Anxiety and associated factors in Northwest Ethiopian pregnant women: a broad public health concern

Introduction

Pregnancy-related anxiety is a prevalent mental health issue that mostly affects women in low-income countries such as Ethiopia. It has been linked to unfavorable pregnancy outcomes, such as miscarriage, prematurity, and low birth weight. However, it has often received less attention, and community-based evidence lacks its prevalence and associated factors. Thus, the purpose of this study was to assess the prevalence and associated factors of anxiety in Northwest Ethiopian pregnant women in Gondar city.

Methods

A community-based cross-sectional study was conducted from 1 July to 30 August 2021 in Gondar city. A cluster sampling technique was used to select a sample of 872 pregnant women, and in-person interviews were conducted to gather data. Descriptive and analytical statistical procedures were carried out.

Results

Of the participants, pregnancy-related anxiety was reported in 29.4% (95% CI: 26.3, 32.4) of women. The likelihood of having anxiety was higher among women who had known medical illness (AOR = 3.16; 95% CI: 1.8, 5.35), loneliness (AOR = 2.52; 95% CI: 1.34, 4.73), depression (AOR = 2.38; 95% CI: 1.48, 3.85), poor social support (AOR = 1.93; 95% CI: 1.21, 3.07), and intimate partner violence (AOR = 2.87; 95% CI: 2.04, 4.04).

Conclusion

In this study, three out of ten women have suffered from anxiety. It is strongly advised to identify and treat known medical illnesses early in pregnancy, enhance social support, diagnose and treat depression, and limit intimate partner violence through multimodal and integrative activities with concerned bodies.

The prevalence and associated factors of success of labor induction in Hargeisa maternity hospitals, Hargeisa Somaliland 2022: a hospital-based cross-sectional study

BACKGROUND

The induction of labor is an artificial initiation of labor and has become one of the most common interventions in modern obstetrics to improve maternal and neonatal health. Understanding the prevalence and pregnancy outcomes following labor inductions is crucial in regions with high rates of maternal mortality and morbidity because of insufficient access to comprehensive emergency obstetric care. Therefore, this study aimed to assess the prevalence and associated factors of the success of induction of labor in Hargeisa maternity hospital Somaliland.

METHODS

A hospital-based cross-sectional study was employed among 453 women in Hargeisa maternity hospitals, Somaliland from January 1st to March 30th, 2022. Data were entered using Epi data version 4.6 and analyzed by using SPSS version 25. Bivariable and multivariable logistic regression were used to identify the associated factors with the success of labor induction and an odds ratio with a 95% confidence interval was used to measure the strength of the association. A P-value of ≤ 0.05 was considered statistically significant in multivariate analysis.

RESULTS

Of a total of 453 study participants who had undergone induction of labor, 349 (77%) of them had successful induction of labor with a 95% CI: 73%, 81%. Favorable Bishop score (AOR = 3.45, 95% CI: 1.98, 5.99), time from the start of induction to delivery < 12 h (AOR = 4.01, 95% CI: 2.16, 7.450), non-reassuring fetal heart rate pattern (AOR = 0.42, 95% CI: 0.22, 0.78) and amniotic fluid change to meconium (AOR = 0.43, 95% CI: 0.23, 0.79) were significantly associated with the success of labor induction.

CONCLUSION

This study implies that three out of four women who underwent induction had successful induction of labor. Favorable bishop score, time from the start of induction to delivery < 12 h, non-reassuring fetal heart rate pattern, and amniotic fluid change to meconium were significantly associated with the success of labor induction. The hospital should establish a clear bishop scoring system and there should be a strict follow-up on the condition of the fetal heartbeat and take corrective actions as needed. The factors related to healthcare facilities and providers need to be addressed by additional prospective studies.

Self-harm among post-natal mothers in Northwest Ethiopia: Implication for policy and practice

Introduction

Self-harm is a global public health concern affecting thousands of women. However, it is an under-reported and neglected aspect of maternal health, particularly in developing countries. In Ethiopia, there is a paucity of evidence regarding self-harm, and it is rarely given attention. Therefore, this study aimed to assess the proportion of self-harm and associated factors among postnatal mothers in Gondar city, Northwest Ethiopia.

Method

A community-based cross-sectional study was conducted from 1 July, 2021, to 30 August, 2021, in Gondar city. A cluster sampling technique was conducted to select 858 women who gave birth in the last 12 months. The data were collected using a structured questionnaire through face-to-face interviews. The data were entered into EpiData version 4.6 and exported to SPSS 25 for analysis. The multivariable logistic regression analysis was fitted to identify factors associated with the outcome variable. The level of significant association was determined at a p-value of ≤ 0.05.

Result

The proportion of postnatal self-harm was found to be 8.5% (95% CI: 6.7,10.5). Having lower family income (AOR: 2.41, 95% CI: 1.05,5.56), having unplanned pregnancy (AOR: 2.70, 95% CI: 1.53,4.79), experiencing adverse birth outcomes (AOR: 3.11, 95% CI: 1.10,8.83), birth not attended by health provider (AOR: 4.15, 95% CI: 1.76,9.79), experiencing intimate partner violence (AOR: 1.93, 95% CI: 1.12,3.32), and poor decision-making power (AOR: 1.70, 95% CI: 1.02, 2.84) were the variables significantly associated with self-harm.

Conclusion

This study revealed that the proportion of self-harm among postnatal mothers was prevalent. Factors like monthly income of a family, planned pregnancy, birth outcome, birth assistant, intimate partner violence, and decision-making power show an association with maternal self-harm. Antenatal and postnatal self-harm screening as part of the continuum of maternal healthcare is important. Self-harm is also a danger for women who have experienced intimate partner violence or have low socioeconomic economic status, all of which require exceptional mental health assessment.

Low husband involvement in maternal and child health services and intimate partner violence increases the odds of postpartum depression in northwest Ethiopia: A community-based study

Background

Depression is the most common mental health problem that affects women during pregnancy and after child-birth. Postpartum depression, in particular, has both short and long-term effects on the lives of mothers and children. Women’s health is a current global concern, but postpartum depression is a neglected issue in the maternal continuum of care and is rarely addressed. Therefore, this study aimed to assess postpartum depression and associated factors in Gondar city, northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted from August 1^st to 30^th, 2021 in Gondar city. A cluster sampling technique was employed to select 794 postpartum women. Data were entered by EPI DATA version 4.6 and exported to SPSS version 25 for further analysis. The multivariable logistic regression analysis was carried out to identify factors associated with postpartum depression. The adjusted odds ratio with its 95% confidence interval at a p-value of ≤ 0.05 was used to declare the level of significance.

Results

A total of 794 women were included in the analysis, giving a response rate of 98.5%. The prevalence of postpartum depression was 17.25% (95% CI: 14.5, 20.2). Younger maternal age (AOR = 2.72, 95% CI: 1.23, 5.85), low average monthly income (AOR = 2.71, 95% CI: 1.24, 5.91), low decision-making power (AOR = 2.04, 95%CI: 1.31, 3.18), low husband/partner involvement in MNCH care service (AOR = 2.34, 95%CI: 1.44, 3.81), unplanned pregnancy (AOR = 3.16 95% CI: 1.77, 5.62), and experience of intimate partner violence (AOR = 3.13; 95% CI: 1.96, 4.99) were significantly associated with increased odds of postpartum depression.

Conclusion

In this study, nearly 1/5^th of the study participants had postpartum depression. Thus, it is important to integrate maternal mental health services with the existing maternal health care services. It is also crucial to advocate the need for husband’s involvement in MNCH care services and ensure women’s decision-making power in the household. Moreover, community-based sexual and reproductive health education would be better to reduce risk factors of postpartum depression.

Prevalence and associated factors of poor sleep quality among postpartum women in North West Ethiopia: a community-based study

INTRODUCTION

Although sleep disturbance is a community problem, there is limited study in Ethiopia. Therefore, this study aimed to identify the prevalence and factors affecting postpartum poor sleep quality in women.

METHOD

A community-based cross-sectional study was conducted from July 1st to August 30th, 2021 in Gondar city. The cluster sampling method was used to address 858 study participants. The Pittsburgh Sleep Quality Index (PSQI) 19-item self-report measure of sleep quality over the past month was used to measure maternal sleep quality during the postpartum period and a global PSQI score of 5 or more was used to indicate poor sleep quality. Binary logistic regression was used to identify variable association and 95% confidence level and adjusted Odds Ratio were used to declare association.

RESULT

Poor sleep quality prevalence during postpartum period was 24.0% (95%CI: 21.3-26.9). factors significantly associated with poor sleep quality were family size [AOR = 1.76; 95% CI: (1.14-2.73)], unplanned pregnancy [AOR = 2.11; 95%CI: (1.17-3.80)], had a family history of mental illness [AOR = 3.70; 95%CI: (2.15-6.37)], had known medical disorders [AOR = 2.59; 95%CI: (1.51-4.43)], having intimate partner violence [AOR = 2.58; 95%CI: (1.78-3.75)], and women who can read and write and who complete secondary school [AOR = 2.60; 95% CI: (1.20-5.66)] and [AOR = 2.02; 95%CI: (1.16-3.53)] respectively. On the other hand, being housewife, merchant, and government-employed [AOR = 0.32; 95%CI: (0.14-0.73)], [AOR = 0.13; 95%CI: (0.05-0.34)], and [AOR = 0.38; 95%CI: (0.14-0.98)] respectively were identified to be factors significantly associated with poor sleep quality.

CONCLUSION

Poor sleep quality prevalence is high in the community of Gondar city. Thus, setting strategies to increase women's educational level, providing health education programs to create awareness on the consequence of intimate partner violence which could reduce the violence; increasing screening for medical disorders before or during maternity period, preventing unplanned pregnancy with effective family planning method, and employing women in a certain organization will have a great role in reducing poor sleep quality.

Prevalence and factors associated with maternal loneliness during the postpartum period in Gondar city

Background

Mental health problems have increased worldwide, particularly in developing countries. Currently, loneliness is widely understood as a painful subjective experience when the social connections a person has do not meet their interpersonal needs in respect to the quality or quantity of friendship or social interaction. It has been linked to unpleasant health consequences for both the mother and child. Therefore, this study aimed to assess maternal loneliness during the postpartum period and associated factors in Gondar city.

Methods

A community-based cross-sectional study was conducted from July 1^st to August 30^th, 2021 in Gondar city. A cluster sampling technique was employed to select 858 postpartum women. Data were entered into epidemiological data (EPI data) version 4.6 and exported to SPSS 25 for further cleaning and analysis. The multivariable logistic regression analysis was fitted to identify factors associated with maternal loneliness during the postpartum period. The adjusted odds ratio (AOR) with its 95 % confidence interval (CI) was performed and the level of significance was claimed based on a p-value of ≤0.05.

Results

A total of 858 women were included in the analysis, giving a response rate of 98.4%. Two-fifths (40.9%) of the study participants have experienced loneliness during the postpartum period (95% CI: 37.6, 44.2). Low household decision-making power (AOR = 11.2; 95% CI: 7.59, 16.4) and poor social support (AOR = 2.44; 95 CI: 1.58, 3.76) were significantly associated with maternal loneliness.

Conclusion

In this study, 4 out of 10 women have experienced loneliness during the postpartum period. Thus, it highlights the potential risks of the mother’s loneliness on her postnatal well-being, particularly if the woman has poor social support and low household decision-making power. Encouraging women to be involved in all aspects of the household decision-making and promoting the need for social support for all women during the postpartum period may be optimal initial targets to reduce the impact of loneliness.

Nearly Half of Women Have Experienced Intimate Partner Violence During Pregnancy in Northwest Ethiopia, 2021; The Role of Social Support and Decision-Making Power

Background

In developing countries, intimate partner violence is increasing alarmingly, though attention to this issue is rarely given. It has devastating effects on the general wellbeing of women, pregnancy outcomes, and the long-term health of children, and this needs to be addressed. Hence, this study was designed to assess intimate partner violence and associated factors in northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted from July 1^st to August 30^th, 2021, among 858 postpartum women in Gondar city. A cluster sampling technique was employed to select the study participants. EPI DATA version 4.6 and SPSS 25 were used for data entry, cleaning and analysis, respectively. A bivariable and multivariable logistic regression model was fitted to identify factors associated with intimate partner violence. The level of significant association was declared using the adjusted odds ratio (AOR) with 95 % confidence interval (CI) and a p-value of ≤ 0.05.

Results

In this study, 48.6% of women indicated having experienced intimate partner violence during pregnancy (95% CI: 45.3, 51.7). The odds of intimate partner violence during pregnancy were significantly higher among women who were not able to read and write (AOR = 4.96; 95% CI: 2.15, 11.41), were private workers (AOR = 1.78; 95% CI: 1.05, 3.02), and had low decision-making power (AOR = 1.43; 95% CI: 1.06, 1.95), a poor social support (AOR = 1.99; 95% CI: 1.32, 3.02), and unsupported pregnancy by family (AOR = 2.32; 95% CI: 1.26, 4.24). Whereas a family size of ≥ 5 (AOR = 0.73; 95% CI: 0.54, 0.98) appeared to be a protective factor for intimate partner violence.

Conclusion

The magnitude of intimate partner violence was unacceptably high in the study area and connected to poor women's empowerment and social determinants of health. Thus, it is important to focus on interventions that improve women's access to social support and allow them to participate in all aspects of household decision-making through community-based structures and networks. It is also important to encourage women to improve their educational status and arrange risk-free employment opportunities.

Husband Involvement in Maternal, Neonatal, and Child Health Care among Women who Have a Child Less Than one Year in Gondar City, Northwest Ethiopia, 2021

Background

Improving maternal, neonatal and child health is one of the major components of Sustainable Development Goal and countries implement different strategies to achieve this goal. In spite of this, maternal, neonatal and child mortality remains a public health burden in the developing countries, including Ethiopia. World Health Organization recommend active involvement of men during pregnancy, child birth and the postpartum period as an effective strategy to improve maternal as well as newborn health. Therefore, this study aimed to assess husband involvement in maternal, neonatal and child health care among women who have child less than one year in Gondar city, northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted among 870 married women who have a child less than one year in Gondar city. A cluster sampling technique was employed to select study participants. Data were entered into Epi Data version 4.6 and exported to SPSS version 25 for analysis. Multivariable logistic regression was done and adjusted odds ratio with a 95% confidence interval was used to report the association between covariates and the outcome variable.

Results

Husband involvement in Maternal, Neonatal and Child Health (MNCH) care was 66.2% (95%CI: 63, 69.3). Maternal age (18-25years) and (26-35years), having diploma and above education, husband occupation (government employee), (merchant) and (self-employed), planned pregnancy and cesarean delivery were significantly associated with husband involvement in MNCH care.

Conclusion

In this study, nearly two thirds (66.2%) of women had husband involvement in MNCH care. Therefore, it is important to improve women's educational attainment and actions should be taken to prevent unplanned pregnancy.