Determinants of implanon discontinuation among women in Gedeo Zone, South Ethiopia: a case-control study.

BACKGROUND: The main public health problem that has a significant impact on the high fertility rate, unintended pregnancies, and induced abortion is Implanon cessation. In addition to Implanon being underutilized in Ethiopia, the rate of cessation is higher among women who started using it. Nevertheless, little is known about the factors that lead to Implanon cessation. OBJECTIVES: The study was aimed to determine the factors that led women to discontinue Implanon in Gedeo Zone, Southern Nation Nationalities and Peoples Region, southern Ethiopia, 2019. METHOD: A community-based unmatched case-control study design was carried out. Cases and controls were selected by a multi-stage sampling with a 1:2 case-to-control ratio. Data was entered into EPi-data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 20 for analysis. A bivariate and multivariable logistic regression was used to identify the factors affecting Implanon discontinuation. The adjusted odd ratio (AOR) with 95% Confidence Interval (CI) was used to determine the precision of estimates, and statistical significance was declared at a p-value of 0.05. RESULT: From 516 women included in to the study, 495 (cases = 166 and controls = 329) women have responded to the questionnaires making a response rate of 96%. Monthly income 500-1000 birr [AOR: 0.3; 95% CI (0.2-0.5)], above 1000 birr [AOR: 0.2; 95% CI (0.1-0.4)], history of abortion [AOR: 2.0; 95% CI (1.0-4.1)], birth spacing [AOR: 0.6; 95% CI (0.3-0.9)], partner objection [AOR: 2.4; 95% CI (1.4-4.2)] were significantly associated factors. CONCLUSION: This study identified that monthly income, having abortion history, birth spacing, partner objection were the factors that affect Implanon discontinuation. To reduce implanon discontinuation, reducing abortion, involving partner and increasing the birth spacing, appropriate counseling before the insertion and appropriate follow-up by a health care practitioner are highly recommended.

Minimum dietary diversity and its associated factors among infants and young children in Ethiopia: evidence from Ethiopian Demographic and Health Survey (2016).

BACKGROUND: Adequate infant and young child feeding during the first 1000 days of life is very essential to improve child health, survival, growth, and development through minimum dietary diversity (MDD). Hence, this study aimed to assess MDD and its multi-level factors among infants and young children aged 6-23 months in Ethiopia. METHODS: Ethiopian Demographic and Health Survey (EDHS-2016) data was used to identify both individual and community-level factors of dietary diversity. Weighted samples of 2,962 children were eligible and a multi-level regression model was used for the analysis. Finally, factors with a P-value of <0.05 were considered statistically significant. RESULTS: The prevalence of MDD among children in Ethiopia was 12.09%. According to this study, factors such as having a mother who attended higher education (AOR = 3.09, (95% CI; _1.67-5.71)), being a female household head (AOR = 0.62, (95% CI; _0.40-0.95)), having a mother's agricultural occupation (AOR = 1.89, (95% CI; _1.10-3.23)) and living in the household in the richest wealth index were significantly associated at the individual level. At the community level, children living in rural areas (AOR = 0.62, 95% CI; 0.39-0.98) were significant risk factors for MDD (AOR = 0.62, 95% CI; 0.39-0.98). CONCLUSION: The educational and occupational status of the mother, wealth index, and region were significantly associated with MDD. Hence, strengthening of the existing nutritional intervention is helpful to increase diversified food consumption among children.

The Prevalence of Stunting and Associated Factors among Children Under Five years of age in Southern Ethiopia: Community Based Cross-Sectional Study.

Background: According to the Ethiopian Mini Demographic Health survey (EMDHS) of 2019, about 37% of children under five years of age are stunted. Data are scarce on stunting in the study area. Objective: This study was aimed to assess the prevalence and factors associated with stunting in among children under five years of age in southern Ethiopia. Method: A community-based cross-sectional study was conducted among 660 randomly selected under five child-mother pairs. The study was conducted from December 1 to 30, 2018 using a structured pretested questionnaire and anthropometric measurement tools. A simple random sampling technique was used to select study participants. Data were entered into EpiData version 3.1 and analyzed by Statistical Package for the Social Sciences (SPSS) version 20 and Emergency Nutrition Assessment (ENA) for Standardizing Monitoring and Assessment of Relief and Transition (SMART) 2011 software. Variables with P-value < 0.25 during the bivariate were entered into multivariable logistic regression analysis and significant association with stunting was declared at P-value < 0.05 with 95% CI. Result: Prevalence of stunting among children under five years of age was 37.7%. Factors: family size less than five [AOR = 0.59; 95% CI (0.37, 0.97)], age less than 11 months [AOR = 0.17; 95% CI (0.08, 0.4)] and rich wealth status [AOR = 0.46; 95% CI (0.27, 0.79)] had a protective effect, while source of drinking water like river water [AOR = 5.11; 95% CI (1.6, 16.4)], presence of two or more under five children in the household [AOR = 1.72; 95% CI (1.07, 2.77)], undiversified diet [AOR = 1.82; (1.17, 2.83)] and household food insecurity [AOR = 1.83; 95% CI (1.13, 2.96)] increased the risk of stunting. Conclusion and recommendation: The prevalence of stunting was high. Child age, family size, number of children under five years of age in the household, wealth status, source of drinking water, undiversified diet, and household food insecurity were associated with stunting. Thus, efforts should be made to improve nutritional status through strengthening of nutrition education, promotion of different family planning methods to limit the family size, involvment in different income generating activities to improve wealth status, securing of household food, use of improved sources of water, and nutrition education to diversify child diet. Further longitudinal study is recommended for researchers.

Magnitude of Anemia and Its Associated Factors Among Pregnant Women Attending Antenatal Care in Southern Ethiopia: A Cross-Sectional Study.

PURPOSE: The aim of this study was to assess the magnitude of anemia and its associated factors among pregnant women attending antenatal care (ANC) at Dilla University referral Hospital, South Ethiopia. PATIENTS AND METHODS: An institution-based cross-sectional study was conducted from January to February 2019, among 373 pregnant women who attended antenatal care at Dilla University referral hospital. Socio-demographic factors, nutritional, medical and obstetric information of the study participants were collected using a structured questionnaire. Hemoglobin was measured using a hemacue machine, and fecal specimens were examined to detect intestinal parasites. Bivariate and multiple variable binary logistic regressions were used to identify predictors of anemia. A p-value less than 0.05 was used to declare statistical significance. RESULTS: Overall prevalence of anemia was 28.7%, of which 19.6% had mild anemia. Decreased odds of anemia were found in women with good nutritional status (MUAC ≥24 cm) (AOR= 0.07 95% CI: 0.03-0.1), iron supplementation (AOR=0.06 95% CI: 0.02-0.15) and birth spacing ≥2 yrs (AOR=0.03 95% CI: 0.009-0.45). However, increased odds of anemia were seen in pregnant women with intestinal parasites (AOR=6.11 95% CI 7.70-37.0). CONCLUSION: The magnitude of anemia among pregnant women was found to be a moderate public health problem. Iron supplementation, good nutritional status (MUAC> 24 cm), and birth spacing reduce the odds of anemia. But having intestinal parasites was found to increase the likelihood of anemia during pregnancy. Counseling on birth spacing, strengthening iron supplementation, and intestinal parasite management during pregnancy should be given due emphasis.