Trends and Determinants of Small Birth Weight in Ethiopia: Further Analysis of Ethiopian Demographic and Health Surveys.

BACKGROUND: Globally, Low Birth Weight (LBW) prevalence is estimated to be 14.6%. It is a major cause of neonatal mortality in developing countries including Ethiopia. Despite extensive institution-based studies in Ethiopia, there is no comprehensive study using countrywide data. Thus, this study aimed to investigate trends and determinants of Small Birth Weight (SBW) among under-five children in Ethiopia. METHODS: Under-five children data from 2000, 2005, 2011, and 2016 Ethiopian Demographic and Health Surveys (EDHS) were used. However, only 2787 children were weighed at birth and used for analysis in this study. Descriptive statistics and the logistic regression model were used to determine trends and determinants of SBW respectively. RESULTS: The prevalence of SBW increased from 7.0% (95% CI; 3.1-10.0) to 13.2% (95% CI; 11.4-15.0) between 2000 and 2016. The odds of SBW increased by being a female child (AOR 1.50; 95% CI [1.07-2.09]), mother's with partner occupation of agriculture (AOR 1.54; 95% CI [1.05-2.26]) and mothers who did not know their partner's occupation (AOR 7.35; 95% CI [1.96-27.48]). However, infants born to mothers with primary (AOR 0.43; 95% CI [0.29-0.65]), secondary (AOR 0.30; 95% CI [0.16-0.55]) and higher (AOR 0.55; 95% CI [0.31-0.97]) educational status versus no education and grandmultiparous mothers (OR 0.39; 95% CI [0.19-0.78]) versus primiparous had lower odds of SBW. CONCLUSION: In Ethiopia, during the survey period, there was an increment in prevalence of SBW, and maternal related factors were significant determinants. Therefore, empowering mothers through education and improving the socioeconomic status of the household can be one strategy to reduce SBW.

Unintended Pregnancy and Associated Factors Among HIV Positive Women in Ilu Aba Bora zone, South Western Ethiopia: A Facility-Based Cross-Sectional Study.

BACKGROUND: Unintended pregnancy reflects the existence of unprotected sex. Understanding factors associated with unintended pregnancy among HIV-positive women is very important to design strategies for the prevention of further transmission and infection with the virus. However, there is scarce information in this regard. Given the degree of HIV prevalence among women and the current antiretroviral therapy scale up in Ethiopia, it is important to understand factors associated with un-intended pregnancy in order to prevent mother to child HIV transmission (MTCT). METHODS: An institution-based cross-sectional study design was employed. The sample size was 353; all HIV/AIDS sero-positive reproductive age group (15-49) women having any pregnancy history after their diagnosis and having started HAART were included and simple random sampling was used to select study participants. Data collection period was from March 9 to April 13, 2019. RESULTS: The prevalence of unintended pregnancy among the participants was 40.9%. In the multivariate logistic regression, unemployment (AOR, 3.36; 95% CI: 1.55-7.26), not being knowledgeable on MTCT and prevention of MTCT (PMTCT) (AOR, 3.18; 95% CI: 1.92-5.24), and having had no discussion on reproductive health issues (AOR, 1.83; 95% CI: 1.09-3.07) are factors significantly associated with unintended pregnancy occurrence among HIV-positive women on antiretroviral therapy. CONCLUSION AND RECOMMENDATION: The prevalence of unintended pregnancy among the women in the study is high. To avoid unintended pregnancies, HIV-infected women need access to effective family planning services and risk reduction discussions during routine care visits.

Perinatal Outcomes and Associated Factors among women with hypertensive Disorders of Pregnancy Delivered in Jimma Zone Hospitals, Southwest Ethiopia.

Background: Hypertensive disorders of pregnancy are multisystem diseases that increase the risk of adverse perinatal outcomes worldwide. It Led to early and late serious health consequence on the baby, with a significant proportion occurring in low-income countries. Hence the objective of this study was to determine perinatal outcomes and associated factors among women with hypertensive disorders of pregnancy delivered in Jimma zone hospitals. Method: A Facility based cross-sectional study design was employed from March to May 2020 on 211 hypertensive women delivered in the four randomly selected hospitals. The data were collected by reviewing medical record and face to face interview using consecutive sampling technique. Binary and multivariable logistic regression was performed to identify association. Result: Ninety-one (43.1%) of fetuses developed unfavorable perinatal outcome. Inability to read and write (AOR=2.5; 95% CI:1.03-6.17), being primipara (AOR=4.6; 95% CI:1.6-13.2) and multi-para (AOR=3.1; 95% CI:1.09-9.17), Lack of antenatal care visit (AOR=4.2; 95% CI:1.2-15.01), having preeclampsia (AOR=4.2; 95% CI:1.1-16.6) and eclampsia (AOR=5.8; 95% CI:1.2-26.2) and late provision of drug (AOR=3.9;95% CI:1.9-7.9) were independent factors. Conclusion: Pregnancy complicated with hypertensive disorders was associated with increased unfavorable perinatal outcomes. Preeclampsia and eclampsia, inability to read and write, primipara and multipara, lack of antenatal care and late provision of drug were factors associated with unfavorable perinatal outcomes.

Institutional Delivery Among Young Women in Ethiopia: Further Analysis of Trends and Determinants, from the Four Consecutive Ethiopia Demographic and Health Survey.

PURPOSE: Although young people have a right to sexual and reproductive health, they are facing inadequate access to information and services. The Ethiopian government has started implementing policies and strategies to eliminate inequalities in reproductive health service use. However, there are huge disparities in institutional delivery utilization between different age groups. Therefore, this study aimed to explore trends and factors associated with institutional childbirth among young women in Ethiopia. METHODS: Ethiopian demographic and health survey data (EDHS) from 2000 to 2016 surveys were used. Data on the most recent births to women aged 15-24 years that occurred in the 5 years preceding the survey period were extracted. All the four EDHS data were used to examine trends of institutional delivery, whereas determinants for institutional delivery were analyzed from a 2016 dataset by using multivariable logistic regression analysis. FINDINGS: Between 2000 and 2016, the proportion of institutional delivery among young women increased from 6% (95% CI=3.7-6.5%) to 40.1% (95% CI=30.6-44.3%). The odds of institutional delivery increased for young women who had attended secondary and above education (AOR=2.68; 95% CI=1.559-4.607), started ANC visits early (AOR=1.518; 95% CI=1.095-2.105) and received four or more ANC visits (AOR=1.87; 95% CI=1.370-2.561). However, the odds were lower among young women who had two (AOR=0.31; 95% CI=0.185-0.514), and three or more children (AOR=0.62; 95% CI=0.452-0.849). CONCLUSION: There is an increase in trend of institutional delivery among young women during the 2000 to 2016 EDHS. Having higher educational levels, early ANC booking, and attending four or more ANC visits were positively associated with institutional delivery. Increased number of children is negatively associated with institutional delivery. Strengthening strategies for improving girls' education and addressing their socioeconomic and demographic vulnerabilities, and strengthening strategies being implemented for encouraging early and recommended ANC visits is crucial.

Utilization of non-pneumatic anti-shock garment and associated factors for postpartum hemorrhage management among health care professionals' in public hospitals of Jimma zone, south-West Ethiopia, 2019.

BACKGROUND: Non- pneumatic anti-shock garment is a unique, life -saving first -aid device made of neoprene and velcro, which is used for treatment of women with postpartum hemorrhage. Maternal mortality in the world still very high and postpartum hemorrhage is the leading cause of maternal mortality worldwide. OBJECTIVE: This study was aimed to assess the utilization of non-pneumatic anti-shock garment and associated factors for postpartum hemorrhage management. METHODS: Facility based cross-sectional studies design both quantitative and qualitative data collection methods were employed among 210 health care professionals and 10 key informants respectively. Bivariable and multivariable logistic regression was done to identify factors associated with non-pneumatic anti-shock garment utilization. Qualitative data was transcribed, translated and triangulated with quantitative findings. RESULTS: Seventy six (36.2%) of the respondents used non-pneumatic anti-shock garment in their hospitals for management of post-partum hemorrhage. Having good knowledge [(AOR = 3.96, 95% CI: (1.67, 9.407)], having positive attitude [(AOR = 3.54, 95% CI: (1.37, 9.13)], attending training [AOR = 13.156, 95% CI: (4.81, 36.00], having two and above non-pneumatic anti-shock garment at their hospitals [AOR = 8.7, 95% CI: (2.89, 26.20)] were significantly associated with utilization of non-pneumatic anti-shock garment. … "I didn't use non-pneumatic anti-shock garment for the management of postpartum hemorrhage complication before because I have no training and experience how to use it." CONCLUSION: The utilization of non-pneumatic anti-shock garment for the management of postpartum hemorrhage was low. Having positive attitude, having good knowledge and training on non-pneumatic anti-shock garment were statically associated with its use. The health care professionals that involved in the maternity service should be trained on how to use this important garment in the management of postpartum hemorrhage.