Magnitude and Reasons for Harmful Traditional Practices among Children Less Than 5 Years of Age in Axum Town, North Ethiopia, 2013

Prevalence of traditional uvulectomy and its associated factors among parents who had less than 6 months of infants in Gondar City, north-west Ethiopia: Mixed study design

BACKGROUND

Traditional uvulectomy is widely practiced in Africa especially in sub-Saharan countries including Ethiopia. Limited Studies conducted in different times and areas of the world have shown that the prevalence of uvulectomy and its associated factors are varied from country to country. There is limited evidence to determine the prevalence and reasons of malpractice in Ethiopia. Therefore, this study aimed to assess the prevalence of traditional uvulectomy, and its associated factors among parents who had children aged less than 6 months.

METHODS

A community-based cross-sectional mixed study design was conducted among 630 participants selected by a systematic sampling technique. Data were collected using a pretested interviewer-administered questionnaire. The collected data were entered into Epi-data, and analyzed by using STATA version 14software. Descriptive statistics were computed and presented using tables, figures and texts. Factors associated with the prevalence of uvulectomy were selected for multiple logistic regressions at the probability value (p-value) of less than 0.2 in the X2- analysis. Statistically significant associated factors were identified at the probability value (p-value) less than 0.05 and adjusted OR (AOR) with a 95% CI. A total of 10 individual depth interviewees and 5 key informants were included using purposive sampling techniques. For the qualitative study, and thematic content analysis was employed to analyze the data, which were transcribed, translated, coded, screened, thematized, analyzed, synthesized, and finally supplemented the quantitative finding.

RESULTS

The prevalence of traditional uvulectomy was 84.60% (CI: 81.77%n-87.42%). Being rural residence (adjusted OR = 2.08, CI = 1.06-4.12), mothers aged 30 to 34 years (adjusted OR = 2.9, CI = 1.28-6.60), having no antenatal care visit (adjusted OR = 3.91, CI = 1.33-11.47), having no bad obstetric history (adjusted OR = 2.11, CI = 1.12-3.98), having no postnatal care visit (adjusted OR = 3.88, CI = 1.36-11.12) and mothers' poor attitude (adjusted OR = 3.32, CI = 2.01-5.47) were statistically significant associated factors of traditional uvulectomy. Seeking traditional uvulectomy, lack of information and third-party pressure were the main themes of the qualitative study that support the findings of the quantitative study.

CONCLUSION

The prevalence of traditional uvulectomy was high. Being rural residents, mothers aged 30 to 34 years, having no antenatal care visit, having no complications of obstetric history, having no postnatal care visit and mothers with poor attitude were statistically significant associated factors of traditional uvulectomy. Lack of information about uvulectomy and third-party pressure was the reason for seeking traditional uvulectomy.

Traditional uvulectomy; practice and belief among Sudanese children in Khartoum hospitals: A multi-center cross-sectional study

BACKGROUND

Traditional healing practices are common in Sub-Saharan Africa. Traditional uvulectomy (TU) is the removal of the uvula with a sharp curved knife and is often practised in children under five years old. This practice is believed to have a therapeutic effect on children suffering from sore throat, vomiting or difficulty breastfeeding.

OBJECTIVES

This study aimed to describe the practice of traditional uvulectomy and Sudanese mothers' perception of it.

METHODS

A cross-sectional study was conducted in seven teaching hospitals across Khartoum State. We interviewed 385 mothers of children who presented to pediatric units using a semi-structured questionnaire. The study period spanned from July 2022-February 2023.

RESULTS

A total of 385 mothers of children under five participated in this study. 33 % of mothers believed in the practice of traditional uvulectomy, yet only 17.9 % of children under five years had undergone TU. Reasons for performing TU included persistent cough (36.9 %), vomiting (33 %), difficulty in breastfeeding (22.6 %) and TU being a family tradition (25.7 %). Factors significantly associated with these practices were the mother's age, her level of education and the family's regional origin. Mothers reported that no major complications to the children were perceived as a result of the TU procedure.

CONCLUSION

The practice of TU is prevalent among children who present to hospitals seeking medical advice. More than one-third of mothers had misconceptions regarding the uvula. Health education campaigns targeting females of childbearing age, and health practitioners at primary health centres and hospitals must raise awareness related to this practice.

The burdens, associated factors, and reasons for traditional uvulectomy in Ethiopia: A systematic review and meta-analysis

INTRODUCTION

Traditional uvulectomy is a harmful procedure in which the entire or a portion of the uvula is removed by traditional practitioners. It causes complications like septicemia, transmission of infectious diseases, anemia, excessive bleeding, infection, tetanus, meningitis, and death. A summary of national data was lacking, thus, the study aimed to determine the pooled national burden and determinants of traditional uvulectomy in Ethiopia.

METHODS

Studies were retrieved from PubMed, EMBASE, CINHAL (EBSCO), Google Scholar, Web of Sciences, MEDLINE, Cochrane Library, SCOPUS, and Google databases. Finally, 19 studies were included. The methodological quality of the included studies was assessed using the JBI checklist. Data synthesis and statistical analysis were conducted using STATA Version 17 software. Heterogeneity and publication bias were assessed. Forest plots were used to present the pooled and summarized with random-effects meta-analysis models.

RESULTS

Totally 19 articles with 23,559 study participants were included in this systematic review and meta-analysis. The overall pooled prevalence of uvulectomy in Ethiopia was 44 % (95 % CI: 31%-57 %). The highest prevalence was observed among studies conducted in the Tigray region (63 % (95 % CI: 34%-94 %), between the year 2011-2014 (58 % (95 % CI: 29%-87 %)) and, community setting (57 % (95 % CI: 36%-78 %). Mothers' educational status (AOR: 1.66, 95 % CI: 1.31-2.01) and residence (AOR: 1.70, 95 % CI: 1.16-2.23) were found to be significantly associated with traditional uvulectomy in Ethiopia. Frequently cited reasons for traditional uvulectomy were to prevent swelling, pus, and rupture of the uvula, for better care, prevention of sore throats and coughs, religion, and culture.

CONCLUSION

The pooled result revealed that almost half of children are still subjected to traditional uvulectomy in Ethiopia. There is a need to intensify awareness creation campaigns against the practice by giving special attention to rural residents and uneducated ones.

Spatial multilevel analysis of age at death of under-5 children and associated determinants: EDHS 2000-2016

OBJECTIVE

This study examines trends, spatial distribution and determinants of age at death of under-5 children in Ethiopia.

DESIGN

This study used secondary data from the 2000, 2005, 2011 and 2016 Ethiopian Demographic and Health Surveys. A multilevel partial ordinal logistic regression model was used to assess the effects of variables on the age at death of children under 5 years.

SETTING

Ethiopia.

PARTICIPANTS

The final analysis included a sample of 3997 deaths of newborns, infants and toddlers.

RESULTS

A total of 1508, 1054, 830 and 605 deaths of under-5 children were recorded in the 2000, 2005, 2011 and 2016 survey years, respectively. The death of newborns, infants and toddlers showed a significant decrease from 2000 to 2016, with reductions of 33.3% to 17.4%, 42.4% to 12.6% and 45.2% to 11.6%, respectively. The analysis using Global Moran's Index revealed significant spatial autocorrelation in mortality for each survey year (p<0.05). The intraclass correlation of age at death of under-5 children within regions was substantial. Furthermore, the odds of newborn deaths among under-5 children (OR: 0.638, 95% CI: 0.535, 0.759) were lower for those delivered in health institutions compared with those delivered at home.

CONCLUSIONS

Throughout the survey years from 2000 to 2016, newborn children had higher mortality rates compared with infants and toddlers, and significant spatial variations were observed across different zones in Ethiopia. Factors such as child's sex, age of mother, religion, birth size, sex of household head, place of delivery, birth type, antenatal care, wealth index, spatial autocovariate, Demographic and Health Survey year, place of residence and region were found to be significant in influencing the death of under-5 children in Ethiopia. Overall, there has been a decreasing trend in the proportion of under-5 child mortality over the four survey years in Ethiopia.

Cultural malpractice during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa city administration, Eastern Ethiopia, in 2021

Background

Cultural practices are any experiences or beliefs that are socially shared views and behaviors practiced in a certain society at a certain time. Cultural malpractices are defined as socially shared views and traditionally accepted behaviors experienced in a certain society that harm maternal health. Worldwide, the period of pregnancy, labor, and delivery is embedded with different beliefs, customs, and rituals in different societies that contribute a lot to maternal death. They are responsible for the annual deaths of 303,000 mothers and 2.7 million newborns globally. In developing countries, it accounts for approximately 5%-15% of maternal deaths. In Ethiopia, approximately 18% of infant deaths occur due to cultural malpractice, and 52% of pregnant mothers give birth at home following cultural customs in Dire Dawa city. The objective of this study was to assess cultural malpractices during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa City in 2021.

Methods

Community-based mixed study was conducted. A total of 624 study participants were selected through a systematic random sampling technique, and a purposive sampling method was used for qualitative data. The study was conducted in the randomly selected Kebeles of Dire Dawa City, Eastern Ethiopia, from November 1 to December 30, 2021. Data were entered into Epi Data version 4.1 and exported to SPSS version 24 for analysis. Bivariate and multivariate analyses were done, and the degree of association was measured by using the odds ratio with 95% CI and significance was declared at a p-value of <0.05. The qualitative data were analyzed thematically using ATLAS-ti version 7.

Results

The overall prevalence of cultural malpractice during pregnancy, childbirth, and the postnatal period was 74.6% [95% CI: 70.59%, 77.49%]. Women over the age of 35 were two times more likely [AOR 2.61, 95% CI, 1.45-4.72] to commit cultural malpractice than women aged 15-24 and 25-34. Those with no antenatal care (ANC) follow-up were three times more likely to commit cultural malpractice [AOR 3.57, 95% CI, 1.72-7.40], those who were absent from health education were nearly two times more likely to commit cultural malpractice [AOR 1.83, 95%CI, 1.25-2.67], and women whose culture allows harmful traditional practices were nearly two times more likely to commit cultural malpractices than their counterparts [AOR 1.69, 95%CI, 1.29-2.54].

Conclusion

In this study, nearly three-fourths of participants were involved in cultural malpractices. Therefore, strengthening community education and behavioral change messages on the importance of ANC and avoiding unhealthy care during pregnancy, childbirth, postnatal and neonatal periods, especially with pregnancy at old age (age > 35), may help to reduce cultural malpractices.

Prevalence of Milk Teeth Extraction and Enabling Community Factors Among Under Five-Year-Old Children in Alle Special Woreda, SNNPR, Ethiopia, 2022: Community-Based Cross-Sectional Study; Based on Theory of Planned Behavior Model

Background

Milk tooth extraction (MTE) is one of the most common harmful traditional practices performed by traditional healers without anesthesia and unsterile materials. The acute and chronic complications of this practice greatly affect the health of children. In order to develop effective preventive measures towards this harmful practice, the extent of the problem and factors contributing to the practice should be verified. The objective of this study was to assess the prevalence and associated factors of MTE among under five-years-old children in Alle special Woreda.

Methods

A community-based cross-sectional survey was undertaken at Alle Special Woreda among 363 women using a multi-stage stratified sampling method. Data was collected using semi-structured questionnaires and data entry was done with Epi-data version 4.4.3.1, while data management and analysis were done with STATA version 14.0. Univariate and multivariate binary logistic regression models were used while model’s fitness was checked by Hosmer and Lemeshow test. Variables having a p-value of less than 0.05 were declared statistically significant in the final model.

Result

Milk teeth extraction was practiced on 58.68% (95% CI:0.5,0.6) of children. Age of the child less than 12 months, AOR:1.27 (95% CI:1.02,1.6), maternal occupation (housewife) AOR:1.3 (95% CI:1.04,65), paternaleducational, level (illiterate) AOR:1.4 (95% CI:1.2,1.9), residence (rural) AOR:3.6 (95% CI:1.08,12.4), positive attitude AOR:1.65 (95% CI:1.01,2.8) and intentions AOR: 1.82 (95% CI:1.1,3.3) towards MTE practice showed statistically significant association with MTE practice.

Conclusions and Recommendations

It was found that milk teeth extraction practice was the most common practice in the study area, with a prevalence of 58.68%. Age of the child, maternal occupation, paternal educational level, residence, having a positive attitude and intentions toward MTE practice all had a statistically significant (P value less than 0.05) association with MTE practice. Society’s barriers, such as knowledge, attitude, and practice (KAP) related, health facility related, and peer and social pressure-related factors, were identified. All stakeholders should put great emphasis on the elimination of this harmful practice.

Antenatal care follow-up decreases the likelihood of cultural malpractice during childbirth and postpartum among women who gave birth in the last one-year in Gozamen district, Ethiopia: a community-based cross-sectional study

Background

Recent evidence has found widespread reports of women experiencing cultural malpractice during childbirth in Asia and sub-Saharan African countries. Despite an endeavor made to drop maternal and neonatal mortality, Ethiopia remains amongst the highest mortality rate. Thus, strengthening antenatal care (ANC) follow-up is the midst of cultural malpractice reduction during childbirth. This study was aimed to assess the magnitude of cultural malpractice and associated factors during childbirth and postpartum among women who gave birth within one year in Gozamen district, Ethiopia.

Methods

A community-based cross-sectional study was conducted from November 1st to December 30th, 2019. A two-stage sampling technique was used to get a total of 600 women who gave birth within the last one year. Data were collected by using a semi-structured and pretested questionnaire. Then, data were entered into Epi info version 7.0 and exported to SPSS version 25 for analysis. Both bivariate analysis and a multivariable logistic regression model were fitted. The level of significance was declared based on the adjusted odds ratio (AOR) with its 95% confidence interval (CI) and a p-value of ≤0.05.

Result

The Overall magnitude of cultural malpractices during childbirth and postpartum was found to be 31.2% (95%CI: 27.8, 34.7). Out of 600 women, 203(33.9%) were delivered at home, 67(11.2%) practiced abdominal massage, 31(16.6%) avoided colostrum, 24(12.8%) practiced pre-lacteal feeding and 138 (23%) washed their baby before 24 h after delivery. Mothers who have antenatal follow-up (AOR=0.52 95%CI 0.28, 0.94), married marital relation (AOR=0.24, 95%CI:0.07, 0.89), being farmer husband occupation (AOR=6.25 (95%CI: 1.22, 30.30), parity ≥5 (AOR=5, 95%CI: 2.44, 9.52), had significant association with cultural malpractice during childbirth and postpartum.

Conclusions

This study showed there is an improvement in the magnitude of cultural malpractices during childbirth and postpartum, but still it’s high as compared to the country’s maternal health service utilization aim. A well-enforced health education program by well-trained healthcare personnel besides sufficient number of ANC visits are needed to overcome these cultural practices. Further, intervention modalities health education communication outreach programs would be very important to reduce the prevalence of cultural malpractices in the community.

Determinants of Under-Five Child Mortality in Ethiopia: Analysis Using Ethiopian Demographic Health Survey, 2016

Background

Under-five mortality rate is a leading indicator of the level of child health and the overall development in countries which indicate the quality of life of a given population, as measured by life expectancy.

Objectives

To identify and analyze factors that may have a significant influence on under-five mortality in Ethiopia.

Methods

A national representative cross-sectional study and a quantitative study were conducted among 18,008 households selected based on 2016 EDHS data. The analysis was done using SPSS version 20 statistical software. Both bivariate and multivariable analyses were employed. In multivariable analysis, p value less than 0.05 was considered statistically significant and odds ratio with 95% CI (confidence interval) was used to assess the determinants of under-five child mortality.

Results

A total of 10,641 children were included in the study with a 99.0% response rate. The U5CM for being a rural resident (AOR = 1.802, 95% CI: 1.251, 2.595), not breastfeeding (AOR = 2.956, 95% CI: 2.490, 3.511), having multiple birth (AOR = 4.755, 95% CI: 3.440, 6.572), male gender (AOR = 1.363, 95% CI: 1.153, 1.612), having first birth order (AOR = 1.592, 95% CI: 1.275, 1.992), and having family size six and above (AOR = 2.187, 95% CI: 1.769, 2.707). The increment of family size increases the risk of U5CM.

Conclusion

Multivariate logistic analysis reflected that place of residence, mothers' educational level, religion, current breastfeeding status, type of birth, sex of child, birth order, and family size were found to be significant predictors of under-five child mortality. So, government policy, nongovernmental organizations, and all concerned bodies should be focused on the major determinants of under-five child mortality and put in a lot more effort to reduce under-five child mortality, and health intervention policies should be revised.

Factors Influencing Neonatal Practice in a Rural Community in Kano (Northern), Nigeria

Nigeria has the highest number of neonatal and under-five deaths in Africa. Socio-cultural determinants play an important role in disease burden in low-middle income countries. This study aimed to describe knowledge, attitudes and neonatal care practice among household caregivers in a rural community in Nigeria, specifically uvulectomy, female genital mutilation (FGM), failure to routinely immunize and unsafe cord care. Further, relationships between demographic characteristics and knowledge, attitudes and neonatal care practices among caregivers were analyzed. The study design was descriptive correlational and cross-sectional. Consented caregivers (N = 298) were enrolled and interviewed using a structured questionnaire. Data were collected on demographic characteristics of the study participants and practice of uvulectomy, FGM, immunization and cord care. Statistically significant correlations were found between the practice of uvulectomy, FGM and failure to immunize based on occupation (p = 0.0202, p = 0.0290, p = 0.0071) and educational level (p =< 0.0001, p =< 0.0001, p =< 0.0001), with variations by ethnicity. Intense, preventative health measures and maternal education to eliminate harmful care practices are essential to influence outcomes.