Effective breastfeeding techniques and associated factors among lactating women in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Effective breastfeeding is crucial for maternal and child health, particularly in low-resource settings like Ethiopia. It encompasses a range of skills and strategies, including proper latch, positioning, and frequency of feeding. These techniques not only ensure sufficient milk transfer but also foster bonding between mother and child, enhancing the breastfeeding experience. To effectively prioritize maternal and child health, it is crucial to comprehensively understand the prevalence and factors influencing effective breastfeeding nationwide. Therefore, this study aimed to provide a pooled prevalence of effective breastfeeding techniques and associated factors among lactating mothers in Ethiopia. METHODS: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist, focusing on studies conducted in Ethiopia. We identified eight relevant studies through Google Scholar, Medline, PubMed, Scopus, and the Cochrane Library. Analysis was conducted using STATA version 11, and systematic data extraction employed a checklist to extract relevant data. I2 tests and the Cochrane Q test statistic were used to evaluate heterogeneity. To explore potential publication bias, Egger's weighted regression, Begg's test, and a funnel plot were utilized. RESULTS: We identified a total of 955 research articles. Eight studies meeting the eligibility criteria were incorporated into this meta-analysis and systematic review. The pooled prevalence of effective breastfeeding techniques was 41.99% [95% CI 32.16-51.81]. According to the results of the current meta-analysis, effective breastfeeding techniques were significantly associated with antenatal care follow-up [OR = 1.75, 95% CI 1.10-2.78], maternal educational status [OR = 2.70, 95% CI 1.55-4.71], breastfeeding technique counseling [OR = 2.02, 95% CI 1.41-2.90], the absence of breast problems [OR = 2.26, 95% CI 1.49-3.43], breastfeeding experience [OR = 1.98, 95% CI 1.14-3.46], and immediate skin-to-skin contact [OR = 2.32, 95% CI 1.56-3.44]. CONCLUSION: Our findings highlight the vital role of various factors in shaping effective breastfeeding. IMPLICATIONS: To improve practices and health outcomes, we recommend targeted interventions, such as strengthening antenatal care, implementing maternal education, and providing comprehensive breastfeeding counseling. Proactively addressing breast problems and prioritizing immediate skin-to-skin contact is crucial for successful breastfeeding.

Late postpartum depression and associated factors: community-based cross-sectional study.

BACKGROUND: Late postpartum depression is the presence of depressive symptoms beyond the early postpartum period and is a significant mental health problem that has a devastating impact on mothers, infants, partners, family members, the healthcare system, and the world's economy. However, there is limited information regarding this problem in Ethiopia. OBJECTIVE: To assess the prevalence of late postpartum depression and associated factors. METHOD: the community-based cross-sectional study was employed among 479 postpartum mothers in Arba Minch town from May 21 to June 21, 2022. The pre-tested face-to-face interviewer administered a structured questionnaire used to collect the data. A bivariate and multivariable analysis was done using a binary logistic regression model to identify factors associated with late postpartum depression. Both crude and adjusted odds ratios with 95% CI were calculated, and a p-value of < 0.05 was used to declare statistically significant factors. RESULT: The prevalence of late postpartum depression was 22.98% (95% CI: 19.16, 26.80). Husband Khat use (AOR = 2.64; 95% CI: 1.18, 5.91), partner dissatisfaction with the gender of the baby (AOR = 2.53; 95% CI: 1.22, 5.24), short inter-delivery interval (AOR = 6.80; 95% CI: 3.34, 13.84), difficulty to meet husband sexual need (AOR = 3.21; 95% CI: 1.62, 6.37), postpartum intimate partner violence (AOR = 4.08; 95% CI: 1.95, 8.54), and low social support (AOR = 2.50; 95% CI: 1.25, 4.50) were significantly associated factors at p-value < 0.05. CONCLUSION: Overall, 22.98% of mothers suffered from late postpartum depression. Therefore, based on the identified factors, the Ministry of Health, Zonal Health Departments, and other responsible agencies should establish effective strategies to overcome this problem.

The practice of early mother-newborn skin-to-skin contact after delivery of healthy term neonate and associated factors among health care professionals at health facilities of Southwestern Oromia, Ethiopia: A cross-sectional study.

INTRODUCTION: Skin-to-skin contact between a mother and her new-born baby after birth is beneficial for both the mother and her baby. Although mother-newborn skin-to-skin contact after birth is an essential practice, it is limited to a small proportion of premature babies in low-income countries including Ethiopia. The aim of this study was to assess the practice of early mother-new-born skin-to-skin contact after the delivery of healthy term neonates and associated factors among health care professionals in Southwestern Oromia, Ethiopia. METHODS: An institutional-based cross-sectional study was conducted to assess the practice of 286 health care practitioners towards early mother-new-born skin-to-skin contact after delivery. Data was collected using a pre-tested observational checklist and a self-administered questionnaire from March to April 2017. Epi Info 3.5 was used for data entry, while SPSS version 20 was used for cleaning and analyzing the data. To determine the association between outcome variable and independent variables, bivariate and multivariable logistic regressions were used with a 95% confidence interval and P <0.05. Frequency tables and charts were used to present the findings. RESULTS: Only 128 (44.8%) of the study participants practiced mother-newborn skin-to-skin contact within the first hour of life after birth. Mother newborn skin-to-skin contact after birth was found to be significantly associated with health professional's knowledge (AOR = 4, 95% CI = 1.7, 10), training (AOR = 7, 95% CI = 2.2, 21), complicated delivery (AOR = 0.12, 95% CI = 0.04, 0.4), and maternal chronic illness (AOR = 0.13, 95% CI = 0.03, 0.6). CONCLUSION: In general, the practice of health care providers on mother-newborn skin-to-skin contact in the first one hour after birth was low. Knowledge, training, childbirth related maternal complication, and maternal chronic illness were significant factors associated with the practice of mother-newborn skin-to-skin contact immediately after birth. Policies should be revised and enforced, with monitoring and awareness building through training among health care workers, to improve the practice of skin-to-skin contact between mothers and newborns shortly after birth.

Determinants of early discontinuation of long-acting and reversible contraceptive methods among women within childbearing age attending health facilities in Ethiopia, 2019.

Objective: This study aimed to identify the determinants of early discontinuation of long-acting and reversible contraceptive methods among women within childbearing age in Ethiopia, 2019. Methods: The institutional-based case-control study design was implemented from June to August 2019. Eligible study participants were sampled using systematic random sampling technique. Data were collected using structured and pre-tested questionnaire and entered into Epi Info and exported to SPSS version 20 for further analysis. All variables with a p value of <0.05 at odds ratio of 95% confidence interval in multivariable logistic regression analysis were considered as determinants of early discontinuation of long-acting and reversible contraceptive methods. Results: A total of 825 study participants (206 cases and 619 controls) were included in the study. Decision-making on the use of contraception (adjusted odds ratio: 4.8, 95% confidence interval: 1.4-16.8 and adjusted odds ratio: 5.6, 95% confidence interval: 1.7-18.8), the women who got counseled about side effects of contraceptive methods being 84% less likely to discontinue long-acting and reversible contraceptive methods compared to the women of their counterpart (adjusted odds ratio: 0.16, 95% confidence interval: 0.15-0.4), having two or more children (adjusted odds ratio: 10, 95% confidence interval: 3.7-28), and desire to be pregnant (adjusted odds ratio = 0.15 95% confidence interval: 0.06-0.4) were determinants of early discontinuation of long-acting and reversible contraceptive methods. Conclusion: According to the findings of this study, decision-maker on utilization of contraceptive methods, being counseled on side effects of contraception, number of children, and desire of woman to be pregnant were found to be determinants of discontinuation of long-acting and reversible contraceptive methods. Health care providers should strengthen providing pre-insertion counseling in accordance with the national guideline for family planning services, with an emphasis on potential contraceptive side effects and consideration of counseling on decision-making.

Willingness to utilize cervical cancer screening among Ethiopian women aged 30-65 years.

Background: Cervical cancer screening is a means of detecting cervical cancer early, before it develops, in order to reduce disease mortality and morbidity. When women are screened for cervical cancer between the ages of 30 and 40 years at least one time in their life, their risk of cancer could be decreased by 25-36%. Despite this advantage, cervical cancer screening coverage in Ethiopia is still <2%. As a result, we wanted to see how ready women in the Girar Jarso district, Ethiopia, were to get a cervical cancer test. Methodology: Community-based cross-sectional study was done using a stratified cluster sampling technique among 855 women aged 30-65 years in the Girar Jarso district, Ethiopia, from 1 June 2021 to 1 September 2021. A pretested and semi-structured interviewer-administered questionnaire was used to collect the data. EpiData management version 4.6 was used to enter data, which was then exported to SPSS version 23 for analysis. Logistic regression analysis was performed, and variables with a p-value of <0.05 were taken as statistically significant predictors of the willingness to utilize cervical cancer screening. Results: Of the 855 women, only 315 (46.7%, CI = 43-50.3) women were willing to be checked for cervical cancer, with 181 (21.2%) women having been screened at least one time in their life. Age of 30-39 years [AOR = 2.80 (95% CI: 1.05, 7.48)], urban resident [AOR = 2.12 (95% CI: 1.06, 4.48)], positive attitude [AOR = 1.68 (95% CI: 1.11, 2.53)], wealth status, awareness of cervical cancer, and low perceived barriers were independent predictors of the willingness to utilize cervical cancer screening. Conclusion and recommendation: The willingness to utilize cervical cancer screening services is low in the Girar Jarso district. To improve community awareness and attitude, continued and sustainable advocacy on the value of cervical cancer screening should be offered through mass media and health extension workers.

Safe menstrual hygiene management practice and associated factors among female adolescent students at high schools in central Ethiopia: A mixed-method study.

Background: Menstrual Hygiene Management (MHM) is a much-neglected issue in developing countries, including Ethiopia. Menstruating women and girls are forced into isolation, prevented from movement, dietary restrictions, and can be prevented from participating in daily routine activities. Furthermore, the way almost all previous studies conducted in Ethiopia measured the practice of MHM did not meet standard definition of safe MHM. This study aimed to assess safe management of menstrual hygiene practice and associated factors among female adolescent students in public high schools in central Ethiopia. Methods: A mixed-methods approach was employed in this study. Systematic random sampling technique was used to select 846 study participants. The collected data were entered through EPI INFO version 7 and exported to SPSS version 23 for cleaning and analysis. Bivariate and multivariate logistic regression analysis were performed to identify the association between MHM and independent variables. Finally, AOR, 95% CI, and p-value < 0.05 were considered statistically significant. The qualitative data was analyzed by ATLAS.ti in order to extract the main themes and categories. Direct quotations were presented with a thick description of the findings. Results: The safe management of menstrual hygiene was 28.20%. Living with parents (AOR = 2.51, 95% CI:1.11-5.68), living with relatives (AOR = 7.41, 95% CI:2.55-21.54), having a merchant mother (AOR = 1.81, 95% CI:1.14-2.9), having a mother who has private work (AOR = 4.56, 95% CI:1.31-5.90), having a farmer father (AOR = 1.53, 95% CI:1.1-2.31), rural resident (AOR = 1.61, 95% CI: 1.17-2.21) and realizing the absence of container for storing sanitary napkins in the toilet of the school latrine (AOR = 1.44, 95% CI: 1.1-0.94) were factors associated with MHM. Findings from a qualitative study were discussed under four themes to explore barriers to menstrual hygiene management, and three themes emerged as enablers to menstrual hygiene management. Conclusions: The safe management of menstrual hygiene was low among adolescent girls. People with whom adolescent girls live, the occupational status of mother and father, residence, the availability of a container to dispose of sanitary napkins in school toilets were factors associated with menstrual hygiene management. Behavioral change communications must be provided to female students about menstrual hygiene.

Intimate partner violence in the postpartum period and its associated factors among women attending a postnatal clinic in Central Ethiopia.

Objective: Intimate partner violence may affect women at any stage of their lives, including during pregnancy and after childbirth, and can have major health consequences for both the mother and the child. Therefore, the study was aimed to assess Intimate partner violence against postpartum women and its associated factors among women attending the postpartum clinic in Central Ethiopia, 2021. Methods: The hospital based cross-sectional study design was implemented among postpartum women attending Sendafa Beke Hospital from September to October 2021. Systematic random sampling procedure was used to select 414 eligible postpartum women. Data were collected using a structured interviewer administered questionnaire. The data were entered into Epi Info and exported to SPSS version 24 for analysis. All variables with p-value < 0.05 under adjusted odds ratio were taken as statistical significant associated factors with postpartum intimate partner violence. Results: A total of 414 postpartum women participated in the study with a 97% of response rate. The prevalence of postpartum intimate partner violence was 31.4%. The study identified that monthly income 1000-5000 birr (adjusted odds ratio = 3.4; 95% confidence interval = 1.08, 10.5), partners' alcohol consumption (adjusted odds ratio = 0.17, 95% confidence interval = 0.06, 0.45), decision-maker of household affairs (adjusted odds ratio = 4.8; 95% confidence interval = 1.5, 15.1), and infant's sex (adjusted odds ratio = 0.03; 95% confidence interval = 0.02, 0.063) were significantly associated with postpartum intimate partner violence. Conclusion: According to the findings of this study, nearly one-third of postpartum women were violated by their intimate partner after childbirth. Postpartum intimate partner violence was found to be associated with monthly income, partners' alcohol intake, decision-maker of household affairs, and infant's sex. To reduce the magnitude of the problem, different efforts should require from health professional, community, and government. The policy makers, planners and other concerned bodies establish appropriate strategy to prevent and control violence against women.

Utilization of cervical cancer screening service and associated factors among women of reproductive age group in Ilu Abba Bor zone, southwestern Ethiopia, 2019: Cross-sectional study.

Introduction: Cervical cancer is one of the severest risks to women's life. It is the main reason for more than half million of morbidity and 266,000 deaths worldwide annually. Objective: The aim of this study was to assess the level of cervical cancer screening service utilization and associated factors among women of the reproductive age group coming for health care service to public health facilities of Ilu Abba Bor zone, southwestern Ethiopia, 2019. Methods: An institutional-based cross-sectional study design was employed from 1 May to 30 May 2019. Participants were selected by systematic random sampling technique. Data were collected using a pretested questionnaire and entered into Epi data 3.1 and exported to SPSS version 23 for analysis. Multivariable logistic regression was used to observe the factors associated with cervical cancer screening utilization service. An adjusted odds ratio with a 95% confidence interval was used. Variables with a p-value of <0.05 were considered to be statistically significant. Results: From a total of 259 women involved in the study, about 19 (7.3%) of the study participants had been screened for cervical cancer at least once in the past 3 years during the study period. Educational status: primary (grade 1-8) (adjusted odds ratio = 3; 95% confidence interval = (1.15-7.91)), secondary (grade 9-12) (adjusted odds ratio = 4.21; 95% confidence interval = (1.04-7.46)), and tertiary (grade 12+) (adjusted odds ratio = 6.01; 95% confidence interval = (3.01-11.35)), nulliparous (adjusted odds ratio = 0.256; 95% confidence interval = (0.105-0.642)), and looking for information about cervical cancer (adjusted odds ratio = 3.4; 95% confidence interval = (1.8-6.2)) were significant factors associated with utilization of cervical cancer screening service. Conclusion: The study revealed that there was low cervical cancer screening service utilization in the study area. Educational status, parity, and looking for cervical cancer information were independently associated with cervical cancer screening utilization service. There is need to improve women's education, dissemination of information about importance of cervical cancer screening, and focus on nulliparous women to have good practice of cervical cancer screening.

What Factors Encourage Young People to Engage in Substance Use? Substance Use and Associated Factors Among Youth in Southwest Ethiopia: A Community-Based Study.

Background: Substance use indicated the use of psychoactive substances such as alcohol, cigarettes, khat, and illegal drugs. Substance use has varying impacts on the health and socio-economics of countries, and is a major public health concern globally. Currently, substance use is a common public health problem among Ethiopian youth mainly in the city of Jimma. Therefore, this study aimed to assess the magnitude of Cigarette smoking, alcohol drinking, khat chewing, and associated factors among the youth of Jimma town in 2019. Methods: A community-based cross-sectional study was conducted among youth of Jimma town from March 2019 to April 2019. A simple random sampling technique was used to select 423 study participants. Data were collected using a structured interviewer-administered questionnaire. The collected data were entered into EPI data manager version 4.4.1 and transported to SPSS version 23 for data cleaning and analyses. The disruptive study was carried out to determine the prevalence of cigarette smoking, alcohol consumption, and khat chewing. Binary and multivariable analyses were carried out to identify factories associated with cigarette smoking, alcohol consumption, and khat chewing. Finally, adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to determine the presence and strength of association. Results: The current prevalence of cigarette use, alcohol use, and khat use was 16.0, 30.6, and 45.7%, respectively. Factors associated with current smoking use were substance use by siblings, subjective norm factors, and perceived benefits of substance use. Factors associated with current alcohol consumption were youth who highly perceived substance use as important. Factors associated with current khat use were male, substance use by siblings, out-of-school youth, and subjective norms. Concussion: The study findings indicated that the prevalence of khat, alcohol, and cigarettes was high among the youth of the city of Jimma. To reduce the prevalence of khat, alcohol, and cigarettes among youth, coordinated efforts from the youth, the government, health professionals, and the community at large are needed.

Determinants of neonatal sepsis among neonates delivered in Southwest Ethiopia 2018: A case-control study.

INTRODUCTION: Neonatal sepsis is one of the principal causes of neonatal morbidity and mortality. In spite of interventions with different preventive methods, the burden of neonatal sepsis is being reported in different parts of Ethiopia. For further interventions, identifying its determinants is found to be essential. OBJECTIVE: The study aimed to assess the determinants of neonatal sepsis among neonates delivered in Southwest Ethiopia in 2018. METHODS: A hospital-based case-control study was conducted in Southwest Ethiopia from May 2018 to August 2018. Systematic random sampling technique was used to select study participants; Cases were neonates diagnosed with sepsis and controls were neonates without sepsis. Data were entered into Epi info version 7.2 and analyzed using Statistical Package for Social Sciences version 23. Bi-variable logistic regression was used to identify determinants of neonatal sepsis and those variables with a p-value < 0.05 in the multivariable logistic regression analysis were considered as significantly associated at a 95% confidence interval. RESULTS: The findings from the multivariable logistic regression revealed that history of meconium-stained amniotic fluid (adjusted odds ratio [95% confidence interval] = 9.2 [1.1, 19.8]), history of foul-smelling liquor (adjusted odds ratio [95% confidence interval] = 5.2 [1.2, 22.3]), history of maternal sexually transmitted infection/urinary tract infection (adjusted odds ratio [95% confidence interval[ = 4.7 [1.1, 19.7]), history of vascular catheter (adjusted odds ratio [95% confidence interval] = 4.7 [1.11, 20]), and low birth weight (adjusted odds ratio [95% confidence interval] = 5.3 [1.3, 28.9]) were identified as determinants of neonatal sepsis. CONCLUSION: Generally, history of meconium-stained amniotic fluid, foul-smelling liquor, maternal history of the sexually transmitted disease, urinary tract infection, low birth weight, and the vascular catheter was identified as determinants of neonatal sepsis. Health education should be provided for pregnant mothers regarding health care-seeking behavior. Similarly, diagnoses and care should be accessible on time for foul-smelling liquor, premature rupture of membrane, and low birth weight.