Induced abortion in Africa: A systematic review and meta-analysis.

BACKGROUND: One of the main factors contributing to maternal morbidity and mortality is induced abortion. The WHO estimates that over 44 million induced abortions take place annually around the world. The majority of these abortions-about 50%-are unsafe, significantly increasing maternal morbidity and contributing to 13% of maternal deaths. Thus, this review aimed to estimate the pooled prevalence of induced abortion and its associated factors in Africa. METHODS: To find literature on the prevalence of induced abortion and its associated factors, a thorough search of the internet databases such as PubMed/MEDLINE, African Journals Online, and Google Scholar was conducted. The data were extracted using a structured method of data collection. Software called STATA 14 was used to do the analysis. funnel plot and Egger regression test were used to evaluate potential publication bias. I2 statistics and Cochrane's Q were used to measure the heterogeneity at a p-value < 0.05. RESULTS: 976 studies were found through a thorough search of electronic databases. Finally, 46 full-text abstract papers were included in this study. The estimated pooled prevalence of induced abortion was 16% (95% CI: 13%-19%). According to the sub-group analysis, most studies were conducted in Ethiopia, and the pooled prevalence was 19% (95% CI: 10%-30%). Similarly, the subgroup analysis by year of study showed that the prevalence of induced abortion was 39% (95% CI: 17%-64%) among studies conducted in 2019. CONCLUSION: The results of this study thus imply that the pooled prevalence of induced abortion is higher than that of earlier studies that were published in some nations. the data from this study are needed to support reproductive and adolescent health programmers and policymakers and to formulate recommendations for future clinical practice and guidelines.

Adherence to Antiretroviral Therapy and Associated Factors Among HIV-Infected Children in Public Health Institutions of Adwa, Axum, and Shire Towns of Tigray, Northern Ethiopia: A Cross-Sectional Study.

Background: Antiretroviral therapy (ART) provision was among the major challenge of treatments. Maintaining the optimal level of adherence among children living with HIV/AIDS is a pivotal step towards achieving treatment success. However, there are limited studies on child's ART adherence. Therefore, this study aimed to assess the level of adherence to antiretroviral therapy and associated factors among HIV-infected children in health institutions of Adwa, Axum, and Shire towns, Tigray, Northern Ethiopia. Methods: An institutional-based cross-sectional study was conducted among human immunodeficiency virus (HIV)-infected children in between February and April, 2016. A total of 255 children who were taking antiretroviral therapy in the randomly selected three health facilities from Adwa, Axum and Shire towns were included. Data were collected using pretested and structured questionnaires using a face-to-face interview. The collected data were entered into Epi Info version 7 and then exported to SPSS version 21 for analysis. Bivariate and multivariate binary logistic regression models were used to determine the factors associated with adherence to antiretroviral therapy among HIV-infected children. Results: A total of the 255 study participants were included in the study. The level of ART adherence among HIV-positive children was 212 (84.8%). Knowledge of caregivers about ART treatment (AOR = 2.78, 95% CI: 1.18, 6.53), occupational status (AOR = 4.78, 95% CI: 1.26, 18.91), appointment to ART less than two months (AOR = 3.05, 95% CI: 1.21, 7.70) and use of memory aids (AOR = 4.58, 95% CI: 1.73, 12.13) were independently associated with adherence to ART. Conclusion: The level of adherence to antiretroviral therapy was low. Healthcare providers should reinforce adherence intervention and counseling sessions during follow-up and address the proper use of medication reminders to help children take their drugs appropriately.

Diarrheal disease in under-five children among model and non-model families in northern Ethiopia, 2017: a comparative cross-sectional study.

OBJECTIVE: Diarrheal disease in under-five children among model families is expected to be lower than non-model families. Therefore, this study compared the prevalence and associated factors of diarrheal diseases among under-five children between model and non-model families. A comparative cross-sectional study was conducted from May to June 2017 among 322 children from each model and non-model family. Using multistage sampling technique data were collected through interview and observation. Both bi-variable and multivariable analyses were used to compute the statistical associations. Statistical significances were declared at 95% CI and p value < 0.05. RESULTS: Diarrheal disease in under-five children for those from model families was 26 (8.1%) and 65 (20.2%) to the non-model families with 95% CI 0.117, 0.168. Being non-model family (AOR = 1.9 and 95% CI 1.004, 3.565), maternal history of diarrhea (AOR = 3.3 and 95% CI 1.975, 5.570), improper waste disposal method (AOR = 2.6 and 95% CI 1.251, 5.578) and not latrine use (AOR = 2.1 and 95% CI 1.128, 3.897) were found determinant factors of diarrhea. Health extension model families training and follow up programs are needed to be expanded for all non-model families.

Factors Associated with Compliance with the Recommended Frequency of Postnatal Care Services in Four Rural Districts of Tigray Region, North Ethiopia.

BACKGROUND: The postpartum period has been advocated as a way to improve the survival of mothers and newborns. However, the status of the recommended number of postnatal care (PNC) services has not been well studied. The purpose of this study was to assess the level of full PNC visits and factors associated with it among mothers. METHODS: A community-based cross-sectional study was performed among 1,109 women from March to April 29, 2017. Data were collected via face-to-face interviews, recorded using EPI INFO ver. 7.0 (Centers for Disease Control and Prevention, Atlanta, GA, USA) and analyzed by STATA ver. 12.0 (Stata Corp., College Station, TX, USA). Multivariate logistic regression was applied to assess the predictors of the recommended frequency of PNC services. Adjusted odds ratios (aORs) at 95% confidence interval (CIs) were performed. P-values <0.05 were declared statistically significant. RESULTS: Status of compliance with the use of full PNC services was found to be 16.1%. Women who had antenatal care follow-up (aOR, 5.60; 95% CI, 2.50 to 12.55) and women who delivered at health institutions (aOR, 3.66; 95% CI, 1.74 to 7.70) were more likely to have full PNC visits. Proximity of women to health facilities was found to lower the odds of complete PNC visits (aOR, 0.24; 95% CI, 0.10 to 0.56). Moreover, district of residence remains a predictor of service use. CONCLUSION: The percentage of women with full PNC visits was found to be low. Therefore, to achieve the recommended frequency of PNC in the study area, the results of this study suggest a need to strengthen the uptake of ANC and institutional delivery services.

Intentions on contraception use and its associated factors among postpartum women in Aksum town, Tigray region, northern Ethiopia: a community-based cross- sectional study.

BACKGROUND: Increased access to contraceptive methods has been established as a cost-effective strategy for developing countries to reduce maternal and child mortality. Intentions to contraceptive uptake appear to be best predictors of actual contraceptive practice than the unmet need. However, intention to contraceptive use in Ethiopia particularly among postpartum women is not well assessed. Therefore, the objective of this study was to assess intention to use modern contraceptive and to identify factors associated among postpartum women in Aksum town. METHODS: A community -based analytical cross-sectional study design was done to collect the data from 604 postpartum mothers using a structured questionnaire. The data was collected from March 25 to April 24, 2015. A multivariable logistic regression was conducted to assess factors associated with intentions to use contraceptive methods. Factors influencing intentions on contraceptive methods use were assessed by computing adjusted odds ratios (AOR) at 95% confidence interval (CI) with statistical significant p- value < 0.05. RESULTS: Intention to use modern contraceptive was 84.3%. Resumed sexual intercourse (AOR = 1.78; 95% CI: 1.34, 3.92) and women whose their husband approved family planning to use (AOR = 1.57; 95% CI: 2.02, 5.57) were more likely to have intention on contraceptive use. In addition, those women who knew at least one method of modern contraceptive (AOR = 5.17; 95% CI: 1.69, 15.82) were more likely to had intention to use modern contraceptive during extended postpartum period compared to their counterparts. CONCLUSION AND RECOMMENDATION: More than eight in ten study participants have intention to use contraceptive in the Aksum town. Resumed sexual intercourse, husband's approval of family planning and knew at least one method of contraceptive are the three major predictors to be an areas when considering interventions to increase of intention on contraceptive. Therefore, this study highlighted that; in order to increase intention and adoption of contraceptive, the family planning services providers and programmers should continue the promotion of partner involvement and increasing family planning knowledge through printed media and mass media.

Blood donation practice and associated factors among health professionals in Tigray regional state public hospitals, northern Ethiopia.

OBJECTIVE: The demand for blood and blood products are increasing in all part of the globe, especially in the developing nations. However, there is limited information on the level of blood donation practice and their related factors. Therefore, assessing the level of blood donation practice and its determinant factors among health professionals have a paramount importance in designing an effective strategy for sustaining adequate and safe blood provision in the hospitals. RESULTS: Out of 556 health professionals, 266 (47.8%) had ever donated blood in their life time. Age above 30 years (AOR = 2.756 95% CI 1.055-7.197), married health professionals (AOR = 1.729 95% CI 1.091-2.739), health professionals' knowledge of blood donation (AOR = 3.403 95% CI 2.296-5.044), health professionals' attitude towards blood donation (AOR = 3.41 95% CI 2.320-5.041) and health professionals who attend degree education (AOR = 0.315 95% CI 0.104-0.950) were significantly associated with blood donation behavior of health professionals. The magnitude of blood donation practice was found low. Therefore, the Ethiopian Red Cross Society and ministry of health should continue increasing the attitude and knowledge of health professionals toward blood donation practices are the key avenues interventions.

A preliminary survey of major diseases of ruminants and management practices in Western Tigray province, northern Ethiopia.

BACKGROUND: Despite the highest population, the productivity of Ethiopian livestock is low, and the direct contribution to the national economy is limited. Poor genetic potential, shortage of feed in quantity and quality, poor health care and management practices are the main contributors to low productivity and production. Data on animal disease and management practices are not in place, in this regard; we estimate the burden of animal health ailments and management practices in ruminants via simple cross-sectional study design in randomly selected peasant associations in western Tigray of northern Ethiopia. RESULTS: A preliminary disease survey in ruminants and their management practices comprising of cattle, sheep and goats was undertaken to evaluate the existence, burden of ruminant diseases and management practices. A total of 121 randomly selected household respondents of Maikhadrah and Bakhar (26.2%), Dansha (19.7%), Adi-Hirdi (18.0%), Adi-Remets and Inda-Selassie (36.1%) sub-districts were inspected throughout the study period. Most (81%) of farmers feed their animals on free grazing in the open environment travelling from highlands and midlands to lowlands in search of adequate feed (different species of grasses) and crop residues during the wet season up to the beginning of the dry season. Majority of farmers (43.8%) had veterinary access from governmental veterinary officers. Thirty-four (33.9%) of the respondents got veterinary access from illegal drug dealers in mini shops or market. Among the major disease constraints identified; Tick infestation (89.3%), lice infestation (68.6%) mange mite infestation (77.7%) lumpy skin disease (LSD) (42.1%), trypanasomiasis (62.8%) bovine pasteurellosis (52.1) mastitis (13.2%), sheep and goat pox (15.7), abortion (19.0%), dystocia (24.8%), retained fetal membrane (25.6%), prolapsed uterus (13.2%) delayed heat period (38.8%) were most endemic ailments directly affecting livestock production and farmers livelihood. CONCLUSION: In conclusion management practices in livestock production is poor to a large extent. Burden and endemicity of livestock diseases are substantially higher. The data obtained could be the source of facts for planners in animal health service delivery system in this sub region.

Knowledge and associated factors of lactational amenorrhea as a contraception method among postpartum women in Aksum town, Tigray Region, Ethiopia.

OBJECTIVES: The objective of the study was to assess the prevalence of knowledge level and predictors of lactational amenorrhea method (LAM) as method of contraception among women who gave birth a year prior to the study period in the Aksum town, Tigray Region. The study was cross sectional in design conducted from March 25 to April 24, 2015. Results of the study could help the design of family planning strategies. RESULTS: The knowledge status of LAM as a contraceptive method was 8.8% [95% CI 6.4-11%)]. Women who delivered at health institution (AOR = 1.4, 95% CI 1.2-4.3), attended postnatal care (AOR = 1.3, 95% CI 1.2-3.0) and visited home and counseled about family planning by health extension in the last 12 months, (AOR = 1.5, 95% CI 1.3-4.0) were more likely found knowledgeable towards LAM. Secondary and above level of the maternal education was also found a significant predictor variable with LAM as a contraceptive method (AOR = 1.2 95% CI 1.1-4.0). Our findings recommend that to address the knowledge gap of mothers; improving the uptake of maternal health services and strengthening family planning counseling at home are a key area for improving the knowledge level of LAM.

Predictors of postpartum contraceptive use in rural Tigray region, northern Ethiopia: a multilevel analysis.

BACKGROUND: Postpartum family planning services is one of the recommended public health intervention aimed at reducing maternal and child morbidity and mortalities. However, there is a paucity studies in rural Tigray region. Therefore, determining the level and associated factors of contraceptive use among postpartum women has the potential to contribute in achieving the Ethiopian Health Sector Transformation Plan and to the Sustainable Development Goals on maternal and infant survival. METHODS: A community-based cross-sectional study was done among 1109 postpartum women from March 29, 2017 to April 29, 2017. Face -to-face interview was used for data collection. The collected data were entered and cleaned using EPI - INFO version 7statistical software and later exported to and analyzed using STATA version 12. Mixed-effects multilevel logistic regression analysis was used to identify the individual and community-level factors associated with contraception adoption. A two side p-value< 0.05 was considered to be statistically significant. RESULTS: The level of contraceptive use was 38.3%. Individual-level variables such as women belong to fourth (AOR = 1.2; 95% CI: 1.1-3.2) and fifth (AOR = 1.5; 95% CI: 1.3-2.5) wealth quintiles were identified as key predictors of contraception use. In addition, partner secondary (AOR = 2.3; 95% CI: 1.8-3.5) and diploma (AOR = 1.2; 95% CI, 1.1-2.6) educational-level and postnatal care (AOR = 2.0; 95% CI: 1.9, 4.3) were also significantly affected contraception use. Community-level variables such as high community-level antenatal care services use (AOR = 2.1; 95% CI: 1.9-4.2) and proximity of women to health facility (AOR = 3.0; 95% CI: 2.7-4.6) were also determinants of contraception uptake. CONCLUSIONS: The status of contraceptive use in rural Tigray region was found to be low. It was found that both individual and community-level variables showed a marked determinant on postpartum contraception use. This study suggested that in order to increase contraceptive use the government should focus on increasing postnatal care, antenatal care services use and reduction of poverty level are important avenues for intervention.

Breast self-examination practice and associated factors among women aged 20-70 years attending public health institutions of Adwa town, North Ethiopia.

OBJECTIVE: Breast cancer is the leading cause of cancer mortality worldwide. The incidence of breast has been increasing in most regions of the world. Regular breast self-examination is one of the most cost-effective methods for early detection of breast cancer in asymptomatic women. Despite this fact, breast self-examination practice remains low in Ethiopia. Therefore, the aim of this study is to assess breast self-examination practice and associated factors among women aged 20-70 years attending public health institutions of Adwa town, North Ethiopia. RESULTS: From the total study participants, only 26 (6.5%) of them had ever practice breast self-examination, and only 25 (6.25%) of them practice breast self-examination regularly. Being a government employee (AOR = 0.22, 95% CI = 0.071-0.683), having good perceived confidence to do breast self-examination (AOR = 5.32, 95% CI = 1.89-14.95) and having perceived good susceptibility to develop breast cancer (AOR = 3.79, 95% CI = 1.74-9.74) were the factors significantly associated with breast self-examination. Breast self-examination practice among the study participants was low. Therefore, informing every woman is susceptible to breast cancer, improving the confidence of women is recommended to increase breast self-examination practice.

Predictors of back disorder among Almeda textile factory workers, North Ethiopia.

OBJECTIVES: To guide the development of targeted interventions for the prevention of work-related back pain, this manuscript estimates the prevalence of back pain and its association with a variety of risk factors among Almeda textile factory production works from March to April 2015. An institutional-based cross-sectional study was carried out in Almeda textile factory, North Ethiopia. Randomly selected workers were administered a structured questionnaire about their socio-economic status, lifestyle, working conditions, back pain and selected risk factors. The data was entered to Epi Info 3.5.4 version and analyzed using SPSS version 16. Descriptive statistics were done to characterize the study participants. Bivariate and multiple logistic regressions were fitted to control confounding variables. Adjusted odds ratio with 95% confidence intervals was computed. RESULTS: The prevalence of work-related musculoskeletal disorders was 53.1%. Gender, age, years of service, lack of physical activity, unavailability of adjustable chair, work-load and poor light were significantly associated with increased risk of back pain. The high prevalence of work-related back pain disorder implies that; habit of doing physical exercise, availing adjustable chair and light at the working place, are key issues which require specific interventions.

Postpartum modern contraceptive use in northern Ethiopia: prevalence and associated factors.

OBJECTIVES: The postpartum period is a critical period for addressing widespread unmet needs in family planning and for reducing the risks of closely spaced pregnancies. However, contraception during the extended postpartum period has been underemphasized in Ethiopia. Therefore, this study aimed to assess postpartum modern contraceptive use among women in northern Ethiopia and to identify factors associated with modern contraceptive use in the postpartum period. METHODS: A community based cross-sectional study was conducted from March to April, 2015. Data were entered using Epi Info version 7 and then exported into Stata version 12 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of postpartum modern contraceptive use. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, and p-values <0.05 were considered to indicate statistical significance. RESULTS: Nearly half (48.0%) of women used modern contraceptives during the extended postpartum period. Postpartum modern contraceptive use was significantly associated with secondary and tertiary education levels (aOR, 4.25; 95% CI, 1.29 to 14.00; aOR, 5.36 ; 95% CI, 1.14 to 25.45, respectively), family planning counseling during prenatal and postnatal care (aOR, 5.72 ; 95% CI, 2.67, 12.28), having postnatal care (aOR, 2.36; 95% CI, 1.15 to 4.87), resuming sexual activity (aOR, 9.53; 95% CI, 3.74 to 24.27), and menses returning after birth (aOR, 6.35; 95% CI, 3.14 to 13.39). In addition, experiencing problems with previous contraceptive use was negatively associated with modern contraceptive use (aOR, 0.34; 95% CI, 0.16 to 0.72). CONCLUSIONS: Low rate of postpartum modern contraceptive use were found in the study area. Therefore, strengthening family planning counseling during antenatal and postnatal care visits, improving utilization of postnatal care services and improving women's educational status are crucial steps for to enhance modern contraceptive use among postpartum women.