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Mislu E, Kumsa H, Arage MW, Shitie A, Adimasu A. Effective breastfeeding techniques and associated factors among lactating women: a community-based study, north east Ethiopia. Front Public Health 2024; 12:1337822. [PMID: 38577276 PMCID: PMC10993909 DOI: 10.3389/fpubh.2024.1337822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024] Open
Abstract
Background Effective breastfeeding techniques, which include proper attachment, positioning, and suckling, offer a range of benefits for both the mother and the infant. These techniques ensure efficient milk transfer, reduce the risk of infections, support optimal infant weight gain, enhance maternal comfort, and foster a strong emotional bond. This study aimed to identify the magnitude and factors associated with effective breastfeeding techniques among lactating women in the Legambo district of South Wollo, Ethiopia, in 2022. Methods A community-based cross-sectional study was conducted from September to November 2022. Samples were selected using a multi-stage sampling method from 18 wards (kebele). Data were collected using an interviewer-administered structured questionnaire and an observational checklist. The collected data were entered into Epi-Data and then exported to SPSS version 25.0 for analysis. Descriptive statistics and bivariate and multivariable logistic regression analyses were performed to identify the magnitude and associated factors. Variables with a p-value less than 0.05 on multivariable analysis were considered independent factors associated with the outcome variable. Results Six hundred and ten lactating women were included for observation and interviewed, resulting in a 96.2% response rate. The magnitude of effective breastfeeding technique practice was found to be 25.9% (95% CI: 22.47-29.57%). Factors associated with effective breastfeeding technique practice included being a working woman (AOR = 1.70; 95%CI: 1.07-2.72), age between 26 and 30 years (AOR = 0.37; 95%CI: 0.16-0.84), urban residence (AOR = 1.59; 95%CI: 1.06-2.39), initiating breastfeeding 1 to 2 h after birth (AOR = 0.27; 95%CI: 0.16-0.43), and initiating breastfeeding after 2 h of birth (AOR = 0.34; 95%CI: 0.17-0.67). Additionally, not receiving breastfeeding education (AOR = 0.46; 95%CI: 0.30-0.72) and experiencing current breast problems (AOR = 0.28; 95%CI: 0.28-0.75) were also found to have a significant association with effective breastfeeding technique practice. Conclusion Only one in four women demonstrated effective breastfeeding techniques, indicating that their practice was below the WHO's recommendations. Therefore, it is crucial to consider the identified variables to improve the practice of effective breastfeeding techniques.
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Affiliation(s)
- Esuyawkal Mislu
- Department of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Henok Kumsa
- Department of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Mulugeta Wodaje Arage
- Department of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Anguach Shitie
- Department of Midwifery, College of Medicine and Health Science, Wollo University, Woldia, Ethiopia
| | - Abebe Adimasu
- Department of Midwifery, College of Medicine and Health Science, Wollo University, Woldia, Ethiopia
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Kumsa H, Mislu EK, Arage MW, Kidie AA, Hailu T, Tenaw LA. Prevalence and determinants of pregnancy termination in Ethiopia: a systematic review and meta-analysis. BMJ Open 2024; 14:e073799. [PMID: 38485172 PMCID: PMC10941161 DOI: 10.1136/bmjopen-2023-073799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE This review aims to determine the prevalence of pregnancy termination and its determinant factors in Ethiopia. DESIGN Systematic review and meta-analysis. DATA SOURCES Relevant articles were retrieved from databases such as PubMed, EMBASE, Medline and other search engines. ELIGIBILITY CRITERIA FOR SELECTING STUDIES The research design for this study had no restrictions, allowing for the inclusion of cross-sectional and case-control studies that examined the prevalence or determinants of pregnancy termination. However, case reports, case series, reviews, editorials and studies published as abstracts only were excluded from the analysis. DATA EXTRACTION AND SYNTHESIS The review was precisely in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria, and the quality of the review was assessed using the Joanna Briggs Institute critical appraisal checklist. Heterogeneity was indicated by the p value for I2 statistics less than 0.05. Data were entered into Microsoft Excel, and the analysis was conducted by using Stata V.16. RESULTS The pooled prevalence of pregnancy termination in Ethiopia was 21.52% (95% CI 15.01% to 28.03%). Women who had their first sexual initiation before the age of 18 (OR 1.78; 95% CI 1.13 to 2.82, p=0.14), had irregular menstrual bleeding (OR 1.86; 95% CI 1.25 to 2.77, p=0.76), being a student (OR 4.85; 95% CI 1.98 to 11.91, p=0.20) and had multiple sexual partners (OR 4.88; 95% CI 3.43 to 6.93, p=0.33) were significantly associated with pregnancy termination. CONCLUSIONS One in five women terminated their pregnancies, which is higher than in other sub-Saharan countries. Being a student, irregular menstrual bleeding, early initiation of sexual intercourse and multiple sexual partners were determinants of pregnancy termination. Special attention is needed in avoiding early sexual initiation and in reducing sexual risk behaviours.
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Arage MW, Kumsa H, Asfaw MS, Kassaw AT, Mebratu E, Tunta A, Kassahun W, Adissu A, Yigzaw M, Hailu T, Tenaw LA. Assessing the health consequences of northern Ethiopian armed conflict, 2022. J Public Health Policy 2024; 45:43-57. [PMID: 38310169 PMCID: PMC10920422 DOI: 10.1057/s41271-023-00464-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 02/05/2024]
Abstract
Armed conflict is a complicated topic with multidimensional impact on population health. This study aimed to assess of the health consequences of the northern Ethiopian conflict, 2022. We used a mixed method study design with a retrospective cross-sectional study supplemented by a qualitative study conducted from May to June 2022. We interviewed 1806 individuals from 423 households and conducted 100 in-depth interviews and focused group discussion. We identified 224 people who self-reported cases of illness (124/1000 people) with only 48 (21%) people who fell ill visited a health institution. We also detected 27 cases of deaths (15/1000 people) during the conflict. The collapse of the health system, evacuation of health personnel, and shortage of medical supplies, and instability with a lack of transportation were consequences of the conflict. The northern Ethiopian conflict has greatly affected the community's health through the breakdown of the health system and health-supporting structures.
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Affiliation(s)
- Mulugeta Wodaje Arage
- School of Midwifery, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia.
| | - Henok Kumsa
- School of Midwifery, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
| | - Mulu Shiferaw Asfaw
- School of Medicine, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
| | - Abebe Tarekegn Kassaw
- Department of Pharmacy, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
| | - Ephrem Mebratu
- Department of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Amhara Region, Ethiopia
| | - Abayneh Tunta
- School of Medicine, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
| | - Woldeteklehymanot Kassahun
- Department of Medical Laboratory, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
| | - Amanuel Adissu
- Department of Public Health, College of Health Sciences, Injibara University, Injibara, Amhara Region, Ethiopia
| | - Molla Yigzaw
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Amhara Region, Ethiopia
| | - Tilahun Hailu
- School of Public Health, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
| | - Lebeza Alemu Tenaw
- School of Public Health, College of Health Sciences, Woldia University, North Wollo, Amhara Region, Ethiopia
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Mislu E, Assalfew B, Arage MW, Chane F, Hailu T, Tenaw LA, Kidie AA, Kumsa H. Prevalence and factors associated with restless legs syndrome among pregnant women in middle-income countries: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1326337. [PMID: 38188334 PMCID: PMC10771314 DOI: 10.3389/fmed.2023.1326337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Restless legs syndrome (RLS) is a debilitating condition characterized by uncomfortable sensations in the legs, typically occurring during periods of rest or sleep. It is more prevalent during pregnancy and is linked to sleep disturbances, diminished quality of life, and pregnancy complications. However, previous studies yielded inconsistent findings among pregnant women in middle-income countries. Consequently, this systematic review and meta-analysis sought to determine the pooled prevalence of restless legs syndrome and its associated factors in these populations. Method A systematic review and meta-analysis was conducted on published studies from middle-income countries until May 2023. The review strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant search terms were used to search for studies in PubMed, MEDLINE, EMBASE, and Google Scholar. Data extraction was performed using the Joanna Briggs Institute tool for prevalence studies. The meta-analysis was conducted using STATA 17 software, and heterogeneity was assessed using the I2 test, while publication bias was evaluated using Egger's test. Forest plots were also used to present the pooled prevalence and odds ratio (OR) with a 95% confidence interval (CI) using the random-effects model. Result This review included 22 studies from nine countries with a total of 17, 580 study participants. The overall pooled prevalence of RLS among pregnant women in middle-income countries was 13.82% (95% CI: 13.31, 14.32), and having low hemoglobin level (AOR: 1.68, 95% CI: 1.29, 2.18), history of RLS (AOR: 7.54, 95% CI: 3.02, 18.79), muscle cramps (AOR: 3.58, 95% CI: 1.21, 10.61), excessive day time sleepiness (AOR: 4.02, 95% CI: 1.34, 12.04), preeclampsia (AOR: 2.06, 95% CI: 1.28, 3.30), and taking prophylactic iron supplementation (AOR: 0.59, 95% CI: 0.50, 0.69) were the identified factors associated with it. Conclusion Generally, nearly one in every eight pregnant women in middle-income countries develop restless legs syndrome during pregnancy. Having low hemoglobin level, a history of RLS, muscle cramps, excessive daytime sleepiness, preeclampsia, and taking prophylactic iron supplementation were the identified factors associated with it. These findings underscore the importance of addressing the identified factors associated with RLS in order to effectively mitigate its occurrence among pregnant women.
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Affiliation(s)
- Esuyawkal Mislu
- School of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Betel Assalfew
- School of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia
| | | | - Fiker Chane
- School of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Tilahun Hailu
- School of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Lebeza Alemu Tenaw
- School of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Atitegeb Abera Kidie
- School of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Henok Kumsa
- School of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia
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Tenaw LA, Kumsa H, Arage MW, Abera A, Hailu T, Mislu E. Assessment of Place of Delivery and Associated Factors among Pastoralists in Ethiopia: A Systematic Review and Meta-Analysis Evaluation. J Pregnancy 2023; 2023:2634610. [PMID: 38026544 PMCID: PMC10653963 DOI: 10.1155/2023/2634610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 10/15/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Background Pastoralist communities rely on their livestock for at least 50% of their food supply and source of income. Home births raise the risk of maternal morbidity and death, whereas institutional births lessen the likelihood of difficulties during labor. Around 70% of labors in pastoralist regions of Ethiopia were assisted by traditional birth attendants. Methods Studies done from January 2004 to January 2023, accessed in PubMed, EMBASE, Medline, and other search engines, were included. PRISMA guidelines and JBI critical appraisal checklist were used to assure the quality of the review. Ten articles were included in this review. Data were extracted with Excel and exported to STATA 16 for analysis. Heterogeneity of literatures was evaluated using I2 statistics and publication bias using the Egger regression asymmetry test and the Duval and Tweedie trim-fill analysis. Statistical significance was declared at p value less than 0.05. Result The pooled estimate of institutional delivery among the pastoralist community in Ethiopia is 21.2% (95% CI: 16.2-26.1). Husbands who were involved to decide place of delivery (OR = 3.47; 95% CI: 1.61, 7.50), women with good knowledge of MCH services (OR = 2.283; 95% CI: 1.51, 3.44), women who had a positive attitude towards MCH services (OR = 1.69; 95% CI: 0.79, 3.6), availability of health institutions (OR = 2.6; 95% CI: 0.95, 7.20), and women who had an ANC follow-up (OR = 2.78; 95% CI: 2.07, 3.73) were higher institutional delivery prevalence among pastoralist women. Moreover, institutional delivery among women who were educated above the college level was more than two times (OR = 2.56; 95% CI: 1.985, 3.304) higher than among women who were not educated. Conclusion Pastoralist women in Ethiopia were found to be a disadvantaged group for institutional delivery at national level. Husband involvement, educational level, ANC visit, knowledge and attitude for MCH service, and health facility distance were identified to have significant association with institutional delivery.
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Affiliation(s)
- Lebeza Alemu Tenaw
- School of Public Health, College of Health Science, Woldia University, Ethiopia
| | - Henok Kumsa
- School of Midwifery, College of Health Science, Woldia University, Ethiopia
| | | | - Atitegeb Abera
- School of Public Health, College of Health Science, Woldia University, Ethiopia
| | - Tilahun Hailu
- School of Public Health, College of Health Science, Woldia University, Ethiopia
| | - Esuyawkal Mislu
- School of Midwifery, College of Health Science, Woldia University, Ethiopia
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Arage MW, Kumsa H, Asfaw MS, Kassaw AT, Dagnew EM, Tunta A, Kassahun W, Addisu A, Yigzaw M, Hailu T, Tenaw LA. Exploring the health consequences of armed conflict: the perspective of Northeast Ethiopia, 2022: a qualitative study. BMC Public Health 2023; 23:2078. [PMID: 37875885 PMCID: PMC10594710 DOI: 10.1186/s12889-023-16983-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/13/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Conflict is a complicated topic with a multidimensional consequences for community health. Its effects have a broad pattern, starting from direct war-related morbidity and mortality caused by bullets and bombs to indirect consequences due to the interruption of the delivery of preventive and curative health services. This study aimed to explore the health consequences of the northern Ethiopian conflict in the North Wollo zone, northeast Ethiopia, in 2022. METHODS This descriptive qualitative study was conducted from May to June 2022 on six conflict-affected Woredas in the north Wollo zone. A total of 100 purposively selected participants, which included patients, pregnant women, elders, community and religious leaders, and health professionals, were interviewed using IDI and FGD. The data was entered, coded, and analyzed using Open Code version 4.03. Thematic analysis approach employed to conduct the interpretation. Data was presented using descriptive statistics in the form of texts and tables. RESULTS The findings indicate that the conflict has caused a profound consequence on population health. It has resulted in a wide range of direct and indirect consequences, ranging from war-related casualties, famine, and disruptions of supply chains and forced displacement to instances of violence and rape associated with insecurity. The conflict also caused a breakdown in the health system by causing distraction of health infrastructure, fleeing of health workers and shortage of medication, together with insecurity and lack of transportation, which greatly affected the provision and utilization of health services. Additionally, the conflict has resulted in long-term consequences, such as the destruction of health facilities, interruption of immunization services, posttraumatic stress disorders, and lifelong disabilities. The coping strategies utilized were using available traditional medicines and home remedies, obtaining medications from conflict-unaffected areas, and implementing home-to-home healthcare services using available supplies. CONCLUSION The Northern Ethiopian conflict has an impact on community health both directly and indirectly through conflict-related causalities and the breakdown of the health system and health-supporting structures. Therefore, this study recommends immediate rehabilitation interventions for damaged health infrastructure and affected individuals.
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Affiliation(s)
- Mulugeta Wodaje Arage
- School of Midwifery, College of Health Sciences, Woldia University, Woldia, Ethiopia.
| | - Henok Kumsa
- School of Midwifery, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Mulu Shiferaw Asfaw
- School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Abebe Tarekegn Kassaw
- Department of Pharmacy, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Ephrem Mebratu Dagnew
- Department of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Abayneh Tunta
- School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | | | - Amanuel Addisu
- Department of Public health, College of Health Sciences, Injibara University, Injibara, Ethiopia
| | - Molla Yigzaw
- Department of Public health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Tilahun Hailu
- School of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Lebeza Alemu Tenaw
- School of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Kassahun EA, Zeleke LB, Dessie AA, Gersa BG, Oumer HI, Derseh HA, Arage MW, Azeze GG. Factors associated with unintended pregnancy among women attending antenatal care in Maichew Town, Northern Ethiopia, 2017. BMC Res Notes 2019; 12:381. [PMID: 31277714 PMCID: PMC6612166 DOI: 10.1186/s13104-019-4419-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 06/29/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Unintended pregnancy is one of the most public health issues in the world, and it is the major sexual and reproductive health problem which carries a higher risk of morbidity and mortality for women, often due to unsafe abortion. Even though family planning services are effective and available than ever before, unintended pregnancy and unsafe abortion are the major public health problems in the study area. Therefore, this study aimed at assessing the magnitude and associated factors of unintended pregnancy among pregnant women attending antenatal care follow up in Maichew town, northern Ethiopia. An institution based cross-sectional study was conducted on 329 pregnant women selected with a systematic sampling technique from April 5 to May 4, 2017. RESULT The magnitude of unintended pregnancy among pregnant women attending antenatal care in Maichew was found to be 29.7% (95% CI 24.30, 35.50). On the other hand, single in marital status (AOR = 38.6, 95% CI 10.07, 148.01), living alone (AOR = 9.9, 95% CI 1.80, 53.40) and having three or four children (AOR = 3.5, 95% CI 1.10, 11.04) were factors associated with an unintended pregnancy. Creating awareness about unintended pregnancy associated factors and implication of unintended pregnancy is highly recommended.
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Affiliation(s)
| | - Liknaw Bewket Zeleke
- College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Amanuel Addisu Dessie
- Department of Public Health, Faculty of Health Sciences, Woldia University, Woldia, Ethiopia
| | | | | | - Hunegnaw Alemaw Derseh
- Department of Nutrition, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mulugeta Wodaje Arage
- Department of Midwifery, Faculty of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Getnet Gedefaw Azeze
- Department of Midwifery, Faculty of Health Sciences, Woldia University, Woldia, Ethiopia
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