Level of adherence to option B+ program and associated factors among HIV-positive women in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Despite policy initiatives and strategic measures highly focused on preventing mother-to-child transmission through the implementation of the Option B+ program, adherence to the treatment is still challenging. The level of adherence and determinants of Option B+ program utilization reported by different studies were highly inconsistent in Ethiopia. Hence, this systematic review and meta-analysis aimed to estimate the pooled prevalence of adherence to the Option B+ program and its predictors among HIV-positive women in Ethiopia. METHODS: PubMed, Google Scholar, EMBASE, HINAR, Scopus, and Web of Sciences were searched for published articles from March 2010 to March 2022. The pooled prevalence of adherence was estimated using a weighted DerSimonian-Laird random effect model. The I2 statistics was used to identify the degree of heterogeneity. Publication bias was also assessed using the funnel plot and Egger's regression test. RESULTS: A total of 15 studies were included. The pooled estimate of the option B+ program among HIV-positive women in Ethiopia was 81.58% (95% CI: 77.33-85.84). Getting social and financial support (AOR = 3.73, 95% CI: 2.12, 6.58), disclosure of HIV status to partners (AOR = 2.05, 95% CI: 1.75, 2.41), time to reach a health facility (AOR = 0.33, 95% CI: 0.16, 0.67), receiving counseling on drug side effects (AOR = 4.09, 95% CI: 2.74, 6.11), experience of drug side effects (AOR = 0.17, 95% CI: 0.08, 0.36), and knowledge (AOR = 4.73, 95% CI: 2.62, 8.51) were significantly associated with adherence to the Option B+ program. CONCLUSION: This meta-analysis showed that the level of adherence to the Option B+ program in Ethiopia is lower than the 95% level of adherence planned to be achieved in 2020. Social and financial support, disclosure of HIV status, time to reach the health facility, counseling, drug side effects, and knowledge of PMTCT were significantly associated with option B+ adherence. The findings of this meta-analysis highlight that governmental, non-governmental, and other stakeholders need to design an effective strategy to scale up the level of disclosing one's own HIV status, access health facilities, improve knowledge of PMTCT, and counsel the potential side effects of Option B+ drugs, and advocate the program to reduce the multidimensional burden of HIV/AIDS. TRIAL REGISTRATION: Prospero registration: CRD42022320947. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022320947.

Hotspot areas of tetanus-unprotected births and its associated factors in Ethiopia: Spatial analysis of EDHS data.

Neonatal tetanus persists as a public health problem in many developing countries including Ethiopia. Maternal tetanus toxoid vaccination is a cornerstone to prevent neonatal tetanus. However, its prevalence is low in Ethiopia, and little has been devoted to its spatial epidemiology and associated factors. Hence, this study aimed to explore the spatial pattern and factors affecting tetanus-unprotected births in Ethiopia. A further analysis of the 2016 Ethiopia Demographic and Health Survey data was conducted, and a weighted sample of 7590 women was used for analysis. Spatial analysis was done using ArcGIS and SaTScan software. A binary logistic regression model was fitted to identify factors and variables with a p-value <.05 were considered as statistically significant. About 54.13% (95% CI: 53.01, 55.25) of births were not protected against neonatal tetanus, and spatial clustering of tetanus unprotected births was observed (Moran's I = 0.144, p-value = .028). The primary and secondary SaTScan clusters were detected in Northeastern Tigray, Eastern Amhara, and almost the entire Afar (RR = 1.34 & LLR = 66.5, p < .01), and in the Somali region, and the western border of Gambela (RR = 1.44 & LLR = 31.3, p < .01), respectively. Tetanus unprotected births were higher among women without formal education (AOR = 1.63; 95% CI: 1.29, 2.04), came from poor households (AOR = 1.27; 95% CI: 1.12, 1.45), who had no ANC contact (AOR = 6.97; 95% CI: 6.21, 7.88), and who were not exposed to the media (AOR = 1.26; 95% CI: 1.09, 1.47). Hence, tetanus-unprotected birth hotspots require priority interventions, and it is good if the targeted interventions consider the identified factors.

Neonatal mortality and its predictors among neonates in Jabitehnan district, Northwest Ethiopia: A single-arm retrospective cohort study.

Background and Aims: Neonatal period is the most vulnerable time in which children face the greatest risk of death. Worldwide, each year, millions of newborns died in the first month of life. Sub-Saharan Africa, Ethiopia, in particular, is largely affected. However, there is a dearth of information regarding the survival status of neonates and determinants of their mortality in the study area. Therefore, this study was aimed at investigating neonatal mortality and its predictors in Jabitehnan district, Northwest Ethiopia. Method: A single-arm community-based retrospective cohort study was conducted in March 2021 among 952 neonates born between August 2020 and February 2021. Data were collected by a semi-structured questionnaire, and a multistage stratified sampling technique was employed to select one urban and 10 rural kebeles from the district. Then, the total sample size was proportionally allocated to these selected kebeles. Neonatal death was ascertained by community diagnosis. Kaplan-Meier curve was used to estimate survival time. Cox regression was used to identify factors, the hazard ratio was estimated, and a p-value < 0.05 was considered statistically significant. Results: The neonatal mortality rate was 44 (95% confidence interval [CI]: 33-60) per 1000 live births; and the incidence rate was 1.64 (95% CI: 1.21-2.23) per 1000 neonate days. Three-quarters of deaths occurred in the first week of life. Medium household wealth index (adjusted hazard ratio [AHR] = 3.54; 95 CI: 1.21-10.35), increased number of pregnancies (AHR = 1.22; 95%CI: 1.01-1.47), being male (AHR = 2.45, 95% CI: 1.12-5.35) and not starting breastfeeding in the first hour of life (AHR = 4.00; 95% CI: 1.52-11.10) were found to be predictors of neonatal mortality. Conclusion: Neonatal mortality was high compared to the national target. Wealth, number of pregnancies, sex of the neonate, and breastfeeding initiation were factors associated with neonatal death. Hence, strengthening interventions such as providing sexual education in the population, considering households with a medium wealth index in the exemption service, and counseling mothers about early breastfeeding initiation would improve neonatal survival.

Health facility delivery service utilization and its associated factors among women in the pastoralist regions of Ethiopia: A systematic review and meta-analysis.

Background and Aims: Utilizing health facility delivery services is one of the pillars of lowering maternal mortality. However, the coverage of health facility delivery service utilization continues to be uneven around the world. In Ethiopia, particularly among pastoralist regions, health facility delivery service utilization is less common. Therefore, the purpose of this study was to determine the pooled prevalence of health facility delivery service utilization and identify the associated factors among women in the pastoralist regions of Ethiopia. Methods: A comprehensive systematic search was carried out in PubMed/MEDLINE, Hinary, Cochrane Library, Google Scholar, Google, and Ethiopian online university repositories. Studies were appraised using the JBI appraisal checklist. The analysis was done using STATA version 16. The pooled analysis was conducted using DerSimonian and Laird random-effects model. I 2 test and Eggers & Begg's tests were used to assess the heterogeneity and publication bias, respectively. p < 0.05 was set to determine the statistical significance of all the tests. Results: The pooled prevalence of health facility delivery service utilization was 23.09% (95% CI: 18.05%-28.12%). Have ANC visit during pregnancy (OR = 3.75, [95% CI: 1.84-7.63]), have information regarding maternal health service fee exemption (OR = 9.51, [95% CI: 1.41-64.26]), have a nearby health facility (OR = 3.49, [95% CI: 1.48-8.20]), and women attend secondary and above education (OR = 3.06, [95% CI: 1.77-5.29]) were found to be significant associated factors. Conclusions: Health facility delivery service utilization is very low in pastoralist regions of Ethiopia, and ANC follow-up, distance from the health facility, women's educational status, and information regarding maternal health service fees were identified as significant associated factors. Consequently, strengthening ANC services, introducing free health services to the community, and constructing health facilities for the nearby residents are recommended to improve the practice.

Utilization of long-acting contraceptive methods and associated factors among married women in Farta Woreda, Northwest Ethiopia: a community-based mixed method study.

BACKGROUND: Although long-acting contraceptive methods are highly effective, safe, and provide uninterrupted protection from unintended pregnancy compared to short-acting methods, evidences suggest that majority of women were relayed on short-acting contraceptive methods. Thus, this study aimed to determine the level of long-acting contraceptive methods utilization and associated factors among married women in Farta Woreda, Northwest Ethiopia, 2021. METHODS: A community-based cross-sectional study supplemented with qualitative data was performed among 556 married women from March 1 to 31, 2021. A semi-structured interviewer-administered questionnaire and interview guides were used to collect the data. The data were entered into Epi data version 4.6 and analyzed by SPSS version 23 software. The association between variables was analyzed using bivariate and multivariable binary logistic regression. The level of statistically significant association was determined at a P-value < 0.05. After translation and transcription, manual thematic analysis was applied to the qualitative data. RESULTS: The magnitude of long-acting contraceptive methods among married women in Farta Woreda was found to be 14.3% [95% CI 11.5-17.6]. Previous use of long-acting contraceptive methods (AOR = 5.83, 95% CI 3.03, 11.21), positive attitude towards long-acting contraceptives (AOR = 2.74, 95% CI 1.48, 5.07), having formal education for husbands' (AOR = 3.05, 95% CI 1.5, 6.21), and poor wealth index (AOR = 3.39, 95% CI 1.33, 8.67) were positively associated with utilization of long-acting contraceptive methods. Moreover, fear of side effects, misconceptions, and partner opposition were the most commonly identified barriers by the qualitative data. CONCLUSION: Utilization of long-acting contraceptives among married women in Farta Woreda was low as compared to the 2020/21 national reproductive health strategy plan to increase the long-acting reversible and permanent contraceptive methods use to 50%. Previous use of long-acting contraceptives, positive attitude towards long-acting contraceptives, husband education, and household wealth index was found to be significantly associated with long-acting contraceptive utilization. Hence, it is better to work more on changing women's attitudes and increasing husband education.

Long-acting contraceptive methods (LACM) are methods used to prevent pregnancy for a longer period than short-acting methods. LACM are classified in two categories, reversible and non-reversible (permanent).This study use a community-based quantitative cross-sectional study supplemented with qualitative data among married women from March 1 to 31, 2021 in Farta Woreda northwest Ethiopia. The association between variables was analyzed using bivariate and multivariable binary logistic regression. Statistically significant association was declared at a P-value < 0.05. For the qualitative data, a thematic analysis was made manually.The current study found that the magnitude of long-acting contraceptive methods among married women in Farta Woreda was 14.3% 95% CI [11.5­17.6]. Women's husband education, wealth index, previous use LACM, and attitude were significantly associated with long-acting contraceptive utilization. Besides, fear of side effects and partner opposition were the most common barriers of LACM.This study report that utilization of long-acting contraceptives among married women in Farta Woreda was significantly low as compared to the national reproductive health strategy 2020/21 plan. Therefore, establishing strategies and polices to change women's attitudes and increasing husband education will be essential when designing implementation plans to scale up uptake of LACM.

Knowledge and practice of essential newborn care and associated factors among women in Ethiopia: systematic review and meta-analysis.

BACKGROUND: In developing countries, including Ethiopia the risk of neonatal death can be easily prevented and avoided by implementing essential newborn care with simple, low cost, and a short period time immediately after delivery. However, the problem is still persisting due to lack of adequate maternal and newborn care practice. Hence, this review aimed to estimate the pooled prevalence of women's knowledge and practice of essential newborn care and its associated factors in Ethiopia using systematic review and meta-analysis. METHOD: An intensive literature search was performed from PubMed, Google Scholar, EMBASE, HINARI, Scopus, and Web of Sciences from April 1-30, 2021. Data were extracted by using a pre-tested and standardized data extraction format. The data were analyzed by using STATA 14 statistical software. I2 tests assessed heterogeneity across the included studies. A random-effect model was used to estimate the pooled prevalence of knowledge and practice of essential newborn care. RESULTS: From 1275 identified studies, 25 articles were included. The national pooled prevalence of essential newborn care knowledge and practice among women was 55.05% and 41.49% respectively. Secondary education (AOR = 2.75, 95% CI 1.62, 4.66), multiparity (AOR = 2.14, 95% CI 1.41, 3.26), antenatal care (AOR = 2.94; 95% CI 2.03, 4.26), and postnatal follow-up (AOR = 1.64, 95% CI 1.20, 2.23) were significantly associated with knowledge level whereas; primary education (AOR = 7.08, 95% CI 4.79, 10.47), urban residency (AOR = 2.22, 95% CI 1.65, 3.00), attending monthly meetings (AOR = 2.07, 95% CI 1.64, 2.62), antenatal care (AOR = 2.89, 95% CI 1.97, 4.26), advised during delivery (AOR = 2.54, 95% CI 1.80, 3.59), postnatal follow-up (AOR = 7.08, 95% CI 4.79, 10.47) and knowledge (AOR = 2.93; 95% CI 1.81, 4.75) were statistically significant with essential newborn practice. CONCLUSIONS: The current systematic review and meta-analysis findings reported that the level of knowledge and practice of essential newborn care among Ethiopian women was low. Therefore, improvement of essential newborn through the provision of community-based awareness creation forum, improving antenatal and postnatal care follow up, education on essential newborn care to all pregnant and postnatal women are very important. Trial registration Prospero registration: CRD 42021251521.

Essential newborn care (ENC) is a single most cost-effective intervention to reduce neonatal mortality and morbidity both in developed and developing countries. An intensive electronic search from PubMed, Google Scholar, EMBASE, HINAR, Scopus, and Web of Sciences were performed to identify the primary studies. In this meta-analysis a total of 25 articles were included to estimate the polled prevalence of ENC knowledge and practice among Ethiopian women. Accordingly, the national pooled prevalence of ENC knowledge and practice among women was 55.05% and 41.49% respectively. In the current systematic review and meta-analysis, Secondary education, multiparity, antenatal care, and postnatal follow-up were significantly associated with knowledge level whereas; primary education, urban residency, attending monthly meetings, antenatal care, advised during delivery, postnatal follow-up and knowledge on ENC were found to be statistically significant with essential newborn practice. As per finding the knowledge and practice regarding essential newborn care among women in Ethiopian was significantly low. Hence, improvement of essential newborn through the provision of community-based awareness creation forum, improving antenatal and postnatal care follow up, education on essential newborn care to all pregnant and postnatal women are very important.

Acceptance of COVID-19 vaccine and associated factors among health professionals working in Hospitals of South Gondar Zone, Northwest Ethiopia.

BACKGROUND: Health-care professions are among the highly exposed group of population affected by COVID-19 pandemic and identified as the target population to get vaccination against the spread of the infection. However, vaccine reluctance is still high, which may negatively affect the efforts to prevent the spread of the infection. Hence, this study was aimed to assess acceptance of COVID-19 vaccine and associated factors among health professionals working in Hospitals of South Gondar Zone, Northwest Ethiopia. METHODS: Institutional-based cross-sectional study was performed among 422 health professionals working in Hospitals of South Gondar Zone, Northwest Ethiopia, from March 1 to 30, 2021. Study participants were selected through simple random sampling techniques. Data were collected through a self-administered questionnaire. Multivariable logistic regression analysis was performed to identified factors associated with acceptance of COVID-19 vaccine with a p-value < 0.05 at 95% CI considered as statistically significant. RESULT: Overall, 45.3% of health professionals accepted COVID-19 vaccine. Age (AOR: 2.55; 95% CI: 1.32-4.92), being male (AOR: 1.729; 95% CI: 1.32-2.34), had higher risk of COVID-19 (AOR: 1.74, 95% CI: 1.00-3.02), and positive attitude (AOR: 3.26, 95% CI: 2.14-4.96) were found to be statistically significant with the acceptance of COVID-19 vaccine. CONCLUSION: The acceptance of COVID-19 vaccine among health professionals was significantly low. Participant's age, sex, high risk of COVID-19, and attitude toward COVID-19 vaccine were significantly associated with vaccine acceptance. Therefore, the government with respective stakeholders should emphasize addressing the concern of the health professionals and increase attitudes regarding COVID-19 vaccine to scale up vaccine acceptance.