Utilization of growth monitoring and promotion services among children younger than 2 years in West Armachiho district, Northwest Ethiopia.

Introduction: Inadequate physical growth and poor development of children are prevalent and significant problems worldwide, with 149 million children younger than 5 years stunted and 49 million wasted. Growth monitoring and promotion (GMP) is one of the major activities implemented with the aim of capturing growth faltering before the child reaches the status of undernutrition. In relation to this, the Amhara region, where the study area is found, is a highly burdened area for child malnutrition. Thus, it needs further investigation about the utilization of GMP services and associated factors among children younger than 2 years in the study area. Objective: The aim of this study was to assess the utilization of growth monitoring and promotion services and associated factors among children younger than 2 years. Methods: A community-based cross-sectional study was conducted in the West Armachiho district, including 703 mother-child pairs, with a response rate of 94.7%. A simple random sampling technique was used to select the respondents. Both bivariable and multivariable logistic regression analyzes were performed. An adjusted odds ratio (AOR) with a 95% confidence interval was used to measure the strength of the association. Results: The proportion of utilization of growth monitoring and promotion services in the West Armachiho district was 13.7% (95%Cl; 11.2, 16.4). Factors such as maternal educational status (AOR = 2.17, 95%Cl; 1.05, 4.49), institutional delivery (AOR = 3.16, 95%Cl; 1.62, 6.13), family size (AOR = 2.66, 95%Cl; 1.13, 6.23), access to health facility (AOR = 3.17, 95%Cl; 1.45, 6.95), and maternal knowledge (AOR = 4.53, 95%Cl; 2.71, 7.59) were significantly associated with the utilization of growth monitoring and promotion services. Conclusion: Utilization of growth monitoring and promotion services in children younger than 2 years in the West Armachiho district was low. Thus, giving due attention to the improvement of the knowledge of the mothers/caregivers about child GMP services and counseling them about the importance of facility delivery is vital to improving growth monitoring and promotion services in the area.

Prevalence and factors associated with stunting and thinness among school age children in rural primary schools, East Dembia District, Northwest Ethiopia.

PURPOSE: To assess the prevalence and factors associated with stunting and thinness among school-age children in rural primary schools in the East Dembia District, Northwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted using a systematic random sampling procedure to select 840 school-aged children. A structured interviewer-administered questionnaire was used to collect the data. Height and weight measurements were taken, and a combined wet mount and concentration technique was used. Epi Data 3.1 was used to enter data, which was then exported to SPSS version 20 for analysis. Bi-variable and multivariable logistic regression analyses were done. Variables with a p-value of less than 0.05 were considered significantly associated with stunting and thinness. RESULTS: The prevalence of stunting and thinness was 25.5 and 13.0%, respectively. Being infected with an intestinal parasite (AOR =4.34; 95% CI: 2.52, 12.27), being in the age group 11-14 years (AOR =3.73; 95% CI: 2.19, 6.34), having the lowest dietary diversity practice (AOR =4.61; 95% CI: 1.73, 12.27), unimproved water sources (AOR =1.76; 95% CI: 1.07, 2.91), not practicing good hygiene practice (AOR =1.71; 95% CI: 1.04, 2.804) and having an unimproved latrine type (AOR =1.72; 95% CI: 1.03, 2.89) were significantly associated with stunting. On the other hand, unsecured food (AOR =1.74; 95% CI: 1.08, 2.81), eating less than 3 meals per day (AOR = 2.67; 95% CI: 1.11, 6.46), and untreated water (AOR =1.72; 95% CI: 1.08, 2.75) were factors associated significantly with thinness. CONCLUSION: Stunting and thinness are predominant public health problems in the study area, provided that the prevalence of stunting is slightly higher than that of a national survey on health and nutrition in schoolchildren, whereas the prevalence of thinness is lower when compared to the same national survey. In this study, the primary factor that was significantly associated with stunting was dietary diversity; the primary factor that was associated with thinness was eating fewer than 3 meals per day. So, an integrated strategy is important to alleviate undernutrition among school-aged children in the current study area.

Lifestyle Modification Practice and Associated Factors Among Diagnosed Hypertensive Patients in Selected Hospitals in Central Gondar Zone.

Background: Hypertension is one of the leading causes of disability and death in both developed and developing countries including Ethiopia. Non-communicable diseases account for 42% of deaths in Ethiopia. However, it is still widely undetected and poorly controlled. Hence, this study aims to assess the lifestyle modification practices and related factors of adult hypertensive patients in the central Gondar region of northwestern Ethiopia. Methods: Institutional based, cross-sectional study was conducted from April 10 up to May 10, 2021. A simple random sampling was used to select 629 study participants. Data were collected by using self-administered and structured questionnaire. Data were entered to EpiData 4.6 and exported to SPSS 20 for further analysis. A multivariable logistic regression analysis was employed to identify the factors associated with lifestyle modification. Adjusted Odds Ratio (AOR) with 95% confidence interval was used to show the strength of association, while a P-value <.05 of was used to declare the significance of association. Results: The overall prevalence of recommended lifestyle modification in hypertensive patients was 24.2% (95% CI (20.8, 27.5)). Age ⩾65 years (AOR = 0.59, 95% CI: 0.39, 0.88), no formal education (AOR = 0.65, 95% CI: 0.4, 0.97), diagnosis time is 5 to 10 years (AOR = 1.93, 95% CI: 1.11, 3.34), co morbidities (AOR = 0.47, 95% CI: 0.3, 0.73), and rich wealth index (AOR = 1.99, 95% CI: 1.22, 3.27) are is significantly associated with good lifestyle modification practices. Conclusions: The practice of good lifestyle modifications in the study area was found to be low among the hypertensive patients. Respondents' age, education status, wealth index, duration of diagnosis, and co morbidities were found to be significant factors related to good lifestyle modification practices. Therefore, more attention should be paid to providing nutrition counseling and health promotion to improve the practice of lifestyle modification in patients with hypertension.

Adequate vitamin A rich food consumption and associated factors among lactating mothers visiting child immunization and post-natal clinic at health institutions in Gondar Town, Northwest Ethiopia.

BACKGROUND: Vitamin A deficiency is highly prevalent in low-income countries and is a major public health problem worldwide. Lactating mothers are the most vulnerable population group to vitamin A deficiency. Despite this, there is limited study on vitamin A-rich food consumption by lactating mothers in Ethiopia. Therefore, this study aimed to assess adequate vitamin A rich food consumption and associated factors among lactating mothers visiting child immunization and postnatal care centers in health institutions of Gondar Town. METHODS: An Institution-based cross-sectional study design was employed at a health institution in Gondar Town from February to March 2019, and included 631 study participants. Simple random sampling followed by a systematic sampling technique was used to select participants. The data were collected using the Helen Keller International Food Frequency Questionnaire, entered using Epi-Info 7 statistical software and exported to STATA version 14 for analysis. A multivariable logistic regression analysis was used to identify factors associated with the outcome variable and variables with p-value <0.05 were considered as statistically significant. RESULT: A total of 624 lactating mothers participated in the study giving a response rate of 98.89%. The study shows adequate consumption of vitamin A-rich food was 38.94% (95% CI: 35%- 43%). Predictors such as attending college diploma and above (AOR = 2.26, 95% CI; 1.02-4.99), having household family size ≤ 3 (AOR = 4.04, 95% CI; 1.60-10.17), being in higher economic class (AOR = 1.93, 95% CI; 1.18-3.14), having dietary diversity score of ≥ 5 (AOR = 1.59, 95% CI; 1.09-2.32) and meal frequency of ≥ 4 (AOR = 1.64, 95% CI; 1.09-2.32) were statistically significant. CONCLUSION AND RECOMMENDATION: The majority of respondents had inadequate consumption of foods rich in vitamin A. Educational status, family size, wealth index, dietary diversity, and meal frequency were found to be factors that affect adequate consumption of vitamin A-rich foods. Encouraging and educating lactating mothers to consume foods rich in vitamin A is crucial.

Adherence to Iron and Folic Acid Supplement and Its Associated Factors among Antenatal Care Attendant Mothers in Lay Armachiho Health Centers, Northwest, Ethiopia, 2017.

BACKGROUND: Iron deficiency is the leading nutrient deficiency globally affecting the lives of more than two billion people worldwide. Pregnant women are at higher risk of iron and folic acid deficiency due to lack of iron and folic acid or due to poor adherence. Adherence to iron and folic acid supplement is taking 65% or more of the recommended supplement, equivalent to taking the supplement at least 4 days a week during 3 months period using recording, reporting, and checking cards. OBJECTIVE: The current study aimed at assessing adherence to iron and folic acid supplement during pregnancy and its associated factors among pregnant women attending antenatal care. METHODS: Institution based cross-sectional study was conducted from February to March 2017. Systematic random sampling technique was used to select the study subjects. Data were collected using structured and pretested interviewer-administered questionnaire. Bivariable and multivariable logistic regression analysis were used to identify factors associated with adherence to iron and folic acid supplement among pregnant women. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to display the level of significance. Variables with a p-value less than 0.05 had been considered statistically significant. RESULT: Adherence to iron and folic acid in the current study was 28.7% with 95% CI (24.3, 33.6%). Educational status of mothers (AOR= 9.27 (95%CI: 2.47, 34.71)), educational status of husband (AOR= 0.31(95% CI: 0.11,0.88)), family size of four (AOR=3.70(95%CI: 1.08,12.76)), family size of five and above (AOR= 4.88(95% CI: 1.20, 19.85)), mothers who had 2500-3500 Ethiopian birr household average monthly income (AOR= 0.46(95% CI: 0.24,0.89)), mothers who had registered at 17-24 weeks of gestation (AOR=0.40(95% CI: 0.22-0.74)) and registered at 25-28 weeks (AOR=0.20(95% CI 0.10, 0.41)), and mothers who had collected their iron and folic acid starting at first visit at first month of pregnancy (AOR= 2.42(95% CI:1.05, 5.58)) had significant association with iron and folic acid adherence. CONCLUSION AND RECOMMENDATION: Adherence of iron and folic acid was only 28.7% in the current study. Maternal and husband education status, family size, registration time, economic status, and first visit in the first month with duration of iron and folic acid taken were factors significantly associated with adherence to iron and folic acid supplement. Therefore, anaemia prevention strategy via improved iron and folic acid supplement adherence should comprise strategies of educating pregnant mothers, improving economic status, and early antenatal care (ANC) registration that can improve adherence to iron and folic acid supplement.

Antenatal care and mothers' education improved iron-folic acid adherence at Denbiya district health centers, Northwest Ethiopia: using pills count method.

BACKGROUND: Anemia is the leading public health problem among pregnant women worldwide. Iron-Folic Acid (IFA) supplementation is the strategy to control pregnancy induced anemia, but its adherence status was not well studied. OBJECTIVE: The aim of this study was to assess the prevalence of IFA adherence and associated factors among pregnant women attending antenatal care at Denbiya district health centers. METHODS: Cross -sectional study design was conducted in Denbiya district health centers from April 2 to May 27, 2016. A total of 395 study participants were enrolled in the study. Systematic random sampling was used to select study participants. Data were collected using the interviewer-administered technique. Adherence to IFA supplementation was assessed by the pills count method. A logistic regression model was used. RESULTS: The study revealed that the prevalence of good adherence towards IFA supplementation among Antenatal care (ANC) service users' at Denbiya district health centers were found to be 28.01% [95% CI, 24.01, 35.9]. Attending secondary school and above [Adjusted Odds Ratio (AOR) = 3.44, 95% CI: 1.09, 10.92], having two ANC visits [AOR = 2.53, 95% CI: 1.34, 4.76] and three and above ANC visits [AOR = 4.14, 95% CI: 2.14, 8.01] were significantly associated with good adherence of IFA supplementation. To the contrary, husband education status; secondary school and above reduced the odds of good adherence by 77% compared to illiterates to IFA supplementation [AOR = 0.23, 95% CI: 0.07, 0.72]. CONCLUSION: The prevalence of good adherence among pregnant women towards IFA supplementation was low. Mothers' education and having two or more ANC visits were positively associated with good adherence towards IFA supplementation.

Feeding practices according to the WHO- recommendations for HIV exposed children in northwest Ethiopia: A cross-sectional study.

BACKGROUND: Malnutrition is a major problem for HIV exposed children, which is mainly caused by inappropriate feeding practice. Hence, the study aimed to assess adherence to optimal complementary feeding practices recommended by the WHO and associated factors among HIV exposed infants and young children aged 6-18 months in selected Amhara Regional Hospitals, northwest Ethiopia. METHODS: An institution based cross-sectional study was conducted from March 10 to April 30, 2017. Systematic random sampling was employed to select study participants. A 24hr dietary recall was used to assess compliance with child optimal complementary feeding practice. Children were considered to have received optimal complementary feeding when they fulfill the criteria of the timely introduction of solid, semi-solid or soft foods, and minimum acceptable diet. Both bi-variable and multivariable binary logistic regression analysis were applied to identify factors associated with optimal complementary feeding practice. RESULTS: In this study, about 25.5% of HIV exposed children received optimal complementary feeding. More than two thirds, (70.7%), and more than a third, (36.9%), of the children received the recommended meal frequency and minimum acceptable diet, respectively. Father's education; primary (AOR = 2.39; 95%CI: 1.18, 4.88) and higher (AOR = 2.44; 95%CI: 1.37, 4.34), rich household wealth status (AOR = 2.08; 95%CI: 1.13, 3.82), and satisfactory media exposure (AOR = 1.70; 95%CI: 1.04, 2.78), and mothers disclosing that they have HIV (AOR = 1.78; 95%CI: 1.07, 2.98) were positively associated with optimal feeding practices. CONCLUSION: Optimal complementary feeding practice was not at the level recommended by the WHO. Household wealth status, mother's HIV disclosure, and paternal educational status were positively associated with optimal complementary feeding practices among HIV exposed children. Therefore, a social safety net program for HIV positive mothers is recommended. In addition, strengthening maternal counseling about disclosure of HIV status and increased media promotion of optimal child feeding is important to achieve the recommended feeding goals.

Prevalence of Thinness and Stunting and Associated Factors among Adolescent School Girls in Adwa Town, North Ethiopia.

Introduction. Despite the fact that adolescence is a window of opportunity to break the intergenerational cycle of malnutrition, adolescents are the neglected age groups. Hence information regarding the nutritional status of adolescents is lacking making creating and implementing intervention programs difficult. Objective. To assess the prevalence of thinness, stunting, and associated factors among adolescent school girls in Adwa town, Northern Ethiopia. Methods. Data on 814 adolescent female students were collected from March to April 2015 using interviewer administered pretested semistructured questionnaire and anthropometric measurements. Data were entered using EPI INFO version 3.5.3 and analyzed using SPSS version 20 and WHO Anthroplus software. Results. The prevalence of thinness and stunting was 21.4% and 12.2%, respectively. Age of adolescent [AOR = 2.15 (1.14,4.03)], mother's educational status [AOR = 2.34 (1.14,4.80)], eating less than 3 meals per day [AOR = 1.66 (1.12,2.46)], having family size >5 [AOR = 2.53 (1.66,3.86)] were significantly associated with thinness among the adolescent girls. Family size >5 [AOR = 2.05 (1.31,3.23)] and unimproved source of drinking water [AOR = 3.82 (2.20,6.62)] were significantly associated with stunting. Conclusion and Recommendation. Thinness and stunting are prevalent problems in the study area. Strategies to improve the nutritional status of girls should be given much attention.

Dietary Diversity and Meal Frequency Practices among Infant and Young Children Aged 6-23 Months in Ethiopia: A Secondary Analysis of Ethiopian Demographic and Health Survey 2011.

Background. Appropriate complementary feeding practice is essential for growth and development of children. This study aimed to assess dietary diversity and meal frequency practice of infants and young children in Ethiopia. Methods. Data collected in the Ethiopian Demographic and Health Survey (EDHS) from December 2010 to June 2011 were used for this study. Data collected were extracted, arranged, recoded, and analyzed by using SPSS version 17. A total of 2836 children aged 6-23 months were used for final analysis. Both bivariate and multivariate analysis were done to identify predictors of feeding practices. Result. Children with adequate dietary diversity score and meal frequency were 10.8% and 44.7%, respectively. Children born from the richest households showed better dietary diversity score (OR = 0.256). Number of children whose age less than five years was important predictor of dietary diversity (OR = 0.690). Mothers who had exposure to media were more likely to give adequate meal frequency to their children (OR = 0.707). Conclusion. Dietary diversity and meal frequency practices were inadequate in Ethiopia. Wealth quintile, exposure to media, and number of children were affecting feeding practices. Improving economic status, a habit of eating together, and exposure to media are important to improve infant feeding practices in Ethiopia.