Interventions to improve the quality of maternal care in Ethiopia: a scoping review.

Introduction: Quality improvement interventions have been part of the national agenda aimed at reducing maternal and neonatal morbidities and mortality. Despite different interventions, neonatal mortality and morbidity rates remain steady. This review aimed to map and synthesize the evidence of maternal and newborn quality improvement interventions in Ethiopia. Methods: A scoping review was reported based on the reporting items for systematic reviews and meta-analysis extensions for the scoping review checklist. Data extraction, collation, and organization were based on the Joanna Briggs Institute manual of the evidence synthesis framework for a scoping review. The maternal and neonatal care standards from the World Health Organization and the Donabedian quality of health framework were used to summarize the findings. Results: Nineteen articles were included in this scoping review. The review found that the studies were conducted across various regions of Ethiopia, with the majority published after 2013. The reviewed studies mainly focused on three maternal care quality interventions: mobile and electronic health (eHealth), quality improvement standards, and human resource mobilization. Moreover, the reviewed studies explored various approaches to quality improvement, such as providing training to healthcare workers, health extension workers, traditional birth attendants, the community health development army, and mothers and supplying resources needed for maternal and newborn care. Conclusion: In conclusion, quality improvement strategies encompass community involvement, health education, mHealth, data-driven approaches, and health system strengthening. Future research should focus on the impact of physical environment, culture, sustainability, cost-effectiveness, and long-term effects of interventions. Healthcare providers' knowledge, skills, attitudes, satisfaction, and adherence to guidelines should also be considered.

Level of adherence to option B+ program and associated factors among HIV-positive women in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Despite policy initiatives and strategic measures highly focused on preventing mother-to-child transmission through the implementation of the Option B+ program, adherence to the treatment is still challenging. The level of adherence and determinants of Option B+ program utilization reported by different studies were highly inconsistent in Ethiopia. Hence, this systematic review and meta-analysis aimed to estimate the pooled prevalence of adherence to the Option B+ program and its predictors among HIV-positive women in Ethiopia. METHODS: PubMed, Google Scholar, EMBASE, HINAR, Scopus, and Web of Sciences were searched for published articles from March 2010 to March 2022. The pooled prevalence of adherence was estimated using a weighted DerSimonian-Laird random effect model. The I2 statistics was used to identify the degree of heterogeneity. Publication bias was also assessed using the funnel plot and Egger's regression test. RESULTS: A total of 15 studies were included. The pooled estimate of the option B+ program among HIV-positive women in Ethiopia was 81.58% (95% CI: 77.33-85.84). Getting social and financial support (AOR = 3.73, 95% CI: 2.12, 6.58), disclosure of HIV status to partners (AOR = 2.05, 95% CI: 1.75, 2.41), time to reach a health facility (AOR = 0.33, 95% CI: 0.16, 0.67), receiving counseling on drug side effects (AOR = 4.09, 95% CI: 2.74, 6.11), experience of drug side effects (AOR = 0.17, 95% CI: 0.08, 0.36), and knowledge (AOR = 4.73, 95% CI: 2.62, 8.51) were significantly associated with adherence to the Option B+ program. CONCLUSION: This meta-analysis showed that the level of adherence to the Option B+ program in Ethiopia is lower than the 95% level of adherence planned to be achieved in 2020. Social and financial support, disclosure of HIV status, time to reach the health facility, counseling, drug side effects, and knowledge of PMTCT were significantly associated with option B+ adherence. The findings of this meta-analysis highlight that governmental, non-governmental, and other stakeholders need to design an effective strategy to scale up the level of disclosing one's own HIV status, access health facilities, improve knowledge of PMTCT, and counsel the potential side effects of Option B+ drugs, and advocate the program to reduce the multidimensional burden of HIV/AIDS. TRIAL REGISTRATION: Prospero registration: CRD42022320947. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022320947.

Knowledge and skills of newborn resuscitation among health care professionals in East Africa. A systematic review and meta-analysis.

INTRODUCTION: Newborn resuscitation is a medical intervention to support the establishment of breathing and circulation in the immediate intrauterine life. It takes the lion's share in reducing neonatal mortality and impairments. Healthcare providers' knowledge and skills are the key determinants of the success of newborn resuscitation. Many primary studies have been conducted in various countries to examine the level of knowledge and skills of newborn resuscitation and associated factors among healthcare providers. However, these studies had great discrepancies and inconsistent results across East Africa. Hence, this review aimed to synthesize the pooled level of knowledge and skills of newborn resuscitation and associated factors among healthcare providers in East Africa. METHOD: Studies were systematically searched from February 11, 2023, to March 10, 2023, using PubMed, Google Scholar, HINARI, and grey literature. The effect size measurement of knowledge and skill of health care newborn resuscitation was estimated using the Random Effect Model. The data were extracted by Excel and analyzed using Stata 17 software. The Cochran's Q test and I2 statistic were used to assess the heterogeneity of studies. The symmetry of the funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was done on the study years, sample sizes, and geographical location. Percentages and odds ratios (OR) with 95% CI were used to pool the effect measure. RESULTS: In this systematic review and meta-analysis, a total of 1953 articles were retrieved from various databases and registers. Finally, 17 studies with 7655 participants were included. The overall levels of knowledge and skills of healthcare providers on newborn resuscitation were 58.74% (95% CI: 44.34%, 73.14%) and 46.20% (95% CI: 25.16%, 67.24%), respectively. Newborn resuscitation training (OR = 3.95, 95% CI: 2.82, 5.56) and the availability of newborn resuscitation guidelines (OR = 2.71, 95% CI: 1.90, 3.86) were factors significantly associated with knowledge of health care professionals on newborn resuscitation. Work experience (OR = 5.92, 95% CI, 2.10, 16.70), newborn resuscitation training (OR = 2.83, 95% CI, 1.8, 4.45), knowledge (OR = 3.05, 95% CI, 1.78, 5.30), and the availability of newborn resuscitation equipment (OR = 4.92, 95% CI, 2.80, 8.62) were determinant factors of skills of health care professionals on newborn resuscitation. CONCLUSION: The knowledge and skills of healthcare providers on newborn resuscitation in East Africa were not adequate. Newborn resuscitation training and the availability of resuscitation guidelines were determinant factors of knowledge, whereas work experience, knowledge, and the availability of newborn resuscitation equipment and training were associated with the skills of healthcare providers in newborn resuscitation. Newborn resuscitation training, resuscitation guidelines and equipment availability, and work experience are recommended to improve healthcare providers' knowledge and skills.

Transactional sex among women in Sub-Saharan Africa: A systematic review and meta-analysis.

INTRODUCTION: Transactional sex is casual sex between two people to receive material incentives in exchange for sexual favors. Transactional sex is associated with negative consequences, which increase the risk of sexually transmitted diseases, including HIV/AIDS, unintended pregnancy, unsafe abortion, and physiological trauma. In Sub-Saharan Africa, several primary studies have been conducted in various countries to examine the prevalence and associated factors of transactional sex among women. These studies had great discrepancies and inconsistent results. Hence, this systematic review and meta-analysis aimed to synthesize the pooled prevalence of the practice of transactional sex among women and its associated factors in Sub-Saharan Africa. METHOD: Data source: PubMed, Google Scholar, HINARI, the Cochrane Library, and grey literature were searched from March 6 to April 24, 2022, and included studies conducted from 2000 to 2022. The pooled prevalence of transactional sex and associated factors was estimated using Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic, a funnel plot, and Egger's test were used to check for heterogeneity and publication bias, respectively. A subgroup analysis was done based on the study years, source of data, sample sizes, and geographical location. RESULTS: The pooled prevalence of transactional sex among women in Sub-Saharan Africa was 12.55% (9.59%-15.52%). Early sexual debut (OR = 2.58, 95% CI: 1.56, 4.27), substance abuse (OR = 4.62, 95% CI: 2.62, 8.08), history of sexual experience (OR = 4.87, 95% CI: 2.37, 10.02), physical violence abuse (OR = 6.70, 95% CI: 3.32, 13.53), orphanhood (OR = 2.10, 95% CI: 1.27, 3.47), and sexual violence abuse (OR = 3.76, 95% CI: 1.08, 13.05) were significantly associated with transactional sex. CONCLUSION: The prevalence of transactional sex among women in sub-Saharan Africa was high. Alcohol consumption, substance abuse, early sex debuts, having a history of sexual experiences, physical violence, and sexual violence increased the practice of transactional sex.

Active management of the third stage of labour in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Post-partum haemorrhage occurs in over 10% of all births and is the leading cause of maternal mortality, accounting for 25% of all maternal deaths worldwide. Active management of the third stage of labor is the most important intervention for reducing maternal morbidity and mortality by preventing postpartum hemorrhage. Previously, documented primary studies had been great discrepancy, inconsistent results, and there is a lack of comprehensive study. Hence, this systematic review and meta-analysis were intended to assess the prevalence and associated factors of the practice of active management of the third stage of labour among obstetric care providers in Ethiopia. METHOD: Cross-sectional studies were systematically searched from January 01, 2010, to December 24, 2020, using PubMed, Google Scholar, HINARI, Cochrane Library, and grey literature. The pooled prevalence of active management of the third stage of labour practice and associated factors was estimated using DerSemonial-Laird Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic was used to assess the studies' heterogeneity. A funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was performed to minimize the underline heterogeneity depending on the study years and the sample sizes. RESULTS: Seven hundred fifty articles were extracted. The final ten studies were included in this systematic review, including 2438 participants. The pooled prevalence of practices of active management of the third stage of labour among obstetric care providers in Ethiopia was 39.65% (30.86, 48.45%). Educational status (OR = 6.11, 95%CI, 1.51-10.72), obstetric care training (OR = 3.56, 95% CI: 2.66, 4.45), work experience (OR = 2.17, 95%CI, 0.47, 3.87) and knowledge of active management of the third stage of labour (OR = 4.5, 95% CI: 2.71, 6.28) were significantly associated with active management of the third stage of labour practices. CONCLUSION: The practice of active management of the third stage of labour in Ethiopia was low. This study showed that educational status, taking obstetric care training, knowledge of AMTSL, and work experience of obstetric care providers were associated with of practices of active management of the third stage of labour. Therefore, obstetric care professionals should improve their academic level, knowledge, and skills in order to provide useful service to AMTSL and save mothers' lives. All obstetric care providers should get obstetric care training. Furthermore, the government should increase obstetric care professionals' educational level.

Female adolescents' knowledge and acceptability of human papillomavirus vaccine in Debre Tabor Town, Ethiopia: a cross-sectional study.

OBJECTIVE: This study aimed to assess the knowledge and acceptability of the human papillomavirus (HPV) vaccine and associated factors among female adolescent students in Debre Tabor Town, Ethiopia, 2021. DESIGN: Cross-sectional study was done from 9 December 2020 to 28 February 2021. ANALYSIS: The data were entered into EpiData V.4.2 and analysed with SPSS V.23 software. The OR, 95% CI and p<0.05 were used to determine the bivariable and multivariable statistical association. SETTING: Three high schools (grades 9 and 10) and six primary schools (grades 7 and 8) were included in the study. PARTICIPANTS: Adolescent female students in Debre Tabor Town. RESULTS: The overall knowledge score in the questionnaire was six, and it was divided into two groups based on scoring level: poor (score <3) and good (score ≥3). More than half respondents (59.2%) scored good knowledge. The proportion of acceptability of the HPV vaccine was 61.9%. Age (adjusted OR, AOR 1.70, 95% CI 1.17 to 3.88), and having a source of information (AOR 1.94, 95% CI 1.06 to 3.22) were significantly associated with the knowledge of the HPV vaccine. Place of birth (AOR 1.55, 95% CI 1.15 to 1.95), fathers' educational status (AOR 2.80, 95% CI 1.18 to 5.65), having a source of information (AOR 2.14, 95% CI 1.05 to 4.32) and knowledge about the HPV vaccine (AOR 6.41, 95% CI 3.45 to 11.90) were significantly associated with the acceptance of the female adolescent HPV vaccine. CONCLUSION: In this study, the knowledge and acceptability of students of the HPV vaccine were low. Health authorities, through the mass media, should strengthen HPV vaccine promotion in schools, religious institutions and health facilities.

Knowledge and willingness of parents towards child girl HPV vaccination in Debre Tabor Town, Ethiopia: a community-based cross-sectional study.

BACKGROUND: Cervical cancer is currently the second-leading cause of cancer death among women in Ethiopia. Vaccination against the human papillomavirus (HPV) is an effective primary prevention strategy for HPV-related illnesses. The knowledge and willingness of parents toward the HPV vaccine are crucial to increasing the uptake of the vaccine. The vaccine's acceptance by children and young adolescents is dependent on parental consent. Therefore, this study aimed to assess knowledge, willingness, and associated factors of the human papillomavirus vaccine among parents of girls aged 9-14 years at Debre Tabor Town. METHOD: A community-based cross-sectional study was conducted among participants from December 10, 2020, to January 15, 2021. A simple random sample technique was used to include 638 participants. A structured face-to-face interviewer-administered questionnaire was used to collect data. The data were entered and analyzed using Epi-Data and SPSS software, respectively. Bivariate and multivariable analyses were used to examine the association. The Odds Ratio (OR), 95% CI, and p-values less than 0.05 were used to determine the statistical association. RESULTS: Thirty-five percent (35.4%, 95% CI = 31.4%, 38.8%) and 44.8% (95% CI = 40.40%, 48.67%) of participants were knowledgeable about HPV vaccination and willing to get it, respectively. Being government employees (AOR = 5.46, 95% CI = 2.42, 9.34), and having a family history of sexually transmitted diseases (STD) (AOR = 1.76, 95% CI = 1.14, 2.72) were significantly associated with knowledge of the human papilloma virus (HPV) vaccine. Participants' age (AOR = 1.43, 95% CI = 1.16, 2.87), secondary education and above (AOR = 1.70, 95% CI = 1.05, 2.74), fear of HPV infection (AOR = 2.29, 95% CI = 1.21, 4.32), and having good knowledge of the HPV vaccine (AOR = 3.30, 95% CI = 2.21, 4.93) were significantly associated with willingness to receive the HPV vaccine. CONCLUSION AND RECOMMENDATION: The knowledge and willingness of parents toward the HPV vaccine were low. Then, health officials should boost HPV vaccination promotion through public media. In schools, churches, mosques, and health facilities, health extension workers and health professionals provide information about the HPV vaccine for the parents. Mixed quantitative and qualitative studies are preferable for future research to address "why" issues.

Infection with the Human Papillomavirus (HPV) causes nearly 99% of cervical cancer cases and more than 20% of breast, neck, and anogenital cancers. The HPV vaccines protect against high-risk types of HPV (types 16 and 18), which account for approximately 70% of cervical cancers. Global coverage of the HPV vaccine was 39.7%, with high-income countries (68%), middle-income countries (28%), and lower-middle-income countries (2.7%). For different reasons, cervical cancer screening is very poor in Ethiopia (below 2%). Cervical cancer is mostly asymptomatic more than 20 years after infection. Primary prevention (enhancing the HPV vaccine) is the best way to protect women from cervical cancer. Adolescents' uptake and acceptance of the vaccine depend on parental consent. Assessing parental knowledge and willingness at a community level is very crucial.A simple random sample technique was used to include 638 participants. A structured and pre-tested face-to-face interviewer-administered questionnaire was used to collect the data. The data were entered and analyzed using Epi-Data, and SPSS software, respectively. Bivariate and multivariable analyses were used to examine the association.Nearly one-third (35.4%) and less than half (44.8%) of participants were knowledgeable and willing to receive the HPV vaccination. The knowledge and willingness of the parents are significantly lower. Being government employees and having a family history of sexually transmitted diseases (STD) were factors affecting the knowledge of parents about the human papillomavirus vaccine. Participants' age, secondary education and above, fear of HPV infection, and having good knowledge of the HPV vaccine were significantly associated with their willingness to use the HPV vaccine. The knowledge and willingness of the parents are significantly lower. Health officials and stakeholders should scale up HPV vaccine promotion through public media.

Interbirth interval practices among reproductive age women in rural and Urban kebeles in Farta Woreda: Case-control study.

BACKGROUND: Closely spaced births have been reported all over the world especially in developing countries, and they have been correlated with poor maternal and infant health. Enhancing optimal birth interval is one of the key strategies to promote the health status of mothers and their children. However, factors affecting short birth intervals have not been identified in the study area and region. This study was aimed to assess determinants of short birth interval practice among reproductive women in Farta woreda, Ethiopia, 2019. METHODS: Community based unmatched case-control study design was conducted from February to March 2019. The sample size of 303 (101 case and 202 controls) was included by using multistage sampling and then study participants were selected by simple random sampling technique. The data was collected by structured and pre-tested face-to-face interviewer-administered questionnaires from the selected respondents. The collected data were entered with Epi-Data version 4.2 and analyzed by using SPSS version 23 software. Bivariate and multivariate analyses were used to examine the association. Odds ratios, 95% CI, and P-value <0.05 were used to determine the statistical association. RESULTS: Women who had no formal education (AOR = 2.15, 95% CI (1.19, 3.88), had not a history of antenatal care follow up (AOR = 2.66, 95% CI (1.55, 4.56)), did not use modern contraceptives before getting the latest pregnancy (AOR = 3.48, 95% CI (1.74, 6.95)) and duration of breastfeeding less than 24 months (AOR = 3.59, 95% CI (2.06, 6.24)) were significantly associated with short birth interval. CONCLUSIONS AND RECOMMENDATION: Maternal education, duration of breastfeeding, contraceptive utilization, and antenatal follow-up were identified as the predictor variables of short birth interval practice. Therefore, providing health information for reproductive-age women about the benefit of contraceptive utilization, breastfeeding practice and antenatal care follow up to minimize problems resulting from the short birth intervals.

The effect of substance use during pregnancy on neonatal outcomes in Ethiopia: A systematic review and meta-analysis.

BACKGROUND: Substance use during pregnancy mainly khat chewing (20%) and alcohol drinking (18.1%) are commonly practiced in Ethiopia. However, the effect of using these substances has not been studied nationally yet. Thus, this study was aimed to examine national evidence about the effect of substance use during pregnancy on birth outcome in the country, 2020. METHODS: Primary studies were accessed through Google scholar, HINARI, SCOPUS and PubMed databases. The methodological and evidence quality of the included studies were critically appraised by the modified Newcastle-Ottawa quality assessment tool scale adapted for observational studies. From eligible studies, two authors extracted author/year, study region, study design, sample size and reported effect of antenatal substance use on birth outcome on an excel spreadsheet. During critical appraisal and data extraction, disagreements between the two authors were resolved by the involvement of a third author. The extracted data were then exported to stata version 14. Effect sizes were pooled using the fixed-effects model due to homogenous primary studies (I2 = 0.0%). Presence of publication bias was detected from asymmetry of funnel plot and statistically significant Egger's test (p = 0.000). RESULTS: In this systematic review and meta-analysis, a total of 5,343 mother-neonate pairs were included from 15 studies. Alcohol, khat, cigarette and narghile were used during pregnancy, and significant adverse birth outcomes attributable to these substances were reported. From the pooled effect of alcohol use, drinking mothers were twice (95%CI: AOR = 2.16; 1.16, 3.17) likely to have newborns with birth defect; 9 times (95% CI: AOR = 9.39; 2.84, 15.94) more prone to own low birth weight neonates; and 1.9 times more prone to deliver preterm neonates (95% CI: AOR = 1.93; 0.52, 3.33) than the nondrinkers. Khat users were 2.4 times (95%CI: AOR = 2.4; 1.11, 5.19) more likely to have congenitally defected neonates; and 3.1 times (95%CI: AOR = 3.19; 1.01, 5.37) more risked to possess low birth weight neonates. Furthermore, antenatal cigarette smokers (95% CI: AOR = 4.36 (1.75, 6.98)) and narghile users (95% CI: AOR = 20.1; 3.94, 103) were at 4 and 20 times more likelihood of having low birth weight neonates as compared to their counterparts. CONCLUSION: Prematurity, low birth weight and congenital malformation were the investigated adverse effects of antenatal substance use in Ethiopia. Therefore, the existing public health efforts should be encouraged to help women stop using these substances completely before pregnancy. Moreover, increasing public awareness about the potential negative impacts of substance use during pregnancy on birth outcome would be of greatest importance for comprehensive prevention of the problem.

Magnitude of Gender-Based Violence and Its Associated Factors among Female Night Students in Bahir Dar City, Amhara Region, Ethiopia.

BACKGROUND: Gender-based violence (GBV) is a major public health issue that affects the health and well-being of millions of young people worldwide each year. Gender-based violence was prevalent throughout Sub-Saharan Africa. However, research in Africa is extremely diverse. OBJECTIVE: The purpose of this study is to determine the extent and risk factors of gender-based violence among night female students in Bahir Dar, Ethiopia. METHODS: This cross-sectional study was conducted among 788 elementary and high school night female students in Bahir Dar from October 15 to November 15, 2019. Data was gathered using self-administered questionnaires. A binary and multiple logistic regression model was used to identify factors associated with gender-based and sexual violence. An adjusted odds ratio (AOR) with a 95 percent confidence interval (CI) was calculated to determine the level of significance. RESULTS: The overall lifetime prevalence of gender-based violence (sexual, physical, and emotional violence) was 71.1% with a 95% CI of 67.8%-74.1%. The lifetime prevalence of sexual violence, physical violence, and emotional violence was 49.1%, 57.5%, and 41.6%, respectively. Rural childhood residence (AOR: 3.37, 95% CI: (2.17-5.54)), low school performance (AOR: 3.44, 95% CI: (2.13-5.56)), lack of sexual and reproductive health conversation experience (AOR: 3.68, 95% CI: (2.07-6.54)), poor family control (AOR: 5.62, 95% CI: (3.25-9.71)), and being sexually active (AOR: 3.79, 95% CI: (2.35-6.12)) increased significantly the risk of gender-based violence. The risk factors for sexual violence were young people living with both parents (AOR: 0.28, 95% CI: (0.19-0.41)), peer pressure (AOR: 5.73, 95% CI: (4.11-7.98)), and family support (AOR: 0.31, 95% CI: (0.22-0.43)). CONCLUSION: In the study area, the lifetime prevalence of sexual violence, physical violence, and emotional violence was high. As a result, it is recommended that policymakers, district officials, schools, and other stakeholders pay attention to and act on gender-based values.

Youth Reproductive Health Service Utilization and Associated Factors among Amhara Region Female Night Students, Ethiopia.

INTRODUCTION: Youth is a decisive age to shape the direction of their life and that of their family. However, due to the host of biological, social, and economic factors, adolescent females can be at high risk of adverse sexual and reproductive health outcomes. Therefore, assessing youth reproductive service utilization and associated factors among female night students is very crucial for timely intervention to their gaps. METHOD: An institutional-based cross-sectional study design was conducted in Amhara region among 2,050 female night students from September 15 to November 15, 2018. A self-administered pretested questionnaire was used to collect the data. Bivariate and multivariable logistic regression models were used. Odds ratio with 95% confidence interval was computed to determine the strength of association between predictor and outcome variables. P value less than or equal to 0.05 is considered as the level of significance. RESULTS: Out of the total respondents, about 54.6%(CI: 52.5%-56.8%) of them utilized reproductive health services. Respondents who were attending secondary education (AOR = 2.55, 95%CI = 1.97-5.62), attitude towards youth reproductive health services (AOR = 2.74, 95%CI = 2.07-5.30), those who had a habit of communicating on sexual and reproductive health issues with their family (AOR = 3.66, 95%CI = 3.59-7.41), discussion on sexual and reproductive health issue with peers/friends (AOR = 1.43, 95%CI = 1.01-2.02), respondents with good knowledge on youth reproductive health services (AOR = 2.03, 95%CI = 1.49-2.75), and those who had faced reproductive health problems (AOR = 2.03, 95%CI = 1.49-2.75) were significantly associated with youth reproductive health service utilization. CONCLUSION: Youth reproductive health service utilization among female night students was not satisfactory. Therefore, special focus should be given to female night students by providing accessible, acceptable, confidential, flexible, and friendly reproductive health service utilization. Finally, community health promotion and education are mandatory to promote the practice of discussing youth reproductive health issues with their children.

Determinant factor of married women's knowledge on vertical transmission of HIV in Mecha district, Ethiopia; a community-based study.

INTRODUCTION: Mother-to-child transmission (MTCT) of HIV infection remains a major public health problem and constitutes the most important cause of HIV infection in children. Knowledge of married women on MTCT of HIV is very important for successful intervention toward prevention of mother-to-child transmission (PMTCT) and achieving the goal of eliminating the new HIV infection. The objective of the study was to assess knowledge of married women on MTCT of HIV and associated factors in Mecha district Northwest Ethiopia. METHODS: A community based cross sectional study was conducted involving 520 married women from January 1 to February 30 /2017 in Mecha district. Interviewer administered questionnaires were used to collect the data. The collected data was entered, cleaned and checked using Epi Data version 3.1 and then analyzed with SPSS version 20. Bivariate and multivariable logistic regression was computed for all explanatory variables to identify determinant factors at 95% confidence interval. Explanatory variables having P-value <0.05 taken as a predictor for knowledge of married women on mother to child transmission of HIV. RESULT: This study was carried out among a total of 520 married reproductive age group women with a response rate of 98%. From the total of 510 respondents, 160(31.4%) of women were knowledgeable on vertical transmission of HIV (MTCT). Women who were knowledgeable on MTCT of HIV was positively associated with urban residence (AOR = 1.75, 95% CI: 1.05-2.92), women who had history of ANC follow up (AOR = 2.68, 95% CI: 1.17-6.13), women who were pregnant during the study period (AOR = 1.86, 95%CI: 1.10-3.13) and those who had discussions with their husband about HIV/AIDS/ MTCT (AOR = 2.40, 95% CI: 1.52-.3.80). CONCLUSION AND RECOMMENDATION: The finding from this study revealed that knowledge of married women on MTCT of HIV was low. This may contribute to increase the spread of MTCT of HIV. Therefore, giving more attention and emphasis on continuous education regarding MTCT of HIV is highly recommended.

Determinants of obstructed labor among women attending intrapartum care in Amhara Region, Northwest Ethiopia: A hospital-based unmatched case-control study.

OBJECTIVES: maternal and neonatal mortality in Ethiopia is a major reproductive health problem. Obstructed labor is one of the leading causes of maternal, fetal, and neonatal morbidity in developing countries. The evidence regarding its determinants at the tertiary level of care is sparse. Therefore, this study aimed to study the determinants of obstructed labor among women attending intrapartum care in Amhara region referral hospitals. METHODS: A Hospital-based unmatched case-control study was conducted from March 1stto August 30, 2017. Cases were women whose labor was obstructed (n = 270), and controls were women whose labor was not obstructed (n = 540). Both cases and controls were selected randomly, and a proportional to size allocation was made to the referral hospitals selected for the study. A binary and a multivariable logistic regression model was computed to identify the determinant factors at 95% CI. RESULTS: The mean age of the study participants was 27.66 years (27.4 ± 5.44 for cases and 28.15 ± 6.16 for controls), ranging between 16 and 45 years. Relatively, higher proportions of cases than controls were unable to read and write (58.5%) and were urban residents (53.7%). Distance from hospital, distance from health center, mothers inability to read and write, mothers primary level of education, more than 28 weeks of gestation at the first visit of antenatal care, 37 to 42 weeks at admission, above 42 weeks at admission, women of a merchant spouse, and history of pregnancy-related complications were the positive determinants of obstructed labor. However, mothers whose gestational age was 16 to 28 weeks at the first antenatal care visit were 62% less likely to be exposed to obstructed labor. CONCLUSIONS: Obstetric, service-related, and system factors were predictors of obstructed labor. Improving women's literacy status, health service access, and utilization will help reduce obstructed labor.

Knowledge of prevention of mother to child transmission of HIV among women of reproductive age group and associated factors at Mecha district, Northwest Ethiopia.

OBJECTIVE: This study was aimed to asses knowledge of prevention of mother to child transmission of HIV among reproductive age women and associated factors at Mecha district, North West Ethiopia. A community based cross sectional study was conducted among 853 reproductive age women from July 1- 30/2016 in Mecha district. By multistage sampling technique data were collected through pre-tested questionnaire. The collected data was entered in Epi Data 3.1 and analyzed with SPSS version 20. Bivariate and multivariable logistic regression model were used. RESULT: About 22.4% of the respondents were knowledgeable on prevention of mother to child transmission (PMTCT) of HIV. Having knowledge on PMTCT of HIV was significantly associated with urban residence (AOR = 2.486, 95% CI 1.160-5.328), education level of secondary and above (AOR = 5.445, 95% CI 2.698-10.986), those having history of antenatal care followup (AOR = 4.430, 95% CI 1.471-13.340), those with history of institutional delivery (AOR = 4.766, 95%CI 2.004-11.334), those having comprehensive knowledge on HIV/AIDS (AOR = 1.697, 95%CI 1.011-2.846), women who were knowledgeable about mother to child transmission of HIV (AOR = 2.203, 95% CI 1.37-3.54), and women who held discussions with their husband regarding HIV/AIDS, (AOR = 2.700, 95% CI 1.658-4.396).

Women's Awareness and Associated Factors on Preconception Folic Acid Supplementation in Adet, Northwestern Ethiopia, 2016: Implication of Reproductive Health.

INTRODUCTION: Preconception folic acid supplementation is the provision of folate for reproductive age group women who have a plan to be pregnant. According to different studies, in African countries, there is poor utilization of preconception folic supplementation. So this study aimed at assessing women's awareness on preconception care and its associated factors in Adet, Northwestern Ethiopia. METHODS: A community-based cross-sectional study was conducted from March 1 to April 1, 2016, among 422 reproductive age group women. Systematic random sampling was used to get the study unit, and the data were collected using pretested structured questionnaire via face-to-face interview. The collected data were entered, cleaned, checked using EpiData version 3.1, and finally analyzed using SPSS version 20. Descriptive summary of the data was presented in terms of percentage and frequency. Binary and multiple logistic regressions were used in order to identify predictors using odds ratio at 95% confidence interval. RESULT: In this study, a total of 422 reproductive age group women participated with a response rate of 100%. Of a total of 422 participants, 67 (15.9%) of the women had good awareness on preconception folic acid supplementation. Women's awareness on preconception folic acid supplementation was affected by having a chronic health problem, monthly household income, educational status, and a history of family planning use. Women who were educated (AOR 4.77, CI 1.85-6.98), had a history of family planning use (AOR 3.89, CI 1.77-8.55), had a chronic health problem (AOR 3.47, CI 2.68-5.98), and had a better monthly income (AOR 2.6, CI 2.05-6.76) had good awareness than their counterparts. CONCLUSION AND RECOMMENDATION: This study concluded that women's awareness on preconception folic acid supplementation was low. This finding suggests that there is a need to give emphasis and deliver health education about preconception folic acid supplementation for women.