Risk factors of dropout from institutional delivery among HIV positive antenatal care booked mothers within one year postpartum in Ethiopia: a case-control study.

BACKGROUND: The uptake of maternal healthcare services remains suboptimal in Ethiopia. Significant proportions of antenatal care attendees give birth at home in the context of HIV. However, in Ethiopia, evidence is scarce on the predictors of dropout from maternity continuum of care among HIV-positive mothers. Therefore, this study aimed to supply valuable information on risk factors regarding dropout of HIV-positive mothers for institutional delivery services in northwest Ethiopia. METHODS: A multicenter case-control study was conducted at governmental health facilities in Gondar City from May one to June 30/2018. A total of 222 HIV-positive women were included in the study. Data were collected using structured questionnaires and checklists through face-to-face interview and chart review; entered into EPI INFO version seven, and then exported to SPSS version 25. Both descriptive and analytical procedures were performed. Binary logistic regression analysis was undertaken. A significant association was declared based on the adjusted odds ratio (AOR) with its 95% CI and p-value of ≤ 0.05. RESULTS: This study illustrates that maternal age of ≥ 35 years (AOR = 2.37; 95%CI: 1.13,5.13), unmarried marital relation (AOR = 3.28; 95%CI: 1.51, 7.13), unemployed spousal occupation (AOR = 3.91; 95%CI: 1.54, 9.91), family monthly income of ≤ 36 US dollar (AOR = 4.87; 95%CI: 2.08, 11.42) and no obstetric complication in the index pregnancy (AOR = 13.89; 95%CI: 2.73, 27.71) were positively associated with dropout from institutional delivery among HIV positive antenatal care booked mothers. CONCLUSION: In this study, the risk factors of dropout from institutional delivery in the context of HIV-positive women were connected to social determinants of health such as advanced maternal age, unmarried marital status, unemployed husband occupation, and low family income. Therefore, interacting with the health system by focusing on these women in lower socio-economic strata and unmarried HIV-positive ANC attendees, and increasing access to information on obstetric complications during the antenatal care visit would retain clients in the continuum of maternity services.

Married women's decision-making autonomy in the household and maternal and neonatal healthcare utilization and associated factors in Debretabor, northwest Ethiopia.

BACKGROUND: Women's decision-making autonomy is very crucial for the improvement of women empowerment, and maternal, neonatal, and child healthcare utilization. As time immemorial, Ethiopian culture is largely gender stratified, and the position of women is subordinate to men in various household and health-seeking decision-making matters. However, there is a dearth of empirical evidence on women's decision-making autonomy, especially in the household and on maternal and newborn healthcare utilization. Therefore, this study assessed married women's decision-making autonomy in the household and on maternal and neonatal healthcare utilization and associated factors in Debretabor, Northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted from October 1st to 30th, 2019. A two-stage sampling technique was used to select 730 married women. Data were collected using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI INFO 7 and analyzed by SPSS version 23. Multivariable logistic regression model was fitted to identify factors associated with women's decision-making autonomy in the household and maternal and neonatal healthcare utilization. The adjusted odds ratio with its 95% confidence interval was computed to determine the level of significance at a p-value of ≤ 0.05. RESULTS: A total of 730 married women were included in the analysis. Thus, three-fourths (75.1%) of women had higher decision-making autonomy on their health, neonatal health, and other socio-economic aspects. Besides, the proportion of four and above antenatal visits, delivery at a health facility, postnatal checkup, knowledge of neonatal danger signs, and appropriate health-seeking practices for sick newborns among autonomous women were 52.1%, 56.1%, 71.4%, 32%, and 80% respectively. Age greater than 35 years old (AOR = 2.08; 95% CI: 1.19, 3.62), monthly income of > 5000 ETB (AOR = 3.1; 95% CI: 1.36, 7.07), husband involvement (AOR = 2.36; 95% CI: 1.55, 3.43), and adequate knowledge of neonatal danger signs (AOR = 2.11; 95% CI: 1.4, 3.2) were factors independently associated with women's decision-making autonomy on maternal and neonatal healthcare utilization and other socio-economic affairs. CONCLUSION: Our findings show that women's decision-making autonomy in the household and maternal and neonatal healthcare utilization was optimal. Increasing household income level, promotion of husband's involvement starting from the prenatal period, and increasing women's knowledge of maternal and neonatal danger signs will have a great role in the improvement of women's decision-making autonomy.

The effect of women's body mass index on pelvic organ prolapse: a systematic review and meta analysis.

BACKGROUND: Pelvic organ prolapse remains the public health challenge globally. Existing evidences report the effect of woman's weight on the pelvic organ prolapse inconsistently and this urges the need of pooled body weight effect on the pelvic organ prolapse. Although there was a previous work on this regard, it included papers reported before June 18/2015. Thus, updated and comprehensive evidence in this aspect is essential to devise strategies for interventions. OBJECTIVE: This review aimed at synthesizing evidence regarding the pooled effect of body weight on the pelvic organ prolapsed. METHODS: For this review, we searched all available articles through databases including PubMed, Web of Sciences, CINAHL, JBI library, Cochran library, PsycInfo and EMBASE as well as grey literature including Mednar, worldwide science, PschEXTRA and Google scholar. We included cohort, case-control, cross-sectional and experimental studies which had been reported between March 30, 2005 to March 30, 2020. In the effect analysis, we utilized random model. The heterogeneity of the studies was determined by I2 statistic and the publication bias was checked by Egger's regression test. Searching was limited to studies reported in the English language. RESULTS: A total of 14 articles with 53,797 study participants were included in this systematic review (SR) and meta analysis (MA). The pooled result of this Meta analyses depict that body mass index (BMI) doesn't have statistical significant association with pelvic organ prolapse. CONCLUSION: This review point out that women's body mass index has no significant effect on the development of pelvic organ prolapse. However, the readers should interpret the result with cautions due to the presence of considerable limitations in this work. Trial registration The protocol of this systematic review (SR) and meta analysis (MA) has been registered in PROSPERO databases with the Registration number of CRD42020186951.