The effects of advanced maternal age on perinatal mortality in Ethiopia: A systematic review and meta-analysis.

Background: Pregnancy in women over the age of 35 years is considered advanced maternal age. The relationship between advanced maternal age and the risk of perinatal mortality is still controversial. As a result, this systematic review and meta-analysis were carried out to clarify the relationship between advanced maternal age and perinatal mortality in Ethiopia. Methods: The following electronic databases were used for this systematic review and meta-analysis: PubMed, Web of Science, Scopus, Science Direct, Google Scholar, HINARI, and African Journals Online up to March 2022. Addis Ababa, Gondor, and Jimma University research repositories were also searched. A random-effects model was used to pool study-specific odds ratios. Results: A total of 18 articles, including a total of 45,541 participants, were included in the meta-analysis. A total of 11 cross-sectional, 2 case-control, and 5 cohort studies were included. The overall pooled estimate indicates that women with advanced maternal age had a 1.58 higher risk of perinatal mortality compared to women in the younger age group (odds ratio = 1.58; 95% Confidence Interval: 1.13-2.03). The subgroup analysis also revealed that there were differences in the effect size as the geographical region differed. The result showed that the odd of perinatal mortality was highest in the Oromia region and lowest in the Southern Nations Nationalities and Peoples' Region. Conclusion: The overall pooled estimate indicates that women with advanced maternal age had a 1.58-fold higher risk of perinatal mortality. Even though this risk could also be increased with other comorbid diseases, it is important for healthcare providers and other concerned stakeholders to be aware of the increased risks associated with advanced maternal age and provide different intervention programs designed to create awareness and provide counseling services to couples who seek to have a child in their later ages about the risks of advanced maternal age pregnancy on perinatal mortality and other adverse pregnancy outcomes.

Concomitant use of medicinal plants and pharmaceutical drugs among pregnant women in southern Ethiopia.

Background: In several African nations, including Ethiopia, improving mother and child health is a top public health concern. Unfortunately, there is a dearth of study on pregnant women in Ethiopia who concomitantly utilize pharmaceutical drugs and medicinal plants. Hence, the objective of this research was to assess the concomitant use of pharmaceutical drugs and medicinal plants among pregnant women in Southern Ethiopia in 2021. Methods: A community-based cross-sectional study was conducted among systematically selected 400 pregnant women in Shashamane town, Southern Ethiopia, from July 1-30/2021. An interviewer-administered structured questionnaire was used to collect data. Binary logistic regression was performed to examine the association between a dependent variable and independent variables. Results: According to this study, among those who self-medicated, 90 (22.5%) reported using at least one pharmaceutical drug, while 180 (45%) reported using at least one medicinal plant. Moreover, 68 (17%) of the participants who had taken drugs while pregnant also used pharmaceutical drugs and medicinal plants concomitantly. Having a medical condition during pregnancy (AOR = 5.6, 95% CI: 2.7-11.6), not having ANC follow up (AOR = 2.9, 95% CI: 1.3-6.2), gestational age (AOR = 4.2, 95% CI: 1.6-10.7), and not having a formal education (AOR = 4.2, 95% CI: 1.3-13.4) were all significantly associated with concomitant use of pharmaceutical drugs and medicinal plants during pregnancy. Conclusion: This study showed that nearly one in five pregnant women used medicinal plants concomitantly with pharmaceutical drugs. Mother's educational status, medical illness during pregnancy, having ANC follow up and gestational period were significantly associated with concomitant use of medicinal plants and pharmaceutical drugs. Therefore, health care providers and concerned stakeholders should consider these factors to minimize the risks associated with drug use during pregnancy on both mother and fetus.

Human papillomavirus vaccination uptake and its associated factors among adolescent school girls in Ambo town, Oromia region, Ethiopia, 2020.

BACKGROUND: The Human Papillomavirus (HPV) vaccine has offered a great promise to reduce the cervical cancer burden; its utilization (uptake) however has been lagging. However, the levels and factors associated with the uptake of the vaccine have not been well investigated, especially in the local context. OBJECTIVE: To assess the uptake of human papillomavirus vaccination and its associated factors among adolescent school girls in ambo town, Oromia, Ethiopia, 2020. METHODS: An institution-based cross-sectional quantitative study design supplemented with the qualitative inquiry was employed to assess Human Papillomavirus vaccination uptake and its associated factors among 422 adolescent school girls in Ambo town, central Ethiopia from December 1-30, 2020. The collected data were coded, entered, and cleaned by using Epi info 7.2.3 and exported to SPSS version 25 for analysis. Descriptive statistics were used to compute summary statistics and proportions. Both bivariate and multivariable logistic regression was employed to identify factors associated with HPV vaccine uptake. Adjusted odds ratio and 95% confidence interval were used for the strength and directions of association. A P-value of < 0.05 was used to declare statistical significance. Qualitative findings have been analyzed with manual thematic analysis. RESULT: The proportion of HPV vaccination uptake among school girls in this study was 44.4%. Hearing about HPV vaccine [AOR = 2.50, 95%CI: (1.045-5.959)], availability of awareness creation [AOR = 2.53, 95%CI: (1.507-4.258)], and favorable attitude [AOR = 2.049, 95%CI: (1.153-3.64)] were the key identified factors associated with vaccination uptake. In addition, poor perception, fear of side effects, and misunderstanding were among the major factors identified by qualitative findings. CONCLUSION: There was low uptake of HPV vaccination among the school Adolescents in the study area. Availability of awareness creation programs, favorable attitude towards HPV vaccine, and hearing about HPV vaccine was significantly associated with the uptake of the HPV vaccination. Therefore, awareness creation and behavior change education are mandatory to scale up the vaccination.

Determinants of adverse birth outcome in the west shewa zone, Oromia, regional state, Ethiopia: Unmatched case-control study.

INTRODUCTION: Adverse birth outcome (ABO) can lead to higher rates of poor health and infection for newborns, as well as long-term neurological and health problems. Hence, the aim is to identify determinants of ABOs among mothers who gave birth in hospitals in West Shewa zone, Ethiopia. METHODS: A hospital-based, unmatched, case-control study was conducted from March 5to July 29, 2020, among 591mothers (171 cases and 420 controls) who had given birth in hospitals found in West Shewa zone. The questionnaire was collected using census and survey processing system (CS-Pro) version7.1.The data were entered into Epi-data version 3.1 and analyzed by SPSS software version 23. Descriptive statistics, bivariate analysis, and multivariate logistic regression analysis were performed. Finally, P-value < 0.05 was used to declare and include variables with statistically significant in predicting the outcome variable. RESULT: On multivariate analysis, urban residence(AOR=0.65, 95%, CI=0.43-0.98),lack of family support during child bearing(AOR =5.24, 95% CI=3.16-8.71),pregnancy type(AOR = 4.02, 95% CI: 2.47-6.52,),short inter-pregnancy interval (AOR = 1.43,95% CI= 1.23-4.48),less than four antenatal care (ANC) visits (AOR =1.80,95%CI: 1.17- 2.78),and having current obstetric complication (AOR=2.07, 95% CI =1.18-3.61) were significantly associated with adverse birth outcomes. CONCLUSIONS: Residence, lack of family support during childbearing, pregnancy type, short inter-pregnancy interval, having current obstetric complications, and number of ANC visits were identified as determinants of adverse birth outcome. Therefore, improving family support, increasing inter-pregnancy interval through family planning counselling and provision, and having the recommended ANC follow-up were recommended.

Determinants of Neonatal Sepsis among Neonates Admitted to Public Hospitals in Central Ethiopia: Unmatched Case-control Study.

Background. Neonatal sepsis is the cause of substantial morbidity and mortality, mostly affecting the developing countries including Ethiopia. Previously conducted studies also highlighted the high prevalence of neonatal sepsis in Ethiopia. Therefore, this study was aimed at assessing the determinants of neonatal sepsis in the central Ethiopia. Method. Institution based un-matched case control study was conducted among 192 cases (neonates with sepsis) and 384 controls (without sepsis) in public hospitals in Central Ethiopia. The data were collected through face-to-face interview using structured questionnaire and extraction from maternal and neonatal charts. Binary logistic regression (bi-variable and multi-variable) model was fitted. Adjusted odds ratio with respect to 95% confidence interval was employed for the strength and directions of the association. Results. Younger maternal-age; 30 to 34 years (AOR = 0.41, 95%CI: 0.19-0.85) and 25 to 29 years (AOR = 0.38, 95%CI: 0.17-0.84), not having antenatal care (ANC) follow-ups (AOR = 1.89, 95%CI: 1.02-3.49), place of delivery; home (AOR = 12.6, 95%CI: 5.32-29.82) and health center (AOR = 2.74, 95%CI: 1.7, 4.41), prolonged duration of labor (AOR = 1.90, 95%CI: 1.22, 2.96), prolonged rupture of membrane 12 to 17 hours (AOR = 3.26, 95%CI: 1.46, 7.26) and ≥18 hours (AOR = 5.18, 95%CI: 1.98, 13.55) were maternal related determinants of neonatal sepsis. Whereas, prematurity (AOR = 2.74, 95%CI: 1.73, 4.36), being resuscitated (AOR = 1.93, 95%CI: 1.22, 3.06) and not having meconium aspiration syndrome (AOR = 2.55, 95%CI: 1.34, 4.83) were identified as neonatal related determinants of neonatal sepsis. Conclusion. Younger maternal age, not having antenatal care follow-up, home, and health center delivery, prolonged duration of labor, prolonged duration of rupture of membrane, prematurity, had resuscitation, and neonates without meconium aspiration syndrome were found to be determinants of neonatal sepsis. Therefore, the concerned stakeholders should consider those identified determinants during an intervention for improvement of neonatal health.

Maternal health service utilization from urban health extension professionals and associated factors among women who gave birth in the last one year in Ambo town, Oromia regional state, Ethiopia, 2018.

BACKGROUND: Despite the existence of urban and rural health extension workers maternal mortality and morbidity remain, as a public health problem in Ethiopia. The utilization of maternal health services from UHE-ps is key activities, which contribute to the reduction of maternal morbidity and mortality. This study aimed to assess maternal health service utilization from urban health extension professionals and associated factors among women who gave birth in the last one year in Ambo town. METHODS: Community-based cross-sectional study conducted from February to March 2018 among women who gave birth in the last year before the study period, in Ambo town, Oromia, Ethiopia. The Data collections were through face-to-face interview, the Focus discussion group was done using a semi-structured questionnaire. Descriptive, bivariate and multiple logistic regressions computed by SPSS version 20. Statistical significance was considered at p < 0.05 and the strength of statistical association was assessed by odds ratio with 95% confidence intervals. RESULT: From the total respondents, only 57(14.2%) women utilized maternal health services from urban health extension professionals during their recent birth. Regarding maternal health services utilization from urban health extension professional's ANC, Delivery and PNC were 159 (39.7%), 115 (28.7%) and 76 (19%) respectively. The variables, such as graduated as model family (AOR: 2.4; 95% C I: 1.20, 4.78), home visit during pregnancy within month (AOR: 11.6; 95% CI: 3.60, 37.17), awareness on pregnancy danger sign (AOR: 3.8; 95% CI: 1.62, 8.92) and parity (AOR: 2.8; 95% CI: 1.06, 7.61) were factors affecting maternal health services utilization from urban health extension professionals. CONCLUSION: The utilization of maternal health services from urban health extension professionals was found to be low. Being graduated as a model family, awareness on pregnancy danger sign, parity and urban health extension professional's home visit during pregnancy had a positive statistically significant association with maternal health services utilization from urban health extension professionals. Therefore, considering the identified associated variables could increase and sustain maternal health services utilization from urban health extension professionals.

Knowledge, uptake of preconception care and associated factors among reproductive age group women in West Shewa zone, Ethiopia, 2018.

BACKGROUND: Preconception care is a set of interventions that are to be provided before pregnancy, to promrote the health and well-being of womwen and couples . METHODS: A community-based cross-sectional study was employed among a sample of 680 reproductive-aged women in the West Shewa zone, Oromia regional state, from November 2017 until the end of January 2018. The data were collected using a pre-tested and structured questionnaire. The collected data were coded and entered into Epi data version 3.1 and exported to SPSS 22 for analysis. Bivariate and multivariate logistic regression models were utilized to determine factors associated with the outcome variable. The association was presented in odds ratio with 95% confidence interval and significance determined at a P-value less than 0.05. RESULT: A total of 669 participants had participated with a response rate of 98.3%. Among the respondants, only 179 (26.8%) had a good knowledge of PCC and 97 (14.5%) of them had utilized PCC. Factors that show significant association with good knowledge of PCC are history of institutional delivery (AOR = 1.43 (95%CI (1.31-7.33), PNC service utilization, (AOR = 5.02 (95%CI (3.22-7.84), history of using modern contraceptive, (AOR = 1.44 (95%CI (1.37-6.98) higher educational status (AOR = 4.12 (95%CI (1.22-6.52) and being regularly employed (AOR = 1.8 (95%CI (1.01-3.22). Factors like better family monthly income (AOR = 4.1 (95%CI (1.57-9.35), history of PNC (AOR = 6.33 (95%CI (3.94-10.17) and good knowledge of PCC (AOR = 4.3 (95%CI (2.67-6.98) had shown positive association towards the uptake of PCC. CONCLUSION AND RECOMMENDATION: This study found that only one-quarter of the women in the study has good knowledge of PCC and low uptake of PCC. History of institutional delivery, PNC service utilization, history of using a modern contraceptive, educational status and being regularly employed were factors that affect knowledge of PCC and family income, having good knowledge about PCC and history of PNC were affect the uptake of PCC.Therefore, PCC needs serious attention from the government and other stakeholders.

Knowledge of neonatal danger signs, care seeking practice and associated factors among postpartum mothers at public health facilities in Ambo town, Central Ethiopia.

OBJECTIVE: Neonatal mortality has remained high in Ethiopia inspite of different efforts being undertaken to reduce this negative trend. Early detection of neonatal illnesses has an important step towards improving newborn survival. Toward this end, there is a need for postpartum mothers to be able to identify signs in neonates that signifies severe neonatal illnesses. There is limited information about the knowledge of post-partum mothers on NDSs and associated factors in the study area. This study aims to assess knowledge of NDSs, care-seeking practice and associated factors among postpartum mothers in Ambo town, Ethiopia, 2018. A systematic random sampling was employed to select respondents and data was collected through face-to-face interviews. Both bivariate and multivariable logistic regressions were utilized. RESULTS: One-fifth 82 (20.3%) of postpartum mothers have good knowledge about NDSs. Only 60.5% of mothers whom their baby developed danger-sign sought medical care for their baby from health facility immediately. Mothers who have diploma/more education (AOR = 5.25, CI 1.48-18.59), whose current baby developed danger-signs (AOR = 3.18 CI 1.06-9.52), having PNC follow-up (AOR = 2.29, CI 1.24-4.24) and receiving counseling on newborn care after delivery (AOR = 1.78, CI 1.04-3.04) were factors associated with having good knowledge on NDSs. In this study the level of postpartum mother's knowledge on NDSs and care-seeking practice were low.

Determinants of puerperal sepsis among post partum women at public hospitals in west SHOA zone Oromia regional STATE, Ethiopia (institution BASEDCASE control study).

BACKGROUND: Puerperal sepsis is an infection of the genital tract, which occurs from rupture of amniotic sacs and within 42ndday after delivery. It happens mainly after discharge in the 1st 24 h of parturition. It is the third leading cause of direct maternal mortality in developing nations. It is also among preventable conditions. Even though multiple interventions were done to overcome these health problems, maternal mortality and morbidities were still significant. Mainly, in Ethiopia lack of clearly identified causes of maternal mortality and morbidity makes the problem unsolved. METHODS: Case-control study was conducted at public Hospitals in west shoa zone Oromia regional state, Ethiopia from February 01 to April 30/2018.women with puerperal sepsis (n = 67) were selected by convenience method. Controls (n = 213) were selected by systematic random sampling. Controls to cases ratio was 3:1 and structured questionnaire was used to interviewafter verbal consent was obtained. Data was entered in to epi -info 7.2 then exported to SPSS version 20.0 for analysis. A logistic regression model was used for data analysis. Those variables which have p-value < 0.05 were accepted that they are independent determinants of puerperal sepsis. RESULT: Rural residence (AOR [95%CI] = 2.5(1.029-6.054),Mothers with no formal education (AOR [95%CI] = 6.74([1.210-37.541]), up to primary level of education(AOR [95%CI] = 6.72(1.323-34.086), total monthly income of the mother or family<=500 ETB and 501-1500 ETB(AOR [95%CI] = 5.94(1.471-23.93) and (AOR [95%CI] =6.57 (1.338-32.265) respectively, Mothers having 1-2 times antenatal care(ANC)visit (AOR [95%CI] = 6.57([1.338-32.265]), Duration of Labor12-24 h (AOR [95%CI] = 3.12 (1.805-12.115),> = 25 h (AOR [95%CI] = 4.71([1.257-17.687]),vaginal examinations > = 5times (AOR [95%CI] = 4.00([1.330-12.029]), Delivery by C/S (AOR [95%CI] = 3.85 ([1.425-10.413]), Rupture of membrane > 24 h (AOR [95%CI] = 3.73([1.365-10.208]) and those Referred from other health institutions (AOR [95%CI] = 2.53([1.087-5.884],were independent determinants of puerperal sepsis in this study. CONCLUSION: Majority of determinants of puerperal sepsis were related with pregnancy and childbirth. Therefore, to tackle a problem of puerperal sepsis all concerning bodies should take measures during prenatal, natal and postnatal period.