectional study was conducted using simple random sampling. Data were collected from 1 February 2018 to 30 April 2018 from 1831 women who had given birth in the last year in selected zones of southwest Ethiopia, using a structured interviewer-administered questionnaire. The data were cleaned and exported to STATA 14 for analysis, both by bivariate and multivariate logistic regression. P≤ 0.05 at 95% confidence interval of odds ratio was taken as significant in the multivariable model. Results Approximately half (54.5%) of the participants gave birth at home. Rural residence (adjusted odds ratio=0.46, P=0.032), listening to the radio (adjusted odds ratio=0.53, P=0.047), attending 3–5 antenatal care visits (adjusted odds ratio=0.40, P=0.031), being widowed or divorced (adjusted odds ratio=2.89, P=0.045), prolonged labour (adjusted odds ratio=0.76, P=0.021) and waiting time for antenatal care services (adjusted odds ratio=1.85, P=0.042) were significantly associated with home birth. Conclusions More than half of the participants gave birth to their last child at home, and this decision was affected by residence, prolonged labour, antenatal care frequency, media, marital status, and waiting time for antenatal care services. Interventions to increase institutional birth should prioritise those who do not attend antenatal care, are not exposed to media or who are widowed or divorced. Similarly, reducing antenatal care waiting time and encouraging mothers to attend antenatal care are vital to improving rates of institutional birth in Ethiopia.

Uptake of tetracycline eye ointment prophylaxis among newborns in Ethiopia: A 2016 secondary analysis of Ethiopian Demographic health survey

BackgroundOphthalmia neonatorum is one of the main causes of blindness among newborns in developing countries like Ethiopia. According to WHO recommendation, tetracycline eye ointment prophylaxis is applied to the newborns eye to prevent neonatal conjunctivitis in Ethiopia. However, not all newborns get tetracycline prophylaxis at birth in Ethiopia. Information is scarce about TTC eye prophylaxis in Ethiopia. ObjectiveThis study aimed to assess prevalence and factors associated with tetracycline eye ointment prophylaxis among newborns in Ethiopia in 2016. MethodsThis study used the 2016 Ethiopian Demographic and Health Survey data (EDHS) data for analysis. Analysis was restricted to newborns that were born alive in the past five years prior to 2016. Data were weighted to correct sampling bias. Furthermore, complex data analysis was done. Bivariate logistic regression was carried out to identify association between outcome and independent variables and factors with COR with 95%CI was computed and variables with p-value less than 0.25 were taken as candidate variable for multivariable logistic regression analysis. An adjusted odds ratio with 95% confidence interval was computed and a P-value less than 0.05 considered as significant level for identification of as association. Descriptive analysis was presented using tables and charts. ResultsPrevalence of tetracycline eye ointment is 1103(14.5%) in this study. Newborns in Dire-Dawa (AOR = 1.7, 95%CI, 1.2, 2.6), urban (AOR = 2.4, 95%CI, 1.9, 2.98), poorer (AOR = 2.21, 95%CI, 1.6, 2.7), neonates of rich women (AOR = 1.32, 95%CI, 1.1, 1.63), newborns of women who start ANC from 3 to 6 months (AOR = 3.11, 95%CI, 2.53, 3.82), newborns of women who own mobile (AOR = 1.28, 95%CI, 1.04, 1.61) were the positive predictors of tetracycline eye ointment prophylaxis uptake in Ethiopia. ConclusionThe uptake of tetracycline eye ointment prophylaxis among newborns is low in this study. Living in Dire-Dawa, urban, rich families, women ownership of mobile cell phones and early intiation of antenatal care were factors associated positively with tetracycline eye ointment. Hence, we recommend integrating essential newborn care information into antenatal care services. Finally, policy makers and programmers should design and strengthen health information though digital platforms like social media.

The magnitude of episiotomy among women who gave birth in Ethiopia: Systematic review and meta-analysis.

Episiotomy is one of the most common obstetric procedures done by health providers putting the client at high risk of developing complications and lacerations. These days, episiotomy has been done at an alarming rate in Ethiopia as compared to the slant set by World Health Organization. Be that as it may, there is a need for nationally representative data. This study aimed to determine the pooled prevalence of episiotomy practice among women who gave birth at public health institutions in Ethiopia. We accessed PubMed, Web of Science, Google Scholar, EMBASE, and manual search was used to retrieve articles. The extractions of the data were done by using Microsoft Excel and analyzed by STATA version 11 statistical software. The publication bias was checked by funnel plot visually and Egger's test and Begg's test, with P <0.05 considered indicating potential publication bias. I2 was used to check the presence of heterogeneity of the studies. Overall estimated analysis was done. Subgroup analysis was done by region. We carried out a leave-one-out sensitivity analysis. The Joanna Briggs Institute risk of bias assessment tool was used. Out of 254 articles retrieved, 9 studies met the eligibility criteria and are thus included in this study. The overall episiotomy practice in Ethiopia was 45.01% (95% CI: 36.288, 53.741). Based on the sub-group analysis, prevalence of episiotomy practice was 49.32% (95%CI: 12.67, 85.97), 46.92% (95%CI: 29.47, 64.37), 44.23% (95%CI: 37.77, 50.99) and 38.29 (95%CI: 32.38, 44.20) among South region, Addis Ababa, Amhara region and Tigray region respectively. The findings revealed that the prevalence of episiotomy practice in Ethiopia was high (45.01%). Therefore, it is better to have periodic training for birth attendants on the indication of episiotomy and the appropriate use of guidelines to reduce the rate of episiotomy.