Determinants of neonatal mortality among neonates admitted to neonatal intensive care unit of Dessie comprehensive and specialized hospital, Northeast Ethiopia; An unmatched case-control study

Background

According to the World health organization, neonatal mortality is defined as the death of babies within the first 28 days of their lives. The newborn period is the most vulnerable period for a child's survival, with the bulk of neonatal deaths occurring on the first day and week. According to a recent study, about a third of all newborn deaths occur within the first day of life, and nearly three-quarters occur within the first week. This study aimed to assess the determinants of neonatal mortality among neonates admitted to the neonatal intensive care unit in Dessie comprehensive and specialized hospital, northeast Ethiopia.

Methodology

Health institution-based unmatched case-control study was conducted among neonates admitted to Dessie comprehensive and specialized hospital, Ethiopia from February 01 up to March 30, 2020. After keeping cases and controls in separate frames, study participants were chosen using a simple random sampling procedure until the sample size was met. Epi data version 7.0 and SPSS version 25 were used for data entry and analysis respectively. P ≤ 0.05 was used as a cut point of statistical significance in multivariable binary logistic regression.

Results

A total of 698 (233 cases and 465 controls) participated in the study. Pregnancy induced hypertension (AOR = 3.02; 95% CI; 1.47-6.17), public hospital delivery (AOR = 3.44; 95% CI; 1.84-6.42), prematurity (AOR = 2.06; 95% CI; 1.43-2.96), being referred (AOR = 4.71; 95% CI; 3.01-7.39), and hypothermia (AOR = 2.44; 95% CI; 1.56-3.82) were determinant factors of neonatal mortality.

Conclusion

Pregnancy-induced hypertension, public hospital delivery, prematurity, referral, and hypothermia were found to be the determinant factors of neonatal mortality. It would be important to give due attention to neonates delivered from mothers with a history of hypertensive disorder. Besides better to give due attention to neonates delivered in public health institutions, prematurely delivered, referred, and hypothermic neonates. Lastly, further research should be conducted to investigate the additional determinants of neonatal mortality.

Determinants of adolescents' contraceptive uptake in Ethiopia: a systematic review of literature

Introduction

Various studies have identified different factors that affect adolescent contraceptive uptake in different parts of Ethiopia. However, varying results were reported across primary studies and those results need to be systematically collated to inform policies. Therefore, this systematic review aimed to synthesize the findings of those primary studies to obtain more robust and representative evidence about adolescent contraceptive uptake in Ethiopia.

Methods

Five databases (MEDLINE via PubMed, Google Scholar, Scopus, Science Direct and CINAHL) were searched for papers published from January 2000 up to June 2021 in English. We limited our search to start on January 2000 as the health of adolescents have been given more attention after this period and to avoid time-lapsed biases. Seven studies were included in this systematic review. We used the Newcastle-Ottawa Scale and the Mixed Methods Appraisal Tool for quality assessment of the selected studies.

Results

Determinants of adolescent contraceptive utilization were focused on four levels: individual, socio-cultural, healthcare service and knowledge related factors. Individual-related factors that influence adolescents’ contraceptive uptake include; being in the age group of 10–15 years, not currently enrolled in school and being from low-income families, while socio-cultural factors include: lack of discussion with family members, arranged marriage, pressure from a partner, harmful traditional practices, discussion with peer groups and sexual partners. Healthcare service-related factors include; lack of information about contraceptives during health facility visits, lack of privacy during service provision and inconvenient service hours at health facilities, and not visiting health facilities, whereas, knowledge related factors include; having knowledge of contraceptive methods and being heard about contraceptives from media. Also, the proportion of adolescent contraceptive uptake ranged from 12 to 79%.

Conclusions

In this systematic, individual, socio-cultural, health-care-related, and knowledge-related characteristics have all been identified as influencing adolescents’ contraceptive uptake in Ethiopia. Hence, integrated interventions aimed at overcoming barriers to adolescent contraceptive uptake would be beneficial to improving adolescent contraceptive utilization in Ethiopia.

Menstrual irregularity and its associated factors among college students in Ethiopia, 2021

Background

Menstrual irregularity can occur at any age, but it is most common among women under the age of 23 years. Menstrual irregularity is a foremost gynecological problem and a cause of anxiety to students and those close to them. These students experience monthly absenteeism, premenstrual symptoms, and a lack of concentration due to menstrual problems, all of which interfere with their education. Therefore, this study aimed to assess the magnitude of menstrual irregularity and associated factors among college students in Debre Berhan Town, North Shewa, Amhara Regional State, Ethiopia, in 2021.

Methods

An institution-based cross-sectional study was conducted from June to July 2021 in Debre Berhan town. Data was collected using self-administered questionnaires in 420 eligible female college students by systematic random sampling technique. Weight and height were measured and Body Mass Index (BMI) was calculated after data collection. Each questionnaire was checked for completeness, cleaned, coded, entered into EPI-DATA, and then transported to SPSS software. Bi-variable and multivariable logistic regression analyses were employed to determine the association of each independent variable with the dependent variable. P ≤ 0.05 were used to declare association and select predictors.

Results

In the current study, 395 students participated with a response rate of 93.6%. Of all the total respondents, the magnitude of menstrual cycle irregularity was 33.4% (95% CI 28.6–38.2). Age < 20 years old [AOR = 3.88, 95% CI (1.25–12.18)], age of menarche ≤ 12 years [AOR = 4, 95% CI (1.18–13.9), sleeping hours ≤ 5 h [AOR= 2.26, 95% CI (1.04–4.93)], perceived stress [AOR = 2, 95% CI (1.53–3.23)] and being overweight [AOR = 2, 95% CI (1.13–3.23) were the variables significantly associated with the magnitude of menstrual irregularity.

Conclusion and recommendation

This study shows that more than one-third of the college students in Debre Berhan town have experienced menstrual irregularity. Being less than 20 years old, having a history of early menarche, being overweight, and perceived stress were a variable significantly associated with menstrual irregularity. To control menstrual irregularity, girls should control their weight and lead a healthy lifestyle, including getting adequate sleep which could be aided by training on time management.

A Systematic Review and Meta-Analysis on Post-Abortion Contraceptive Utilization and Associated Factors in Ethiopia

Background

Post-abortion contraceptive utilization is the initiation and use of family planning methods at the time of management of abortion or before fertility returns. A significant discrepancy was reported regarding the prevalence and its associated factors of post-abortion contraceptive utilization in Ethiopia. So, this systematic review and meta-analysis aimed to estimate the pooled prevalence of post-abortion contraceptive utilization and its associated factors in Ethiopia.

Methods

Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used. The databases such as PubMed, Google Scholar, Science Direct, Cochrane library, Scopus, CINAHL, Web of Science, and additional searches by using direct Google search, libraries, and preprint were searched. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal.

Results

A total of 17 studies with 13,075 individuals were included. Of these, 14 studies with 5,719 individuals were used to estimate the prevalence. The pooled prevalence of post-abortion contraceptive utilization in Ethiopia was 63.64% (95% CI: 57.75–69.53). The subgroup analysis reported the highest prevalence of post-abortion contraceptive utilization in a study conducted in Addis Ababa (77.40%), a study published in 2015–2021 (66.15%), and among studies with a sample size >400 (66.84%). The pooled odds ratio (OR) of post-abortion contraceptive utilization for the mothers who had post-abortion family planning counseling was 4.15 (95% CI = 1.30, 13.2), and history of family planning utilization was 4.28 (95% CI = 2.66, 6.89).

Conclusions

The pooled prevalence of utilization of post-abortion contraceptives in this meta-analysis remains low. Post-abortion family planning counseling and the history of the utilization of modern family planning methods were significantly associated with the practice of post-abortion contraceptives. The Ministry of Health should encourage post-abortion family planning utilization, making more efforts on post-abortion contraceptive counseling. Health facilities should work hard to strengthen the family planning counseling service, especially focusing on those who had no previous family planning utilization.

Prevalence of antenatal depression and associated factors among pregnant women during COVID-19 pandemic in North Shewa zone, Amhara region, Ethiopia

Background

Antenatal depression is a form of depression that occurs during pregnancy. This problem may worsen during the COVID-19 epidemic and may result in serious consequences for pregnant women, including depression and other multiple psychosocial problems. However, the prevalence of depression during the COVID-19 pandemic in pregnant women and its associated factors has not been studied in the study area, even in Ethiopia.

Methods

An institution-based cross-sectional study was conducted among 422 pregnant women who were attending antenatal care in public health institutions in the North Shewa Zone, Ethiopia. The data were collected from May 1- June 30, 2021. A logistic regression model with adjusted odds ratio (AOR) and P-value < 0.05 at the 95% confidence interval was used to determine significantly associated factors.

Results

The prevalence of antenatal depression among pregnant women during the COVID-19 pandemic was 34.1% (95% CI: 29.6-38.9). Divorced marital status (AOR = 7.52, CI: 2.707-20.911), husband's educational status "cannot read and write" (AOR = 4.05, CI: 1.834-8.962) and "can read and write without formal education" (AOR = 2.39, CI: 1.107-5.154) are statistically significant variables associated with depression among pregnant women during the COVID-19 pandemic.

Conclusions

In this study, the prevalence of antenatal depression in pregnant women during the novel coronavirus pandemic was high. To reduce the level of depression in pregnant women, strategies have to be designed for the early detection of divorced pregnant women with inadequate social support and address enough information for pregnant women and their husbands about depression and COVID-19 during the pandemic.

Assessment of Practice and Factors associated with Sunlight Exposure of Infants among Mothers in Debre Berhan Town, North Shewa Zone, Amhara Region, Ethiopia

Background

Vitamin D deficiency is a common worldwide problem with its prevalence magnified in infants. Prevalence in infants is believed to range from 2.7% to 45% in different countries of the world. Appropriate sunlight exposure of skin is thought to be vital for the prevention of vitamin D deficiency. However, due to a dearth of study the practice of sunlight exposure is incompletely understood. Thus, assessing practice and factors affecting sunlight exposure of infants by mothers was relevant.

Objective

To assess practice level and factors associated with sunlight exposure of infants by mothers in Debre Berhan town, North Showa, Ethiopia, 2019.

Materials and Methods

A community-based cross-sectional study was conducted to collect relevant data among 530 mothers with infants at selected kebeles in Debre Berhan town. A simple random sampling technique was used to select kebeles and systematic sampling was complemented to identify study participant. Data were collected with interview using a pre-tested structured and semi-structured questionnaire. Bivariable and multivariable logistic regressions were run to examine the association among dependent and independent variable. Significant association was declared at P value ≤0.05.

Results

All the mothers were interviewed and 65.7% of them had good practice in sunning of their infant. In multi-variable analysis, mothers who are housewives or government employees, have a maternal age of 33 and above, perceive that sunlight strengthen infant bones, perceive that sunlight makes their infants healthier, and who got information from health-care professionals were significantly associated with good practice in sunning of their infant.

Conclusion and Recommendation

Finding of this study indicated that 34.3% of participants have poor practice in sunning of infants. This is a pointer that sunlight exposure of infants still needs attention from the government and other concerned bodies.

The Engagement Level of Board Members and Associated Health Care Quality in Public Health Centers of Addis Ababa, Ethiopia, 2018

BACKGROUND

A board member was an important bridge to accelerate a day-to-day health care quality in a routine clinical activity at health institutions. They are significant in planning and examine integrated governance systems that encourage quality of care and accountability. So, the current research was planned to identify the level of engagement of the board members in health care quality and factors associated.

METHODS

A facility-based cross-sectional study was implemented among 250 board members and data were collected by self-administered questionnaire at selected governing health centers in Addis Ababa, Ethiopia from May 1 to 30, 2018. A simple random sampling technique was used to reach the study participants. Data were entered using EpiData 3.1 software and analysis was done using SPSS 23. Adjusted odds ratio with 95% confidence interval and p-value < 0.05 was used to declare statistical significance. The level of board members' engagement was found to be low which implies that the board members do not give appropriate attention to the quality of care.

RESULTS

Good level of engagement of board members was (50.9%) [AOR=7.11, 95% CI (3.07-16.47)]. Most of the governing board members did not engage in the quality of health care activities. Uses quality data as a basis for recognition [AOR=7.11, 95% CI (3.07-16.47)], review a quality scorecard or dashboard [AOR=10.83, 95% CI (3.75-31.29)], establishing goals relating to staff satisfaction [AOR=15.42, 95% CI (6.14-38.75)] and receiving formal training [AOR=3.42, 95% CI (1.35 -8.62)], having a strategy relating to communication with clients [AOR= 4.95, 95% CI (2.02-12.15)] and spending more than 20% [AOR=11.96, 95% CI (3.27-43.83)], received training on healthcare disparities [AOR=3.81, 95% CI (1.40-10.36)], and having a plan on quality [AOR=16.38 95% CI (5.39-49.72)] were found to be significant predictors of level of board member engagement.

CONCLUSION

Collectively, most of the governing board members did not engage in the quality of health care activities. Stakeholders should work on capacity building for board members using training and further follow-up. Encouraging them to put quality health services at the forefront of their agenda during their involvement at their respective facilities.

Assessment of Prevalence and Factors Associated with Malnutrition Among Under-Five Children in Debre Berhan Town, Ethiopia

Background

Malnutrition is a deficiency or improper intake of energy and nutrients. It includes undernutrition (wasting, stunting, underweight, and mineral and vitamin-related malnutrition) and overnutrition.

Purpose

To estimate the prevalence and identify the risk factors for undernutrition among under-five children in Debre Berhan Town, North Shewa, Ethiopia.

Methods

A community-based cross-sectional study was conducted in Debre Berhan Town, from October 07, 2019 to January 24, 2020. Three hundred and eighty-five under-five children who were selected using systematic random sampling technique were included in this study. To collect data, a structured questionnaire and anthropometrical measurements were used. Data entry was done through Epi data 4.21, and for data analysis statistical package for social sciences version 20.0 was employed. Bivariate and multivariable logistic regression analysis was used to identify the factors associated with malnutrition. The statistical significance was stated at p value <0.05 with 95% confidence intervals.

Results

In the overall sample the total prevalence of undernutrition in below age-5 children was 61 (15.8%), the corresponding figures for underweight, stunted, and wasting were 26%, 41%, and 33%, respectively. Factors that contributed to under-five undernutrition were maternal illiteracy, not breastfeeding exclusively, preterm birth, absence of antenatal care, exposure to infectious diseases and diarrhea.

Conclusion

There was a higher prevalence of stunting (41%), wasting (33%), and being underweight (26%) in Debre Berhan town than the national (Ethiopia) or regional (Amhara) malnutrition prevalence. Mothers’ educational status should be improved by teaching them that proper nutrition is important for their child’s growth and development. Antenatal care for all pregnant women, education on child care, infection prevention, and child feeding should be provided and further strengthened.

Completing the Continuum of Maternity Care and Associated Factors in Debre Berhan Town, Amhara, Ethiopia, 2020

Background

The continuum of maternity care is the continuity of maternal health care services that a woman practices antenatal care, skilled birth attendant, and postnatal care. Even though there are positive inclinations towards the continuum of maternity care, the problem is still significant. So, the purpose of this study was to assess the utilization of continuum maternity care and associated factors among women who gave birth in the last 12 months before the data collection period in Debre Berhan town.

Methods

A community-based cross-sectional study was conducted from February 17 to March 15/2020. The respondents were selected by using the cluster sampling technique. Face-to-face interview was used for data collection. EpiData software version 3.1 was used for data entry and exported to SPSS version 21 for further analysis. In multivariable logistic regression, a statistically significant association has declared a p-value <0.05.

Results

In this study, the proportion of women who completed the continuum of maternity care was 37.2% (95% CI: 33.4-41.1). Completing primary education (AOR: 2.73, 95% CI: 1.17-6.38), secondary education (AOR: 3.11, 95% CI: 1.32-7.31), college and above educational level (AOR: 4.15, 95% CI: 1.79-9.57), initiation of first ANC visit ≤16wks (AOR: 2.57, 95% CI: 1.41-4.68), knowing key pregnancy danger signs (AOR: 1.91, 95% CI: 1.15-3.19), and well prepared on birth and complication readiness (AOR: 1.59, 95% CI: 1.10-2.32) were found to positively increase the chance of completing maternity care in our study area.

Conclusion

Even if a higher proportion of mothers completed the continuum of maternity care in the study area than the finding at national level of 9.1% basing EDHS 2016 data, further interventions are mandatory to reach the acceptable level. Therefore, health promotion programs targeting mothers with no education and lower educational level are important to increase their awareness about the importance of completing all levels of maternity care, health education, and counseling regarding early initiation of ANC, pregnancy danger signs, and birth preparedness and complication readiness plan.

Utilizing a Minimum of Four Antenatal Care Visits and Associated Factors in Debre Berhan Town, North Shewa, Amhara, Ethiopia, 2020

Background

Receiving a minimum of four antenatal care, as per the World Health Organization recommendation, enhances the possibility of utilizing effective maternal health care during antenatal follow-up. Hence, this study aimed to identify the level of a minimum of 4 ANC usage and factors associated with Debre Berhan town.

Methods

A community-based cross-sectional study was employed from February 20 to March 10/2020 among women who gave birth in the last 6 months before the data collection period in Debre Berhan town. Data were collected using face-to-face interviews with the pre-tested tool by trained data collectors from randomly selected participants. After entering the data into Epi-data software version 3.1, it was further processed using SPSS version 23 statistical package. Both bivariate and multivariable Logistic regressions were fitted to identify the determinants for the utilization of a minimum of 4 antenatal care. A significance level of 0.05 was used to decide the significance of statistical tests.

Results

A total of 390 women were interviewed giving a response rate of 99.2%. In this study, 78.5% (95% CI: 74.4-82.6) of women received a minimum of four antenatal care visits. Maternal educational status, initiation of antenatal visit at ≤16 weeks of gestation, and husband support/partner involvement were identified predictors of utilization of minimum 4 antenatal visits.

Conclusion and Recommendations

Use of at least four antenatal visits in Debre Berhan town was found to be good. Health promotion programs targeting mothers with no education and lower educational level are important to increase their awareness about the importance of antenatal services. Male partner involvement during care related to pregnancy and promoting early initiation of antenatal care is important to overcome challenges towards a minimum of 4 antenatal visits in Debre Berhan town.