Adequacy of iodized salt and its associated factors among households in the Bahir Dar Zuria district, Northwest Ethiopia, 2022.

Background: The inadequacy of iodine in salt is the a contributing factor behind lack of awareness and poor economic performance in developing countries. To address the issue of iodine deficiency, universal salt iodization has been implemented globally. Nevertheless, it is imperative to closely monitor the sufficiency of iodine in salts to achieve its intended objective at the household level in the Bahir Dar Zuria district. Objective: To assess the adequacy of iodized salt and its associated factors among households in the Bahir Dar Zuria district, Northwest Ethiopia. Methods: A community-based cross-sectional study was conducted from May to June 2022 among households in Bahir Dar Zuria district. The data were gathered from 825 households that were chosen using a multistage sampling process. Iodometric titration was used to assess the amount of iodine in salt. The data were gathered using a structured questionnaire that was administered by an interviewer. For data entry and analysis, EpiData version 3.01 and SPSS version 25.0 were used, respectively. To evaluate the association between explanatory factors and the outcome variable, binary logistic regression was conducted, and significance was determined at alpha 0.05. Result: This study analyzed a total of 825 households. Of these, only 384 [46.5, 95% CI, 43.5-50.5%] households had adequately iodized salt at home. Age increase of 1 year [AOR = 1.04, 95% CI = 1.02-1.06], being an urban resident [AOR = 3.18, 95% CI = 1.84-5.48], diploma and above educational attainment [AOR = 3.74, 95% CI = 1.99-7.02], checking salt by asking the seller [AOR = 2.21, 95% CI = 1.26-3.88], storing salts in closed containers [AOR = 1.57, 95% CI = 1.13-2.19], and storing salts in a dry and cool area [AOR = 2.72, 95% CI =1.37-5.42] were associated with the adequacy of iodized salt at the household level. Conclusion and recommendation: The percentage of households in the district (46.5%) that had enough iodized salt in their homes is still extremely low and falls short of the targeted level for the country. At the household level, adequate iodized salt was found to be associated with age, place of residence, level of education, checking salt iodization while purchasing, place of salt storage, and cover use for salt containers. Therefore, increasing the accessibility of iodized salt at the household level is essential.

Diet quality of preparatory school students in Awi Zone, Ethiopia: a cross-sectional study.

OBJECTIVE: The study aimed to assess diet quality and associated factors among preparatory school students in Awi Zone, Ethiopia. DESIGN: A school-based cross-sectional study design was used in this study. SETTING: The study was carried out in Awi Zone, Amhara Region, Ethiopia. PARTICIPANTS: A total of 834 preparatory school students participated in the study. OUTCOME MEASURES: Diet quality was the outcome variable, and it was computed using the dietary diversity score, food variety score and consumption of animal-source foods. Students with high dietary diversity scores, appropriate animal-source food consumption and adequate food variety scores were labelled as having good-quality diets. Data were collected using a pretested structured self-administered questionnaire. Bivariate and multivariable logistic regressions were employed to analyse the data. Variables with p≤0.2 in the bivariate logistic regression analysis were included in the multivariable logistic regression model. Multivariable logistic regression analysis was done to determine the strength of the association. Statistical significance was determined at p value less than 0.05. RESULTS: Only 24.7% (95% CI: 21.7%, 27.7%) of preparatory school students had good-quality diets. Being female (adjusted OR (AOR)=2.88, 95% CI: 2.0, 4.1), residing in an urban setting (AOR=1.90, 95% CI: 1.1, 3.2), having an educated mother (AOR=1.78, 95% CI: 1.1, 2.7), having pocket money (AOR=1.83, 95% CI: 1.2, 2.6) and nutrition information (AOR=1.90, 95% CI: 1.2, 3.1), and family monthly income >8000 Ethiopian birrs (AOR=3.90, 95% CI: 2.2, 7.1) were factors significantly associated with having good-quality diet. CONCLUSION: The majority of the preparatory school students had poor-quality diets. These findings highlight the necessity of nutrition education that considers the sociodemographic characteristics of the students and their families. Implementing income-generating interventions for low-income households was also recommended by the findings.

Prevalence of under-nutrition and its associated factors among 6-23 months old children of employed and unemployed mothers in town kebeles of Dera district, northwest Ethiopia: a comparative cross-sectional study.

BACKGROUND: Child under-nutrition remains a widespread problem around the globe. Improving child nutrition and empowering women are two important and closely connected development goals. These two interconnected goals will affect one another through different mechanisms, and the net effect may not necessarily be positive. Yet, the impact of maternal employment, one method of empowering mothers, on children's nutritional is not well studied in Ethiopia. Hence, this study is to compare the prevalence of under-nutrition and its associated factors among 6-23 months old children of employed and unemployed mothers in town kebeles of Dera district, Northwest Ethiopia, 2022. METHODS: A community-based comparative cross-sectional study design was conducted among 356 employed and 356 unemployed mothers having 6-23 months old children. A systematic random sampling technique was used to select study participants. Epi-data version 3.1 and SPSS version 25.0 statistical software were used for data entry and analysis, respectively. Both bi-variable and multivariable binary logistic regression was done to assess the association between independent and dependent variables. A p-value of less than 0.05 in a multivariable binary logistic regression was declared as the level of statistical significance. RESULT: The prevalence of under-nutrition was 69.8% (95% CI: 65.0, 74.7) among children of unemployed mothers, compared to 27.4% (95% CI: 22.7, 32.2) among children of employed mothers. Under-nutrition among children of unemployed mothers was significantly associated with being a male child, age increase by one month, household food insecurity, lack of ANC follow-up, and not exclusively breastfed. Whereas, among children of employed mothers, being a male child, age increase by one month, being sick during the last two weeks prior to data collection, not immunized to their age, and low meal frequency were significantly associated with their under-nutrition. CONCLUSION: The prevalence of under-nutrition among children of unemployed women is significantly higher than those children of employed women which consolidate the evidence that women's employment status have a positive association with child nutrition. Different factors were also identified as significant predictors of child under-nutrition among these two groups (employed and unemployed women). Thus, multi-sectoral intervention approach together with agriculture and education offices should be strengthened.

Micronutrient intake and associated factors among school adolescent girls in Meshenti Town, Bahir Dar City Administration, Northwest Ethiopia, 2020.

BACKGROUND: Adolescent girls have a greater nutrient demand and their poor dietary intake is associated with micronutrient deficiencies and poor maternal outcomes. Having information on micronutrient intake inadequacy in adolescent girls is critical for promoting healthy behavior and breaking the cycle of intergenerational malnutrition. Thus, this study assessed overall micronutrient intake inadequacy and associated factors among school adolescent girls in Meshenti town of Bahir Dar City Administration, North West Ethiopia. METHODS: A school-based cross-sectional study was conducted among 401 adolescent girls from February 7 to 23, 2020. A Simple random sampling technique was used to select study participants. A multiple-pass 24-hour dietary recall with portion size estimation method and recommended dietary allowance cut-off point were used to assess micronutrient intake inadequacy. Overall micronutrient intake inadequacy was measured using the mean adequacy ratio. Nutrient databases were developed by ESHA FOOD PROCESSOR version 8.1 software. Data were entered into Epi-data version 3.1 and exported to SPSS version 23 for analysis. Multivariable logistic regression was performed to identify determinants of overall micronutrient intake inadequacy and an adjusted odds ratio at a p-value of less than 0.05 was used to see the strength of statistical association. RESULTS: The prevalence of overall micronutrient intake inadequacy was 44.4% (95% CI: 39.7%-49.6%). Early adolescent age (AOR: 2.75, 95% CI: 1.71-4.42), food-insecure household (1.74, 95%CI: 1.087-2.784), low dietary diversity score (AOR = 2.83, 95% CI: 1.35-5.92), and high peer pressure on eating and body concern (AOR = 1.853, 95% CI: 1.201-2.857) were significantly associated factors with overall micronutrient intake inadequacy. CONCLUSION: Findings of this study revealed that micronutrient intake inadequacy among adolescent girls was a high public health problem in the study area. Therefore, attention should be given to adolescent girls of the study area, especially the ones in the early adolescent age. Interventions should also focus on nutrition-sensitive activities to address food insecurity, a less diversified diet, and the negative impact of peer influence.

Effects of guided counseling during pregnancy on birth weight of newborns in West Gojjam Zone, Ethiopia: a cluster-randomized controlled trial.

BACKGROUND: The high proportion of birth weight in Ethiopia is hypothesized to be due to inadequate maternal diet which is associated with poor nutrition education during pregnancy. There was no study that evaluated the effect of nutrition education on birth weight in the study area. This study aimed to assess the effects (overall, direct and indirect effects) of guided counseling on the birth weight of neonates. METHODS: A two-arm parallel cluster randomized controlled community trial was conducted from May 1, 2018, to April 30, 2019, in West Gojjam Zone, Northwest Ethiopia. At the baseline, 346 pregnant women in the 11 intervention clusters and 348 pregnant women in the 11 control clusters were recruited. However, birth weight was measured from 258 and 272 newborns in the intervention and control groups, respectively. In the intervention group, counseling was given monthly for four consecutive months in the participant's homes. Besides, leaflets with key counseling messages were distributed to each woman in the intervention arm. Pregnant women who attended routine nutrition education given by the health system were recruited as control. Dietary practice, nutritional status, and birth weight were the primary, secondary and tertiary outcomes of this intervention. Data were collected using a structured data collection tool. Birth weight was measured within 48 h after birth. Independent sample t-test, linear mixed-effects model, and path analysis were fitted to assess effects of the intervention. RESULTS: The intra-cluster correlation coefficient was 0.095. The average birth weight of newborns in the intervention group was 0.257 kg higher compared with their counterparts in the control arm (ß = 0.257, P < 0.001). The direct effect of this intervention on birth weight was 0.17 (ß = 0.17, P<0.001 ) whereas the indirect effect of this intervention was 0.08 (ß = 0.08, P<0.001 ). CONCLUSION: Counseling using the health belief model and the theory of planned behavior has a positive effect on improving birth weight. The findings suggest the need for enhancing nutrition education of pregnant women through the application of theories to improve birth weight. TRIAL REGISTRATION: Clinical Trials.gov NCT03627156 , "Retrospectively registered Jun, 13, 2018".

The relationship between school meals with thinness and stunting among primary school students, in Meket Wereda, Ethiopia: comparing schools with feeding and non-feeding program.

BACKGROUND: Though undernutrition affects academic performance, significant number of Ethiopian school children have undernutrition. To avert nutritional problems the government in collaboration with the world food program has implemented a school feeding program. However, data on the nutritional status of primary school students were scarce in the country. Therefore, this study aimed to assess the relationship between school meals with thinness and stunting among primary school students in Meket Woreda and to identify associated factors. METHODS: A school-based comparative cross-sectional study was conducted among 1091 students, from April 1-27, 2015. The study participants were selected using a multi-stage stratified sampling method. A structured questionnaire was used to collect data. Data entry and analysis were done using Statistical Package for the Social Sciences (SPSS) version 20 software. Descriptive statistics and logistic regression analyses were done. Anthropometric data were analyzed using Anthro-plus software. RESULTS: In univariate analysis, thinness was commoner in nonschool feeding program schools (37.5%) compared to school feeding program schools (27.8%) but stunting was less common (48.3% versus 58.5%). However, after adjustment for confounding, there was no difference in stunting levels, but the adjusted odds ratio for thinness in nonschool feeding program schools was 2.6 (95% CI: (1.8, 3.8)) times higher than in school feeding program schools. Other independent risk factors for thinness were: having uneducated mother, being a male and taking meal once daily. Independent risk factors for stunting were ethnicity, having uneducated mother, un-piped water supply, taking meal once daily, type of diet and being a male. CONCLUSION: The provision of meals seems to offer considerable protection against thinness, though not against stunting. Thus, school meal program should be scaling up into schools in food insecure areas.

Effect of guided counseling on dietary practices of pregnant women in West Gojjam Zone, Ethiopia.

BACKGROUND: In Ethiopia, although nutrition education has been given during pregnancy, most women have inadequate nutrient intakes. As a result, the prevalence of malnutrition is high during pregnancy. In this study, we set out to evaluate the effect of guided counseling based on the health belief model and the theory of planned behavior on the dietary practices of pregnant women. METHODS: A two-arm parallel cluster randomized controlled community trial was carried out among pregnant women in West, Gojjam Zone, Ethiopia from May 1, 2018, to April 30, 2019. A total of 346 and 348 pregnant women were recruited from the intervention and control clusters, respectively. Of which endline data were collected from 313 and 332 pregnant women in the intervention and control groups, respectively. Each woman in the intervention group attended four counseling sessions. Women in the control group attended the routine nutrition education given by the health care system. Data were collected using a structured questionnaire. McNemar test and Generalized Estimating Equations were used to evaluate the intervention effect. RESULTS: The average difference of appropriate dietary practice between the two groups was 30.7%. After controlling for the possible confounders, women in the intervention group had 7.2 times [AOR = 7.187, 95% CI: (4.49, 11.49)] higher odds of having appropriate dietary practices compared with the control group. Dietary diversity and meal frequency of counseled women were 7 [AOR = 6.994, 95% CI: (4.59, 10.66)] and 8 [AOR = 8.146, 95% CI: (5.377, 12.341)] times higher than dietary diversity and meal frequency of women in the control group, respectively. CONCLUSION: Counseling based on the health belief model and the theory of planned behavior is an effective approach in increasing the proportion of women who had appropriate dietary practices. Thus, these findings suggest the need for employing trimester based counseling using the HBM and the TPB to improve the dietary practices of pregnant women. TRIAL REGISTRATION: The trial was registered in Clinical Trials.gov (NCT03627156).

Effect of guided counseling on nutritional status of pregnant women in West Gojjam zone, Ethiopia: a cluster-randomized controlled trial.

BACKGROUND: Undernutrition during pregnancy affects birth outcomes adversely. In Ethiopia, despite nutrition counseling on the maternal diet being given by the health workers during pregnancy, maternal undernutrition is still high in the country. Hence, this study aimed to assess the effect of guided counseling using the health belief model and the theory of planned behavior on the nutritional status of pregnant women. METHODS: A two-arm parallel cluster randomized controlled community trial was conducted in West Gojjam Zone, Ethiopia, from May 1, 2018, to April 30, 2019. The nutritional status of the women was assessed using mid-upper arm circumference. A total of 694 pregnant women were recruited from the intervention (n=346 ) and control (n=348) clusters. Of which endline data were collected from 313 and 332 pregnant women in the intervention and control clusters, respectively. The intervention was started before 16 weeks of gestation and pregnant women in the intervention group attended 4 counseling sessions. Counseling was given at the participants' homes using a counseling guide with the core contents of the intervention. Leaflets with appropriate pictures and the core messages were given for women in the intervention arm. Women in the control group got the routine nutrition education given by the health care system. Data were collected using interviewer administered structured questionnaires and mid-upper arm circumference was measured using an adult MUAC tape. Descriptive statistics  and linear mixed-effects model were used to assess the intervention effect after adjusting for potential confounders. RESULTS: After the intervention, the prevalence of undernutrition was 16.7% lower in the intervention group compared with the control arm (30.6% Vs 47.3%, P = < 0.001). Women in the intervention group showed significant improvement in nutritional status at the end of the trial than the control group (ß = 0.615, p = < 0.001). CONCLUSION: This study demonstrated that guided counseling using the health belief model and the theory of planned behavior was effective in improving the nutritional status of pregnant women. The results imply the need for the design of model and theory based nutrition counseling guidelines. The trial was registered in Clinical Trials.gov (NCT03627156).

Dietary practices and associated factors among pregnant women in West Gojjam Zone, Northwest Ethiopia.

BACKGROUND: The optimal dietary practice is a critical requisite for maternal nutrition. However, the majority of Ethiopian pregnant women have inadequate nutrient intakes. These may be due to their poor dietary habits. Identifying factors affecting the dietary practices of pregnant women is crucial to design appropriate interventions. In this country, the dietary practices of pregnant women and determinants are not well studied. Therefore, the purpose of this study was to assess the dietary practices and associated factors among pregnant women in West Gojjam Zone, Northwest Ethiopia. METHODS: A community-based cross-sectional study was carried out among 712 pregnant women from May to August 2018. Quantitative data complemented with a qualitative method. Pregnant women were selected using a cluster sampling technique. Structured questionnaires were utilized for data collection. Data were entered into Epi-Info version 7.2.2 and exported to SPSS version 23 software for analysis. Data were described using frequencies and mean. A logistic regression analysis was done. Three focus group discussions and 17 key-informant interviews were conducted for the qualitative data. Focus group discussion participants were mothers, husbands, and health professionals. Typical case and homogeneous sampling techniques were used for the key-informant interviews and focus group discussions, respectively. Thematic analysis was used for the qualitative data. RESULTS: Only 19.9% of respondents had appropriate dietary practices. On the multivariable logistic regression analyses, being food secure [AOR = 2.25, 95% CI: (1.1, 4.5)], having high edible crop production [AOR = 2.00, 95% CI: (1.2, 3.2)] and a favorable attitude [AOR = 1.69, 95% CI: (1.1, 2.6)] were significantly associated with the appropriate dietary practices of pregnant women. In the qualitative study, lack of knowledge on maternal diet, cultural prohibition, and knowledge gap of the professionals were barriers that interfere with dietary practices during pregnancy. CONCLUSION: Pregnant women in the study area are found to have suboptimal dietary practices. Therefore, health professionals should give regular nutrition counseling using cards and role models for promoting diversified food production and consumption.

Factors associated with noncommunicable disease among adults in Mecha district, Ethiopia: A case control study.

BACKGROUND: In Ethiopia, the incidence and prevalence of noncommunicable diseases are rising. Within the country, the magnitude of these diseases varies from region to region. However, information about factors associated with noncommunicable disease is limited in the study area. Therefore, the objective of this study was to identify factors associated with noncommunicable disease among adults in Mecha district. METHODS: Community-based case-control study was carried out among 728 cases and 2907 controls from February1-August 30/2017. The study participants were chosen using a multi-stage sampling technique. Data were collected using structured questionnaire. Fasting blood glucose level was measured in the morning after 8hours of fasting. Statistical Package for Social Science (SPSS) version 20 software was used to enter and analyze data. Crude and adjusted Odds ratios were done for each explanatory variable at 95% confidence level. RESULTS: The likelihood of developing noncommunicable disease was higher among participants who drank alcohol [AOR = 1.72, 95% CI: (1.3, 2.1)] and coffee [AOR = 4.54, 95% CI: (3.4, 5.9)], did not take vegetables [AOR = 2. 30, 95% CI: (1.6, 3.1)] and fruits [AOR = 2.04, 95% CI: (1.4, 2.9)], took packed oil [AOR = 2.35, 95% CI: (1.7, 3.1)], overweight or obesity [AOR = 2.23, 95% CI: (1.3, 3.8)] and physically inactive [AOR = 1.71, 95% CI: (1.2, 2.4)]. CONCLUSION: Of those assessed, the main factors associated with noncommunicable disease were drinking alcohol and coffee, not taking vegetables and fruits, taking packed oil, being overweight and physically inactive. Thus, the finding suggests changing the dietary habit of the community to increase consumption of fruits and vegetables, use of unsaturated fat for cooking, to avoid consumption of alcohol and to decrease taking coffee, to do physical activity and weight reduction.

Factors associated with knowledge on obstetric danger signs among women who gave birth within 1 year in Bahir Dar city administration, North West, Ethiopia.

OBJECTIVE: This study aimed to assess factors associated with knowledge on obstetric danger signs among women who gave birth within 1 year in North West, Ethiopia. RESULTS: Overall, 37.9% of the respondents were knowledgeable. Women mention three and more key danger signs during pregnancy and after delivery were 15% and 18.5% respectively. Decision making power of women [AOR = 1.59, 95% CI 1.10, 2.29], starting antenatal visit lately [AOR = 3.1, 95% CI 1.63, 6.33], housewife [AOR = 2.15, 95% CI 1.25, 3.68], merchant [AOR = 2.01, 95% CI 1.05, 3.88], and government employees [AOR = 2.75, 95% CI 1.38, 5.49] were among the predictors of knowledge on obstetric danger signs.

Food security is not the only solution to prevent under-nutrition among 6-59 months old children in Western Amhara region, Ethiopia.

BACKGROUND: In spite of surplus food production, in Amhara region, a significant number of children had under-nutrition. Investigating factors associated with under-nutrition in food secured households is crucial to design preventive measures. Therefore, the objective of this study was to assess under-nutrition and associated factors among 6-59 months old children in food secured households in Western Amhara Region, Ethiopia. METHODS: A community-based cross-sectional study was performed using interviewer-administered questionnaire on 6-59 months old children from Jun 01-30/ 2017. A multi-stage sampling strategy was used to select study participants. Prevalence of stunting, underweight, wasting and overweight/obesity were computed. Predictors were assessed using logistic regression analysis. RESULT: The prevalence of stunting, underweight, wasting and overweight/obesity were 40%, 19.8%, 11.6%, and 2.7%, respectively. Having mother who have no formal education (AOR] =2.21, 95% CI: [1.5, 3.2]), taking less diversified food (AOR =1.7, 95% CI: [1.1, 2.5]), having mother who did not wash her hands before food preparation (AOR =1.46, 95% CI: [1.1, 2.0]) and living in the households where solid wastes managed by scattering in the field (AOR =1.6, 95% CI: [1.1, 2.1]) were predictors of stunting. Whereas, wasting was associated with having illness in the prior two weeks of data collection day (AOR =2.7, 95% CI: [1.6, 4.7]), lack of getting antenatal care (AOR =2.0, 95% CI: [1.1, 3.4]) and taking food less than four times per day (AOR =2.00, 95% CI: [1.2, 3.2]). CONCLUSION: The prevalence of under-nutrition was very high. Therefore, health professionals and health extension workers should give nutrition counseling about the frequency and diversity of meal, environmental and personal hygiene by giving emphasis to mothers who have no formal education.

Dietary practice and associated factors among type 2 diabetic patients in Felege Hiwot Regional Referral Hospital, Bahir Dar, Ethiopia.

OBJECTIVE: Even if patient's dietary practice is a gold standard measure to manage type 2 diabetes, there is a limited study in the area. Therefore, the objective of this study was to assess dietary practice and associated factors among type 2 diabetic patients. RESULT: The study revealed that only 35.9% of the patients had good dietary practice. Attending above primary education [AOR = 1.9, 95% CI (1.1, 3.2)], having family support [AOR = 2.6, 95% CI (1.6, 4.2)], and receiving nutrition education [AOR = 2.5, 95% CI (1.5, 4.2)] were independent predictors for good dietary practice. Thus, the findings indicate the need to improve a method of nutrition education both for the patients and their families. Moreover, the government needs to improve literacy rate of citizens.

Under nutrition and associated factors among school adolescents in Dangila Town, Northwest Ethiopia: a cross sectional study.

BACKGROUND: Under nutrition in adolescents is an important determinant of health outcomes. Yet, adolescents are not usually part of health and nutrition surveys. Therefore, this research was conducted to assess factors associated with under nutrition among school adolescents. METHOD: A cross-sectional study was conducted among 424 school adolescents from November 1-15, 2015. Simple random sampling was used to select the study participants. Data were collected using structured questionnaire and analyzed by SPSS version 20 software. Both bivariate and multivariable logistic regression analyses were carried out to identify predictors of under nutrition. Furthermore, anthropometric data were calculated using Anthro-plus software. RESULT: The prevalence of stunting and thinness were 24.8 % and 7.1 %, respectively. Male gender [AOR=3.2, 95 % CI: (1.7, 5.8)], infrequent food intake [AOR=4.6, 95% CI: (2.6, 8.0)], unavailability of latrine [AOR=2.7, 95 % CI: (1.2, 6.0)], and poor hand washing practice [AOR=3.9, 95 % CI: (1.9, 8.1)] were independent predictors of stunting. Factors associated with thinness were being male [AOR=11.5, 95% CI: (3.3, 39.5)], illness in the last two weeks [AOR=2.9, 95 % CI: (1.2, 7.0)], and having more than five family members [AOR=3.6, 95% CI: (1.3, 9.4)]. CONCLUSION: The prevalence of under nutrition was high in this study. Infrequent food intake, unavailability of a latrine, poor hand washing practice, and large family members were the factors associated with under nutrition. There is need to implement nutrition education to school adolescents by giving emphasis on environmental and personal hygiene.

Factors associated with mothers' knowledge on infant and young child feeding recommendation in slum areas of Bahir Dar City, Ethiopia: cross sectional study.

BACKGROUND: Malnutrition is a public health concern in Ethiopia. This might be correlated with inappropriate infant and young child feeding practice. This in turn is affected by Mothers' knowledge on feeding practice. However, information on mothers' knowledge on infant and young child feeding recommendation was scarce in Ethiopia. Therefore, this study was designed to assess mothers' knowledge on infant and young child feeding recommendation and associated factors in slum areas of Bahir Dar City, Ethiopia. METHODS: A community based cross-sectional study was conducted from May 1-26/2015. Systematic sampling technique was used to select respondents. Data were collected by pretested, structured, interviewer administered questionnaire. Data were entered and analyzed by SPSS version 20 software. Knowledge score was computed. Binary and multivariable logistic regression analysis were used to identify factors associated with maternal knowledge. RESULTS: Only 28.7% of mothers had sufficient knowledge on infant and young child feeding recommendation. Factors associated with mothers, knowledge were above primary education [AOR 2.5, 95% CI (1.5, 3.9)], possession of radio [AOR 1.7, 95% CI (1.1, 2.7)], attending antenatal care [AOR 2.4, 95% CI (1.5, 4.0)], and having employed husband [AOR 2.3, 95% CI (1.2, 4.4)]. CONCLUSION: Mothers' knowledge on infant and young child feeding recommendation was very low. Hence, education on infant and young child feeding recommendation should be strengthened during antenatal care visit and using mass media especially for mothers with lower educational status to fill up of this gap.

Infant and young child feeding practice among mothers with 0-24 months old children in Slum areas of Bahir Dar City, Ethiopia.

BACKGROUND: Adequate nutrition during infancy and early childhood is essential to ensure the health, growth and development of children. However, infant feeding practice is suboptimal in Bahir Dar City, Ethiopia. The slum area is a heavily populated urban informal settlement characterized by substandard housing, squalor, with a lack of reliable sanitation services, supply of clean water, reliable electricity, law enforcement and other basic services. Residents of the slum area were poor and less educated. This further compromises infant feeding practice. The aim of this study was to assess infant and young child feeding practice among mothers with 0-24 month old children in the study area. METHODS: A community based cross-sectional study was conducted among 423 mothers with 0-24 month old children from June 01-30 / 2016. Simple random sampling technique was used to select the respondents. Infant and young child feeding practice was assessed using the fifteen World Health Organisation (WHO) criteria. RESULTS: The prevalence of exclusive breastfeeding practice was 113 (84%). Sixty (15%) mothers gave prelacteal feeds and, 96 (23%) mothers used a bottle to feed their index child. Appropriate complementary feeding practice was only 20 (7%). Thirty nine out of forty mothers introduced complementary food timely, 131 (47%) of mothers gave the minimum meal frequency, and 20 (7%) children took the minimum food diversity and acceptable diet. Independent predictors for complementary feeding practice were having secondary and above education of the mother, receiving postnatal care, possession of radio and giving birth at hospital. CONCLUSION: In this study infant and young child feeding (IYCF) practice was poor. Therefore, there is a need for strengthening the promotion on IYCF practice during postnatal care and using mass media to giving emphasis for optimal complementary feeding practices, especially for mothers with a lower educational status.

Undernutrition and associated factors among 24-36-month-old children in slum areas of Bahir Dar city, Ethiopia.

BACKGROUND: This study aimed to assess undernutrition and associated factors among 24-36-month-old children in the slum areas of Bahir Dar city. METHODS: A community-based cross-sectional study was conducted among 480 children from May 1 to 26, 2015. The simple random sampling technique was used to select respondents. Data were collected using a structured interviewer-administered questionnaire. Statistical Package for Social Sciences version 20 was used for analysis. The prevalence of undernutrition was computed. Binary and multivariable logistic regression analyses were also carried out to identify the association between the independent and dependent variables and the predictors of undernutrition, respectively. A P-value <0.05 was considered to be statistically significant in the final model. RESULT: The prevalence of stunting, underweight, and wasting was 42%, 22.1%, and 6.4%, respectively. Independent predictors for stunting were illness in the preceding two weeks, having two children under three years old, taking prelacteal feeding, and early or late initiation of complementary feeding. Illness in the preceding two weeks, lack of latrine utilization, and lack of hand washing practice were independent predictors for underweight. CONCLUSION: There was a high prevalence of undernutrition in this study. Thus, health extension workers and health professionals in Bahir Dar city should educate mothers/caretakers on the health impact of giving prelacteal feeding, hand washing practice, time of initiation of complementary feeding, and birth interval.

Knowledge of Health Professionals on Folic Acid Use and Their Prescribing Practice in Bahir Dar City Administration, Northwest Ethiopia: Cross-Sectional Study.

BACKGROUND: Taking folic acid supplement during periconception period is effective to prevent neural tube defects. Unfortunately, a minority of Ethiopian women took folic acid supplement during this period. Low consumption of folic acid might be correlated with knowledge and prescribing practice of health professionals. Therefore, this study was conducted to assess knowledge and prescribing practice of health professionals. METHODS: Institution based cross-sectional quantitative study supplemented by qualitative approach using thematic content analysis of in-depth interview was conducted. A total of 424 health professionals were selected by simple random sampling technique. A convenience sampling technique was used to generate the qualitative data. Bivariable and multivariable logistic regression analysis were used to identify factors associated with knowledge of health professionals. RESULT: About 47.7% of health professionals had sufficient knowledge and 9.7% of them had prescribed folic acid to women during periconception period. Age, having work experience in ANC clinic, and being a general practitioner were independent predictors for knowledge of health professionals. Lack of guideline to use as a reference, refreshment training and clear direction from health bureau, time constraint, differing patient priorities, and competing topics were some of the reasons for insufficient knowledge and poor practice. CONCLUSION: The majority of the health professionals had insufficient knowledge and poor prescribing practice on folic acid during periconception period. Lack of guideline to be used as a reference, refreshment training and clear direction from health bureau, time constraint, differing patient priorities, and competing topics were some of the reasons for low level of knowledge and poor prescribing practice. Thus, guideline to use as a reference, refreshment training, incorporate the topic in the curriculum of health professionals and supportive supervision should be given to increase the knowledge and prescribing practice of health professionals. Regional Health Bureau should give priority on prevention of birth defects.

Factors associated with institutional delivery in Dangila district, North West Ethiopia: a cross-sectional study.

INTRODUCTION: Childbirth in a health institution has been shown to be associated with lower rates of maternal and neonatal mortality. However, about 85% of mothers in Ethiopia deliver at home. OBJECTIVE: To assess factors associated with institutional delivery service utilization among women who gave birth within one year prior to the study in Dangila district. METHODS: A cross-sectional study was conducted from February 01-28, 2015. A total of 763 mothers were interviewed using structured questionnaire. SPSS version 20 was used for analysis. Crude and adjusted Odds ratios were computed for selected variables. A P-value less than 0.05 was considered statistical significant. RESULTS: Only 18.3% of mothers gave birth at health facilities. Knowledge on danger signs [AOR=2.0, 95% CI: (1.1, 3.4)], plan to give birth at health institution [AOR=5.4, 95% CI: (3.0, 9.6)], having ANC follow up during pregnancy [AOR=12.9, 95% CI: (5.0, 33.3)] and time taken to get to a nearby health institution [AOR=5.1, 95% CI: (2.9, 9.1)] were associated with institutional delivery service utilization. CONCLUSION: Institutional delivery was very low. Knowledge about danger signs, having ANC visits, and time were factors associated with institutional delivery service utilization. Thus, the findings recommend repeated re-enforcement of institutional delivery service utilization through professionals. And also, the findings recommend promotion of institutional delivery service utilization through mass media.