Spatial distribution and determinants of undernutrition among reproductive age women of Ethiopia: A multilevel analysis.

INTRODUCTION: Malnutrition is one of the most devastating problems in Ethiopia and is inextricably linked with poverty. Women in the reproductive age group and children are most vulnerable to malnutrition due to low dietary intakes, inequitable distribution of food within the household, improper food storage and preparation, dietary taboos, infectious diseases, and care. Therefore, this study aimed to assess the spatial distribution and determinants of undernutrition among reproductive age of Ethiopia. METHODS: The study was based on the 2016 Ethiopian Demographic and Health Survey. The study included a total sampled weight of 15,139 women aged 15-49 years. The ArcGIS version 10.7 and SaTScan version 9.6 statistical software were used for exploring the spatial distribution of undernutrition. A multilevel logistic regression model was fitted to determine the individual and community level factors associated with women undernutrition. Finally, the factors which were significant at 95% confidence interval were reported. RESULT: The spatial analysis revealed that women undernutrition was significantly varied across the country. The SaTScan analysis identified a total of 144 significant hotspot areas of maternal undernutrition with three significant spatial windows. Of these, 134 clusters were primary. The primary spatial window was identified in the southeast Tigray, northwest Afar, central and north Amhara regions (LLR = 57.48, P<0.01, RR = 1.51). Age at first marriage (AOR = 1.57: CI 1.33, 1.99), middle wealth index (AOR = 3.15: CI 1.4, 6.97), rural residence (AOR = 2.82: CI 1.22, 6.52), being in Afar region, Tigray region and Harari region (AOR = 4.88: CI 1.71, 13.91), (AOR = 4.17: CI 1.57, 11.06) and (AOR = 3.01: CI 1.05, 8.68) respectively were significantly associated with women undernutrition. CONCLUSION: In Ethiopia, undernutrition had significant spatial variations across the country. Residence, age at first marriage, wealth index and region were significantly associated with undernutrition. Therefore, public health interventions that reduce reproductive age women undernutrition and enhance women awareness towards undernutrition in hotspot areas of undernutrition is crucial.

Perceived cause and determinants of help-seeking behavior of schizophrenia among Gondar Zuria district residents, Northwest Ethiopia.

INTRODUCTION: The cause of schizophrenia could be a genetic predisposition, environment, viral infections, exposure to poison substances, living in a highly-populated area, and prenatal exposure to hunger mainly in the first three months. Evidence showed that the perceived cause of schizophrenia is supernatural, biological, spiritual, and social causes. Studies in Ethiopia showed that most of the general population perceived the causes of schizophrenia as traditional and the help they seek ranges to medical, religious, and social. OBJECTIVE: This study aimed to assess perceived cause and determinants of help-seeking behavior of schizophrenia among Gondar Zuria district residents, 2020. METHODS: A community-based cross-sectional study was conducted from December 3 to 25, 2020. A simple random sampling technique was employed to select 435 study participants. Data were collected through a face-to-face interview, entered into EPI DATA version 3, and analyzed using SPSS version 21. Bivariable and multivariable binary logistic regression analyses were employed to identify factors significantly associated with help-seeking behavior for schizophrenia. Statistical significance was declared at p-value < 0.05 with 95% confidence interval. RESULTS: Nearly two-thirds (63.8%), the majority (90.8%), and more than half (52.5%) of the participants seek medical, religious, and social help for schizophrenia respectively. Being student (AOR = 3.43; 95% CI: 1.44, 8.15), unemployed (AOR = 4.87; 95% CI: 1.4, 16.40), perceived biological cause (AOR = 1.7; 95% CI: 1.01, 2.89), perceived religious cause (AOR = 0.48; 95% CI: 0.29, 0.80), and perceived social cause (AOR = 2.05; 95% CI: 1.29, 3.25) were significantly associated with medical help seeking. Attending primary school (AOR = 0.17; 95% CI: 0.04, 0.76), employed (AOR = 0.12; 95% CI: 0.02, 0.64), perceived religious cause (AOR = 2.34; 95% CI: 1.06, 5.11) were significantly associated with religious help. Being in the age group of 18-24 years (AOR = 3.5; 95% CI: 1.33, 9.18) and 25-44 years (AOR = 1.94; 95% CI: 1.03, 3.68) were significantly associated with social intervention. CONCLUSION: Nearly two-thirds, the majority, and more than half of the respondents seek medical, religious, and social help for schizophrenia respectively. Being student, unemployed, perceived biological case, and perceived social cause increases the odds of seeking medical help while perceived religious cause decreases it. Being unemployed, attending primary school decreases the odds of seeking religious help whereas perceived religious cause increases it. Young adults have higher odds of social help-seeking behavior. It is better to create awareness for the community and consider integrating religious and social interventions into medical interventions.