Limited handwashing facility and associated factors in sub-Saharan Africa: pooled prevalence and multilevel analysis of 29 sub-Saharan Africa countries from demographic health survey data.

INTRODUCTION: Handwashing is fundamentally an inexpensive means of reducing the spread of communicable diseases. In developing countries, many people die due to infectious diseases that could be prevented by proper hand hygiene. The recent coronavirus (COVID-19) pandemic is a threat to people who are living in resource-limited countries including sub-Saharan Africa (SSA). Effective hand hygiene requires sufficient water from reliable sources, preferably accessible on premises, and access to handwashing facility (water and or soap) that enable hygiene behaviors. Therefore, this study aims to determine the prevalence of limited handwashing facility and its associated factors in sub-Saharan Africa. METHODS: Data from the Demographic and Health Surveys (DHS) were used, which have been conducted in 29 sub-Saharan African countries since January 1, 2010. A two-stage stratified random cluster sampling strategy was used to collect the data. This study comprised a total of 237,983 weighted samples. The mixed effect logistic regression model with a cluster-level random intercept was fitted. Meta-analysis and sub-group analysis were performed to establish the pooled prevalence. RESULTS: The pooled prevalence of limited handwashing facility was found to be 66.16% (95% CI; 59.67%-72.65%). Based on the final model, household head with age group between 35 and 60 [AOR = 0.89, 95% CI; 0.86-0.91], households with mobile type of hand washing facility [AOR = 1.73, 95% CI; 1.70-1.77], unimproved sanitation facility [AOR = 1.58, 95% CI; 1.55-1.62], water access more than 30 min round trip [AOR = 1.16, 95% CI; 1.13-1.19], urban residential area [AOR = 2.08, 95% CI; 2.04-2.13], low media exposure [AOR = 1.47, 95% CI; 1.31-1.66], low educational level [AOR = 1.30, 95% CI; 1.14-1.48], low income level [AOR = 2.41, 95% CI; 2.33-2.49] as well as lower middle-income level [AOR = 2.10, 95% CI; 2.14-2.17] and households who had more than three children [AOR = 1.25, 95% CI; 1.20-1.31] were associated with having limited handwashing facility. CONCLUSION AND RECOMMENDATION: The pooled coverage of limited handwashing facility was high in sub-Saharan Africa. Raising awareness of the community and promoting access to handwashing materials particularly in poorer and rural areas will reduce its coverage.

Domestic violence during COVID-19 pandemic among pregnant women registered for antenatal care and selected adverse pregnancy outcomes in Amhara region Ethiopia: Prospective cohort study design.

Back ground: Domestic violence during pregnancy is the most devastating but neglected problem in Amhara region. The newly introduced COVID-19 pandemic prevention and control strategies predispose for domestic violence during pregnancy and this in turn the risk for adverse pregnancy outcomes. Objective: To assess the magnitude of domestic violence during COVID-19 pandemic among pregnant women and adverse pregnancy outcomes in Amhara region Ethiopia. Methods: Both institution and community based prospective cohort study design was employed among 774 pregnant. The data were collected from may1/2021 up to march1/2021by face to face interview using pretested and structured questionnaire. Binary logistic regression analysis was done. P value < 0.05 was used to declare statistical association. Results: A total of 774 women were participated in the study. Domestic violence during COVID-19 pandemic among pregnant women was found to be 65.76% (61.1%-69%). The overall prevalence of adverse pregnancy out comes was 9.7% with. Antenatal care visit number 3&above (AOR) = 0.6; 95% CI 0.4-0.8), unintended pregnancy (AOR = 2.2; 95% CI 1-4.6), no ambulance services (AOR = 1.5; 95% CI 1-2.2), not the primary decision maker for family planning use (AOR = 3.3; 95% CI 1.6-6.5), no health care provider support (AOR = 12; 95% CI 6.3-23) were statistically significant with domestic violence during pregnancy. Conclusions: Domestic violence during COVID-19 pandemic was high in the study area. Giving emphasis for antenatal care visit 3& above, type of pregnancy, accessibility of ambulance services, decision maker for family planning service and health care provider support during antenatal care were area of interests that are important for tackling domestic violence during pregnancy.

Perception of risk regarding the use of COVID-19 vaccine among pregnant women in Motta town and Hulet Eji Enese district, northwest Ethiopia.

BACKGROUND: COVID-19 vaccination during pregnancy is a common practice in developing countries like Ethiopia. Despite there being a rumor from the community that the use of COVID-19 vaccination during pregnancy is associated with many pregnancy adverse outcomes. However, there is a paucity of empirical evidence on the perception of risk COVID-19 vaccination during pregnancy in Ethiopia. This study assessed the perception of risk COVID-19 vaccination during pregnancy and associated factors in Motta town and Hulet Eji Enese district, northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted from December 12 to February 12, 2021. A total of 851 women' were selected using the stratified cluster sampling technique. Data were collected by face-to-face interview using a semi-structured pretested and interviewer-administered questionnaire. A multivariable logistic regression model was fitted to identify factors associated with the perception of risk COVID-19 vaccination during pregnancy. The adjusted odds ratio (AOR) with a 95% confidence interval at a p-value of ≤ 0.05 was used to declare the level of significance. RESULTS: Perception of risk COVID-19 vaccination during pregnancy was 34.2% (95%CI (Confidence Interval): 31-37). Unplanned pregnancy (AOR = 3.66; 95%CI: 2.31-5.81), long travel time to the nearby health care facility (AOR: 4.57; 95% CI: 2.34-8.91), have no formal education (AOR: 3.15; 95%CI: 1.71-5.79), attending secondary educational level (AOR: 5.18; 95% CI: 2.17-12.4), no ANC (Antenatal Care) service utilization (AOR: 7.07; 95% CI: 4.35-11.5) and negative attitude towards COVID-19 vaccination (AOR: 6.05; 95%CI: 3.88-9.43) were significantly associated with the perception of risk COVID-19 vaccination during pregnancy. CONCLUSIONS: Most of the participants perceive COVID-19 vaccination during pregnancy as a risk for the outcome of pregnancy. Designing strategies to increase women's educational status, promoting the need for maternal and child health services, and awareness creation regarding COVID-19 vaccination will have a great role in changing the perception of pregnant women. Therefore, the government should design public health programs targeting the identified factor, and should minimize the perception of risk acquiring infection from COVID-19 vaccine to improve maternal and neonatal health outcome.

The Effects of Fear and Knowledge of COVID-19 on Preventive Practice Among Pregnant Women Who Attend Antenatal Care in Northwest Ethiopia, 2020: Institution-Based Cross-Sectional Study.

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) pandemic has infected over one million individuals with almost 50,000 deaths worldwide. COVID-19 is currently a global health threat and a public health emergency. Therefore, accurate and up-to-date information regarding prevention and control methods is essential. OBJECTIVE: The aim of the study was to assess the effects of fear and knowledge of COVID-19 on preventive practices among pregnant women who attend antenatal care in northwest Ethiopia, 2020. METHODS: An institution-based cross-sectional study was conducted between July and August 2020. The systematic random sampling technique was used to select 422 participants. Data collected by a face to face interview on pretested and structured questions were entered using Epi-Info version 7 and it was analyzed using SPSS version 22 software. The bivariate and multivariable logistic regression model was used to assess factors associated with COVID-19 preventive practices. Adjusted odds ratio (OR) with a 95% confidence interval (CI) was used to determine the association between covariates and the outcome variable. The p-value less than 0.05 was considered statically significant. RESULTS: According to this study, good preventive practice of COVID-19 among pregnant women was found to be (47.4%). Fear of COVID-19 was (50.9%). The majority (55.0%) of the respondents had good knowledge. Fear [AOR: 2.485, 95% CI: (1.664-3.711)] and having good knowledge [AOR: 2.308, 95% CI: (1.541-3.457)] were significantly associated with good prevention practices among the women. CONCLUSION AND RECOMMENDATION: Only half of the pregnant women had good preventive practice. The findings suggest that healthcare bodies should consider these findings to develop strategies for preventive practice against COVID-19.