Association between antenatal common mental disorders symptoms, and adverse obstetric and perinatal outcomes: A community-based prospective cohort study in Eastern Ethiopia.

BACKGROUND: Maternal common mental disorders have broad implications for maternal and child mental and physical health that may have a long-lasting social and economic impact. This study aimed to assess the association between symptoms of antenatal common mental disorders and obstetric and perinatal outcomes in Eastern Ethiopia. METHODS: A community-based prospective cohort study was conducted and a total of 1011 randomly selected pregnant women were followed up from February 1, 2021, to January 30, 2022. The modified Poisson regression model with a robust variance was fitted to examine the effect of the symptoms of antenatal common mental disorders on obstetric and perinatal outcomes. RESULTS: Antenatal common mental disorders (SRQ ≥ 6) were presented among 390 (38.58 %) pregnant women. In the final multivariate Poisson regression model, women with antenatal common mental disorders symptoms had an increased risk of some pregnancy complications (ARR = 1.65, 95 % CI: 1.59, 1.84). In the current study, symptoms of antenatal common mental disorders increased also the risk of preterm birth (ARR = 1.71; 95 % CI: 1.20, 2.42) and low birth weight (ARR = 1.93; 95 % CI: 1.36, 2.74). LIMITATION: The indirect effects of some potential mediators and moderators were not assessed in this study. CONCLUSION: The study found a high rate of symptoms of antenatal common mental disorders and adverse obstetric and perinatal outcomes. Antenatal common mental disorders symptoms may have considerable effects on individual and combined pregnancy complications and adverse perinatal outcomes.

Vitamin A deficiency among pregnant women in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Vitamin A deficiency (VAD) during pregnancy is a public health challenge in low-income countries. There are inconsistent findings that can affect policy in planning appropriate intervention. This systematic review and meta-analysis were conducted to summarize the evidence in order to identify existing gaps and propose strategies to reduce VAD during pregnancy in Ethiopia. METHODS: This study included published and unpublished observational studies searched from different databases (PubMed, CINHAL [EBSCO], Embase, Google Scholar, Directory of Open Access Journals, Web of Sciences, MEDLINE, Cochrane Library, Scopus, Google Search and MedNar). Statistical analysis was conducted using Stata version 14 software. Heterogeneity and publication bias were assessed. Forest plots were used to present the pooled prevalence using the random effects model. RESULTS: A total of 37 618 pregnant women from 15 studies were included. The overall pooled prevalence of VAD was 29% (95% confidence interval 21 to 36) with I2=99.67% and p<0.001. Socio-economic and sociodemographic factors were identified as affecting vitamin A deficiencies among pregnant women. CONCLUSIONS: Nearly one-third of pregnant women in Ethiopia had VAD. Strengthening intervention modalities that aimed to increase the uptake of vitamin A-rich foods can avert VAD among pregnant women in Ethiopia.

Blood donation practice and its predictors among undergraduate college students in Harari Regional State, Eastern Ethiopia.

Objectives: The main objective of this study was to assess blood donation practice and its associated factors among undergraduate college students in Harari Region, Eastern Ethiopia. Methods: An institutional-based cross-sectional study was employed among 518 college students selected by using a simple random sampling technique. Data was collected using pretested structured self-administered questionnaire. The collected data was entered into Epi-data 3.41 and exported to Statistical Package for Social Science version 22 for analysis. Bivariate and multivariable logistic regressions were utilized to identify factors associated with blood donation practice. p-Values of 0.05 or less was used to declare statistical significance. Results: In this study, the overall blood donation practice was 35.7% (95% confidence interval: 31.6, 39.8). Students studying health sciences were more likely than non-health sciences students (53.5%) to donate blood. Having positive knowledge about blood donation (adjusted odds ratio = 4.17; 95% confidence interval: 2.50, 6.92), being male (adjusted odds ratio = 0.57; 95% confidence interval: 0.38, 0.87), being student of midwifery department (adjusted odds ratio = 2.16; 95% confidence interval: 1.07, 4.36) and nursing department (adjusted odds ratio = 2.42; 95% confidence interval: 1.18, 4.98) were significantly associated with blood donation practice. Conclusion: Practice of blood donation among college students in the study is relatively low. Knowledge about blood donation, male sex and being a nursing and midwifery student were independently associated with blood donation practice. Therefore, the Regional Health Bureau and Blood Bank in collaboration with college administrators should design and implement appropriate strategies to improve blood donation practice.

Utilization of pharmacological labour analgesia: a survey of obstetric care providers in eastern Ethiopia.

BACKGROUND: Despite a crucial role played by obstetric care providers (OCPs) in providing pain relief methods during labour, the evidence suggests that there is a large number of women in Ethiopia who did not have access to pain relief methods. Moreover, to the best of the investigators' knowledge, evidence is scarce regarding the utilization of pharmacological labour pain management methods in the study area. Thus this study was carried out to determine the practice of pharmacological labour pain management methods among OCPs in Harari regional state health facilities in Ethiopia. METHODS: A facility-based cross-sectional study was conducted from 20 May to 10 June 2021 in Harari regional state health facilities. All (n=464) OCPs in Harari regional state health facilities were included in the study. Data were collected using a structured questionnaire adapted from previous studies. The data were entered into Epi-data version 3.1 statistical software. Statistical analysis was carried out using SPSS for Windows version 22. Bivariate and multivariate logistic regression analyses were employed to determine the association between independent variables and the outcome variable. A p-value <0.05 was used to establish statistical significance. RESULTS: In this study, 464 OCPs participated. The overall utilization of pharmacological labour pain relief methods was 50.9% (95% confidence interval [CI] 45.8 to 55.8). The main barriers to labouring mothers receiving pain relief include high patient flow (54.4%), the limited number of staff (51.9%) and a lack of knowledge and skill (32.9%). Being female (adjusted odds ratio [AOR] 2.07 [95% CI 1.31 to 3.26]), not having training (AOR 1.60 [95% CI 1.02 to 2.53]) and having an unfavourable attitude (AOR 9.1 [95% CI 5.34 to 15.35]) were the predictors of utilization of pharmacological labour pain management methods. CONCLUSIONS: The study revealed that half of the OCPs utilized the pharmacological labour pain management method. In general, this study identified that variables like sex, training and the attitude of OCPs were factors associated with the utilization of pharmacological labour pain management methods. The health facilities should provide training to enhance the skill of OCPs and equip themselves with sufficient analgesic drugs.

Adherence to anti-asthma medications among adult asthmatic patients in Eastern Ethiopia: A multi-center cross-sectional study.

INTRODUCTION: Adherence to anti-asthmatic medications plays a vital role in enhancing an asthma patient's quality of life and prognosis. However, in Ethiopia, the level of adherence and contributing factors were rarely studied. Therefore, this study was conducted to determine the level of adherence to anti-asthma medications and associated factors among adult asthmatic patients in Eastern Ethiopia. METHOD: Institutional based cross-sectional study was conducted at six governmental hospitals found in Eastern Ethiopia. A total of 320 asthma patients aged 18 years and above and using asthma medicines for at least 12 months were involved. An interviewer based structured questionnaires were used to collect the data. Bivariable and multivariable logistic regression analyses were carried out using IBM SPSS version 22 (SPSS, Chicago, IL). The Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to determine the strength of association between independent variables and outcome variable. Variables with a p-value of ≤ 0.05 were considered statistically significant. RESULT: Of the 320 asthma patients that participated in the study, 109(34.1%:28.8-39.1%) of them had good adherence to anti-asthmatic medications. Being a housewife (AOR = 4.265, 95%CI: 1.333, 13.653), having good knowledge about asthma (AOR = 2.921, 95%CI (1.472, 5.795), positive attitude towards asthma (AOR = 3.129, 95%CI: 1.555, 6.293), and use of oral corticosteroid drugs (AOR = 1.967, 95%CI: 1.008, 3.841) were factors positively associated with good adherence to anti-asthmatic medications. Participants on treatment for 2-3 years (AOR = .295, 95%CI: 0.099, 0.873), and those on medication for ≥ 4 years (AOR = 0.229, 95%CI: 0.079, 0.664) were 70.5% and 77.1% times less likely to adhere to anti-asthmatic medications respectively. CONCLUSION: The current study signified a low level of adherence to anti-asthmatic medications. Participant's characteristics and medication related factors were significantly associated with good adherence to anti-asthmatic medications. Health education and advice during follow-up for asthma patients is crucial for better adherence.

Practice of breast self-examination and associated factors among female health professionals working in public hospitals of Harari regional state: Eastern Ethiopia multicenter study.

Breast cancer is the most frequent malignancy among women in both developed and developing countries. Early detection of breast cancer using breast self-examination plays a substantial role in reducing its morbidity and mortality. Despite improved availability of health information the morbidity and mortality caused by breast cancer among females were increasing from time to time and there is no information regarding the practice of breast self-examination in our study area. Objective: This study was aimed at assessing breast self-examination practice and associated factors among female health professionals who were working in public hospitals of Harari Regional State in 2022. Methods: Institutional-based quantitative cross-sectional study design was used to assess the practice of breast self-examination and associated factors among female health professionals who have been working in a public hospital in Harari regional state from March 25 to April 05, 2022. The study subjects were selected using a simple random sampling technique and data were collected by a self-administered and structured questionnaire. The collected data was edited, cleaned, coded, and entered into Epi-Data version 3.1 software and analyzed using the statistical package for social science software version 20. Bivariable and multivariable logistic regression analysis was carried out to see the association between independent and dependent variables. Variable with P-value less than 0.05 at final model were regarded as statistically significant. Result: Among a total of 362 female health professionals, 171 (47.2%) respondents were ever practiced breast self-examination, 229(63.3%) had good knowledge of breast self-examination and 252(69.6%) had a favorable attitude toward breast self-examination. Work experience of ≥5 year (AOR = 2.51; 95% CI: 1.31-4.82), educational status of degree and above (AOR = 7.2; 95% CI: 3.82-10.58), good knowledge about breast self-examination (AOR = 3.4; 95% CI: 1.41-5.40) and favorable attitude toward breast self-examination (AOR = 3.1; 95% CI: 2.11-4.10) were significantly associated with breast self-examination practice. Conclusion: The finding of this study implies that the practice of breast self-examination among female health professionals is low. Work experience of ≥5 year, educational status of degree and above, having a good knowledge and favorable attitude toward breast self-examination were significantly associated with breast self-examination.

Khat use and associated factors during pregnancy in eastern Ethiopia: A community-based cross-sectional study.

Introduction: Women of reproductive age are increasingly using khat. The use of khat is associated with prelabor rupture of membranes, anemia among pregnant women, and other problems related to motherhood and infanthood. Most of the previous studies performed at the facility level revealed that different factors were associated with khat use among pregnant women. Lower educational status, low wealth index, and the age of the mother were the factors significantly associated with maternal khat use. Partner substance use also has a significant association with maternal khat use. However, there is limited information about khat use and its associated factors among pregnant women in the study area. Objective: This study aims at assessing the prevalence of khat use and associated factors among pregnant women in Kersa and Haramaya Health and Demographic Surveillance System Sites, eastern Ethiopia. Methods: A community-based cross-sectional study design was employed among randomly selected 1,015 pregnant women from an open cohort from Kersa and Haramaya Health and Demographic Surveillance System Sites in Ethiopia. Data were collected through face-to-face interviews from January 30 to April 30, 2021, using Open Data Kit (ODK) software and analyzed using SPSS v-26. Descriptive statistics were used to summarize the characteristics of pregnant women. Factors associated with khat use were identified by bivariate and multivariable logistic regression analyses; an adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated. Statistical significance was declared at p < 0.05. Results: The prevalence of khat use among pregnant women was 15.5% (95% CI, 13.3-17.7). Age of the pregnant women; being in the age group between 25 and 35 years (AOR = 2.27, 95% CI, 1.33-4.89) and 35 years and greater (AOR = 2.33, 95% CI, 1.29-4.20); having a chronic medical illness (AOR = 3.28, 95% CI, 1.27-8.48); and having a history of abortion (AOR = 2.87 95% CI, 1.73-4.76) significantly increased the likelihood of khat use among pregnant women. Conclusion: The current study revealed a relatively high magnitude of khat use in pregnant women as compared with previous studies. The age of the pregnant women, history of medical illness, and history of abortion were significantly associated with khat use during pregnancy.

Acceptance of COVID-19 vaccine and associated factors among health care workers at public hospitals in Eastern Ethiopia using the health belief model.

Introduction: Acceptance of COVID-19 vaccination among Health Care Workers is mandatory to lessen and curve the spread of transmission of COVID-19. Even though the Health Belief Model is one of the most widely used models for understanding vaccination behavior against COVID-19 disease, COVID-19 vaccine acceptance among Health Care Workers in Ethiopia was not adequately explored by using the Health Belief Model domains. Purpose: This study aimed to assess COVID-19 vaccine acceptance and associated factors among Health care workers in eastern, Ethiopia. Methods: Institutional-based cross-sectional study design was used among 417 health care workers selected by a systematic random sampling method from June 1- 30/2021. The data were collected by face-to-face interviews using semi-structured questionnaires and analyzed using STATA version 14 statistical software. Multivariable binary logistic regression analysis with a 95% confidence interval was carried out to identify factors associated with willingness to COVID-19 vaccine acceptance and a statistical significance was declared at a P-value < 0.05. Results: The willingness of health care workers to accept the COVID-19 vaccine was 35.6%. Age 30-39 (AOR = 4.16;95% CI: 2.51, 6.88), age ≥ 40 years (AOR = 3.29;95% CI: 1.47, 7.39), good attitude (AOR = 1.97; 95% CI: 1.00, 3.55), perceived susceptibility (AOR = 1.93; 95% CI: 1.12, 3.32), and perceived severity (AOR = 1.78; 95% CI: 1.03, 3.10) were factors significantly associated with Health Care Workers acceptance of COVID-19 vaccine. Conclusion: The willingness to accept the COVID-19 vaccine among HCWs was low. Factors significantly associated with the willingness to accept the COVID-19 vaccine were age, good attitude, perceived susceptibility, and perceived severity of the disease. The low willingness of Health Care Workers to accept the COVID-19 vaccine was alarming and it needs more emphasis from the government in collaboration with other stakeholders to provide reliable information to avert misconceptions and rumors about the vaccine to improve the vaccine status of Health Care Workers to protect the communities.

Nurses' Knowledge and Practicing Level of Cognitive Behavioral Pain Relief Methods in Public Hospitals of Eastern Ethiopia.

Introduction: Despite the fact that cognitive behavioral therapy is regarded as a superior pain relief method and an alternative to drug therapy, little is known about its scope of application and determinant factors. As a result, the study sought to assess nurses' knowledge and practicing level of cognitive behavioral pain relief methods in public hospitals in eastern Ethiopia. Objective: To assess the knowledge and practicing level of cognitive behavioral pain relief among nurses working in public hospitals of eastern Ethiopia. Methods: A cross-sectional study was conducted among randomly selected 390 nurses. The data were collected using a self-administered questionnaire. The data were entered into Epi-data 3.1 and exported to SPSS 22 for analysis. Bivariate and multivariate logistic regression models were used to identify factors associated with cognitive behavioral therapy. Result: In this study, more than half (54.1%) of the respondents had good cognitive behavioral methods practicing levels. Nearly two-thirds (58.8%) of the participants had adequate knowledge about pain relief methods. Having adequate knowledge (adjusted odds ratio [AOR] 2.664; 95% confidence interval [CI]: 1.75, 4.7), having training (AOR 1.7; 95% CI: 1.03, 3.01), and positive attitude (AOR 4.02; 95% CI: 4.5, 12.4) were significantly associated with cognitive behavioral therapy. Conclusion: In this study, more than half of nurses had good cognitive behavioral methods practicing levels. Having a positive attitude, being knowledgeable, and having training were determinant factors in the practice of cognitive behavioral therapy. Continuing education and training should be considered for nurses to enhance their cognitive behavioral therapy practice.

Level of implementation of district health information system 2 at public health facilities in Eastern Ethiopia.

Objective: The major aim of this study was to assess the level of District health information system 2 (DHIS 2) implementation in the public health facilities (HFs) in Dire Dawa City Administration. Methods: This study was employed both quantitative (cross-sectional) and qualitative (phenomenological) study designs. All public HFs found in Dire Dawa City Administration and health workers were participated in the study. Quantitative data were collected using a pre-tested, structured, self-administered questionnaire. The collected data were entered into Epi-Data and analyzed using STATA version 14 software. A descriptive summary was computed using proportion and frequencies. Qualitative data were collected from in-depth interview with key informants (KIs), and the results were then analyzed thematically. Results: The overall implementation level of DHIS 2 was 80%, which shows good implementation. The main difficulties encountered in implementing DHIS 2 were a lack of power backup (64.3%), unreliable internet connectivity (43%), and a lack of training (34.6%). According to an in-depth interview with a 32-year-old professional, "…there is offline and online DHIS 2 software for data collection and reporting that is an opportunity for the health center, but there is a challenge of interruption of electricity lost unsaved data and hinder data to enter and view for making a decision…." Conclusion: The level of DHIS 2 implementation in this study was good compared to other studies in Ethiopia. However, more than half of the HFs require infrastructure maintenance and support.

Factors associated with uncontrolled asthma among adult asthmatic patients in eastern Ethiopia: A multicenter study.

Objective: Asthma is a major public health problem worldwide. Despite various attempts, it is still uncontrolled in most parts of the world. Moreover, it is contributing to the national and global burden of non-communicable diseases. Studying factors associated with uncontrolled asthma in different parts of Ethiopia is crucial to control the disease and improving the quality of life of asthmatic patients. Thus, this study aimed to determine the factors associated with uncontrolled asthma among adult asthmatic patients in Eastern Ethiopia. Methods: Facility-based cross-sectional study was employed from 1st October 2020 to 30th January 2021. A total of 416 adult asthmatic patients participated in the study from six hospitals follow-up clinics. Asthma control test was used to assess the participants level of asthma control and a score of ⩽19 were regarded to have uncontrolled asthma. Data were analyzed using SPSS version 24. Bivariable and multivariable analyses were carried out to identify factors associated with uncontrolled asthma and variables with a p value of less than 0.05 were considered statistically significant. Result: The prevalence of uncontrolled asthma was 66.1 % (95% confidence interval: 61.5-70.4). Not attending scheduled medical follow-up (adjusted odds ratio: 2.54; 95% confidence interval: 1.28-4.99), poor knowledge about asthma (adjusted odds ratio = 4.59; 95% confidence interval: 2.01-10.51), negative attitude toward asthma (adjusted odds ratio = 3.72; 95% confidence interval: 1.83-7.59), and poor adherence to medications (adjusted odds ratio = 2.53; 95% confidence interval: 1.25-5.13) were significantly associated with uncontrolled asthma. Conclusion: In this study, the prevalence of uncontrolled asthma was considerably high. Not attending scheduled medical follow-up, poor knowledge about asthma, negative attitude toward asthma, and poor adherence to anti-asthma medications were associated with uncontrolled asthma. Therefore, it is crucial to focus on increasing the patients' level of awareness about asthma control, improving medication adherence, and avoiding triggering factors.

Magnitude of episiotomy practice and associated factors among women who gave birth at Hiwot Fana Specialized University Hospital, Eastern Ethiopia.

Background: Episiotomy is an intentional surgical incision made on the perineum with the aim of enlarging the introits during the second stage of labor or just before delivery of the baby. It sometimes also interferes with the mother's comfort during the postpartum period and has associated complications especially when it is done without indication. However, there is limited information regarding episiotomy practice in the study area. Objective: This study aimed to determine the magnitude of episiotomy practice and associated factors among women who gave birth at the Hiwot Fana Specialized University Hospital, Eastern Ethiopia, 2021. Methods: A facility-based cross-sectional study was conducted among 408 systematically selected mothers who gave birth at the Hiwot Fana Specialized University Hospital, from 1 January to 30 December 2021. Datas were collected from delivery medical records using a pretested checklist. The extracted data were checked, coded, and entered into the Epi-data version 3.1 and exported to the STATA version 16 software for analysis. Binary logistic regression was fitted to identify factors associated with episiotomy practice. P-values < 0.05 were considered to declare the presence of statistical significance. Results: The overall prevalence of episiotomy practice was found to be 43.4 % (95% CI: 38.7, 48.9), and mediolateral was the most commonly practiced episiotomy type (41.4%). Parity [AOR: 6.2; 95% CI (3.8-17.6)], 1st min Apgar score [AOR: 1.6; 95% CI (1.04-2.67)], presence of maternal medical disease [AOR: 3.3; 95% CI (1.09-6.9)], and induced labor [AOR: 1.6; 95%CI (1.12, 4.13)] were significantly associated with the episiotomy practice. Conclusion: The prevalence of episiotomy practice in the study area was high. Parity, presence of maternal medical disease, induction of labor, and 1st min APGAR score were significant factors associated with episiotomy practice. Considering the presence of appropriate indications or preventing unjustifiable indications, can help to reduce the current high practice rates.

Intimate Partner Violence and Its Predictors among Pregnant Women in Eastern Ethiopia: Generalized Structural Equation Modeling.

Introduction: Intimate partner violence (IPV) has a negative impact on women's physical, mental, sexual, and reproductive health. Identifying the determinant factors of IPV among pregnant women is of paramount importance to overcome its negative consequences thereby increasing the performance of women in all activities. Thus, this study applied a generalized structural equation model (GSEM) to determine the prevalence of intimate partner violence among pregnant women and its predictors in Eastern Ethiopia. Methods: A community based cross-sectional study was conducted in Kersa Health and Demographic Surveillance System (KHDSS), Eastern Ethiopia. Data were collected form a sample of 1051 pregnant women using structured questionnaires. Descript findings were presented in percentage with 95% confidence interval. The generalized structural equation model was used to determine factors associated with each domain of IPV (physical, emotional, and social violence). Adjusted odds ratio (AOR) with a 95% CI were used to declare significant factors associated with intimate partner violence. Results: The overall prevalence of IPV in the Eastern Ethiopia was 48.57% (95% CI: 45.45, 51.69). The highest intimate partner violence was observed in the sexual domain of IPV (31.6%, 95% CI: (28.8, 34.58)). In GSEM, being a farmer (AOR = 0.42, 95% CI: 0.19, 0.91) was significantly associated with psychological domain of IPV. Age (AOR = 0.97, 95% CI: 0.95, 0.99) and educational status (neither read nor write) (AOR = 2.50, 95% CI: 1.61, 3.89) were significantly associated with physical domain of IPV. Being in medium (AOR = 0.64, 95% CI: 0.46, 0.90) and rich (AOR = 0.53, 95% CI: 0.36, 0.78), wealth quintiles were significantly associated with sexual domain of IPV, whereas husband controlling behavior was significantly associated with all domains of IPV. Conclusions: The magnitude of IPV among pregnant women was relatively high in Eastern Ethiopia. This finding pin a light to pay special consideration to pregnant women at each point of service delivery to alleviate consequence of IPV. Being a farmer, older ages and being in higher wealth quintiles were protective factor, whereas being uneducated increase the risk of IPV. Improving socioeconomic status and promoting legal rights of women is needed to alleviate the problem, and younger women require special attention.

Attitudes toward safe abortion care and its associated factors among health care providers working in public health facilities in eastern Ethiopia.

Objectives: The main aim of this study was to assess health care providers' attitudes toward safe abortion services and its associated factors in public health facilities of Harar city, Eastern Ethiopia. Methods: Facility-based cross-sectional study was conducted among 411 health care providers who were working at public health facilities in Harari regional state, in eastern Ethiopia. A simple random sampling technique was used to select study participants. Data were collected using self-administered questionnaires, and collected data were entered into EpiData version 4.6 and then exported to SPSS version 26 for cleaning and analysis. Descriptive statistics, bivariable, and multivariable logistic regression analysis were carried out to compute the prevalence of the outcome variables and to identify factors associated with the outcome variable, respectively. Adjusted odds ratio at 95% confidence interval and p-value < 0.05 was used to declare a significant association. Results: More than half (58.4%, 95% confidence interval: 53.8-63.2) of the health care providers had a favorable attitude toward safe abortion care. Being male (adjusted odds ratio = 2.90; 95% confidence interval: 1.80-4.65), ever trained on safe abortion (adjusted odds ratio = 2.55; 95% confidence interval: 1.39-4.66), familiarity with the current abortion law of Ethiopia (adjusted odds ratio = 2.38; 95% confidence interval: 1.40-4.05), preference of unrestricted abortion law (adjusted odds ratio = 1.86; 95% confidence interval: 1.15-3.02), and being medical doctors or health officers (adjusted odds ratio = 1.90; 95% confidence interval: 1.06-3.41) were the factors significantly associated with health care providers' favorable attitude toward safe abortion care. Conclusion: Approximately three in five of the health care providers working at public health facilities had a favorable attitude toward safe abortion care in eastern Ethiopia. We suggest giving pre-service or in-service training on safe abortion care and supporting health care providers to be familiar with the country's abortion laws are crucial to improve health care providers' attitudes toward safe abortion service in Ethiopia.

Household food insecurity and physically demanding work during pregnancy are risk factors for low birth weight in north Shewa zone public hospitals, Central Ethiopia, 2021: a multicenter cross-sectional study.

BACKGROUND: Despite numerous efforts to improve the quality of maternal and child health medical services, over 20 million babies are born with low birth weights each year globally. However, factors related to low birth weight like physically demanding work during pregnancy, intimate partner violence, and food insecurity have not been explored well in Ethiopia. Thus, this study aimed to assess the prevalence of low birth weight and associated factors among neonates born in public Hospitals in North Shewa Zone, Central Ethiopia. METHODS: A hospital-based cross-sectional study design was conducted from June 15 -to July 15, 2021, in North Shewa public hospitals. A total of 441 mothers and newborn pairs were selected by systematic random sampling. Data were collected using a pretested and structured interviewer-administered questionnaire with chart reviewing. Data entry and analysis were done using Epi Data version 3.1 and Statistical Package for the Social Sciences version 26 respectively. Binary logistic regression was done to identify factors associated with low birth weight. Adjusted odds ratio with its 95% confidence interval and a p-value less than 0.05 was considered to declare the statistically significant association. RESULTS: The prevalence of low-birth-weight was 17.7% (95% CI: 14.3, 21.5). Pregnancy-related complication [AOR = 2.16; 95% CI:(1.12,4.18)], grand-multiparty [AOR = 2.57; 95% CI:(1.12,5.88)], physically demanding work during pregnancy [AOR = 2.19; 95% CI:(1.11,4.33)], midd-upper arm circumference less than 23 cm [AOR = 2.54; 95% CI:(1.26,5.10)], partner violence during pregnancy [AOR = 3.77; 95% CI:(1.81,7.88)], and being member of household with food insecure [AOR = 2.31; 95% CI:(1.12,4.75)] were factors significantly associated with low birth weight. CONCLUSIONS: This study showed that the magnitude of low birth weight was relatively high. Women with pregnancy-related complications, grand multiparty, physically demanding work during pregnancy, intimate partner violence, mid-upper arm circumference less than 23 cm, and food insecurity should be prioritized for mitigating LBW. Health care professionals should focus on Screening pregnant women for intimate partner violence, physically demanding activities, undernutrition and providing appropriate treatment during all maternal continuum of care might be helpful.

Prevalence of Group B Streptococcus Recto-Vaginal Colonization, Vertical Transmission, and Antibiotic Susceptibility Among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Maternal Group B Streptococcus (GBS) recto-vaginal colonization is the most common route for early onset neonatal GBS diseases. A good understanding of the rate of maternal GBS colonization, vertical transmission rate, and antibiotic susceptibility profiles is needed to formulate a broad protection mechanism, like vaccine preparation. For that reason, this meta-analysis aimed at determining the pooled prevalence of GBS recto-vaginal colonization, vertical transmission rate, and antibiotic susceptibility profiles in Ethiopia. Methods: Both published and unpublished studies were searched from MEDLINE/PubMed, CINAHL (EBSCO), Embase, Cochrane Library, SCOPUS, Web of Sciences databases, and Google Scholar. Independent selection was then carried out by the authors based on the eligibility criteria and data extraction using Microsoft excel. The authors then used STATA version 14.1 software for further cleaning and analysis. The review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA guidelines. Using the random-effect model, the prevalence with a 95% confidence interval (CI) and forest plot were used to present the findings. Besides, the studies' heterogeneity was assessed using Cochrane chi-square (I2) statistics, while Egger intercept was used to assess publication bias. Results: This review included nineteen studies. The pooled prevalence of recto-vaginal colonization was 15% (95% CI: 11, 19), while the prevalence of vertical transmission was 51% (95% CI: 45, 58) and highest-level susceptibility to vancomycin was 99% (95% CI: 98, 100). However, the GBS susceptibility to tetracycline was 23% (95% CI: 9, 36). Conclusions: Nearly one out of seven pregnant women in Ethiopia had recto-vaginal colonization of GBS. As a result, half of the pregnancies end with vertical transmission of GBS. Hence, the review emphasizes that policy and programs should consider planning and implementing prophylactic programs. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287540.

Magnitude of Anemia and Its Associated Factors Among Pregnant Women Attending Antenatal Care in Hiwot Fana Specialized University Hospital in Eastern Ethiopia.

Background: Anemia is a significant public health issue, accounting for 20-40% of maternal deaths. Despite the government's commitment and the interventions of various stakeholders, the magnitude and major risk factors of anemia remain unabated. Though there are few documented studies on anemia among pregnant women in eastern Ethiopia in general, in the study area in particular, some of the variables such as helminthics and history of caesarian section in relation to anemia need to be studied. As a result, the purpose of this study was to determine the magnitude of anemia and associated factors among pregnant women attending antenatal care in University Hospital in eastern Ethiopia. Methods: A facility-based cross-sectional study was conducted on a sample of 456 clients who were attending antenatal care in Hiwot Fana specialized university hospital from 01 to 30 June 2021. Systematic sampling was used to select the study participants. A pretested and structured interviewer-administered questionnaire and sample collection were used to collect the data. The data were coded, double-entered to Epi data version 3.1, cleaned, and exported to SPSS version 20 for analysis. Descriptive statistics were used to present frequency distributions. Variables with p-value < 0.25 during bivariate analysis were entered into the multivariate logistic regression models to control for all possible confounders to identify the factors associated with a magnitude of anemia. Odds ratio along with 95% CI were estimated to measure the strength of the association. The level of statistical significance was declared at a p-value of < 0.05. Result: A total of 456 participants were interviewed, with a response rate of 96.9%. The magnitude of anemia among pregnant women was 112 [(25.3%) 95%CI: (21.5-29.2%)], of which, 27 (6.10%), 36 (8.13%), and 49 (11.08%) had mild, moderate, and severe anemia, respectively. Birth interval < 2 years [AOR: 3.24, (95% CI: (1.88, 4.32)], number of children ≥2 [AOR: 2.54, (95% CI: (1.12, 4.64)], monthly income < 1,000 birr [AOR: 2.89, (95% CI: (1.31, 5.58)], third trimester pregnancy [AOR: 2.89, (95% CI: 4.86, 12.62)], and abnormal menstrual history [AOR: 2.28, (95% CI: (1.69, 5.24)] were the factors significantly associated with anemia. Conclusion: Anemia among pregnant women was relatively high compared to previous studies. Birth intervals, number of children, history of menstrual disorder, monthly income, and trimester of pregnancy were all significantly associated with anemia in pregnant women.

Undernutrition and associated factors among rural pregnant women in Eastern Ethiopia.

Objectives: Maternal undernutrition is a burning issue in Ethiopia. However, updated evidence is limited in the eastern part of the country; particularly the mental health-related factors of undernutrition. The study, hence, aimed at assessing the prevalence and predictors of undernutrition among rural pregnant women in eastern Ethiopia. Methods: A cross-sectional research was carried out at a community level among 1015 randomly selected pregnant women. A structured questionnaire was used to collect the data through face-to-face interviews. The characteristics of participants were described and summarized by frequencies, percentages, and summary measures. Logistic regression was performed to find out factors related to undernutrition. Results: The prevalence of undernutrition was 43.8% (95% confidence interval: 40.8, 47.0). Early marriage (adjusted odds ratio = 2.63, confidence interval: 2.00, 3.47), no antenatal care follow-up (adjusted odds ratio = 1.73, 95% confidence interval: 1.31, 2.29), inadequately diversified diet (adjusted odds ratio = 2.48, 95% confidence interval: 1.77, 3.48), current substance use (adjusted odds ratio = 1.50, 95% confidence interval: 1.02, 2.19), history of mental illness (adjusted odds ratio = 2.44, 95% confidence interval: 1.02, 5.82), and common mental disorders (adjusted odds ratio = 1.81, 95% confidence interval: 1.34, 2.43) were the significant predictors of undernutrition among pregnant women. Conclusions: Undernutrition was a significant public health issue among rural pregnant women. Age at first marriage, antenatal care follow-up, dietary diversity, current substance use, history of mental illness, and common mental disorder were the independent predictors of undernutrition. Therefore, the health offices of Kersa and Haramaya districts should invest their efforts to prevent undernutrition among pregnant women through nutrition counselling and education, and mental health and psychosocial support.

Prevalence and Associated Factors of Common Mental Disorders Among Pregnant Mothers in Rural Eastern Ethiopia.

Background: Antenatal common mental disorder is a significant public health issue, especially in low- and middle-income countries with an extensive treatment gap. Common mental disorders have multifaceted implications on maternal and fetal health outcomes during pregnancy with long-running economic and social sequels. This study aimed to determine the prevalence of common mental disorder and associated factors among pregnant mothers in eastern Ethiopia, Kersa and Haramaya Health, and Demographic surveillance sites. Methods: A community-based cross-sectional study was conducted in Kersa and Haramaya health and demographic surveillance sites from January 30 to April 30, 2021. World Health Organization Self-Reporting Questionnaire (SRQ-20) was used to measure common mental disorder among 1,015 randomly selected pregnant women. Data were collected face-to-face using open data kit software. Logistic regression was fitted to identify factors associated with common mental disorders. Results: The overall prevalence of common mental disorders (SRQ > 6) among pregnant women was 37.5% (95% CI: 34.5, 40.5). Current substance use (AOR = 1.99, 95% CI 1.37, 2.88), intimate partner violence (AOR = 2.67, 95% CI 2.02, 3.53), null parity (AOR = 3.10, 95% CI 1.65, 5.84), gestational age [first trimester (AOR = 2.22, 95% CI 1.01, 4.93) and third trimester (AOR = 1.74, 95% CI 1.31, 2.31)], history of abortion (AOR = 2.03, 95% CI 1.27, 3.24), and absence of antenatal care follow-up (AOR = 1.43, 95% CI 1.08, 1.89) were significantly associated with common mental disorder during pregnancy. Conclusion: Common mental disorders are prevalent among pregnant women in the study area with significant correlates. Administration of regular screening programs for maternal mental health conditions in rural, low-income communities, integrating into primary health care settings is imperative to reduce the risk.

Postabortion Contraceptive Acceptance Rate and Its Determinants among Women Receiving Abortion Service before Discharge from the Health Facilities in Harar, Eastern Ethiopia.

BACKGROUND: Annually, around 121 million unintended pregnancies occur in the world and more than 73 million encountered abortion. Ethiopia is also losing 19.6% of mothers due to unsafe abortion. Despite that postabortion contraceptive service is a climactic entry point for the prevention of unwanted pregnancy and associated deaths, the service magnitude and determinants immediately before discharge are not characterized well in Ethiopia. Hence, this study aimed to assess the magnitude of postabortion contraceptive utilization and associated factors among women receiving abortion care service before being discharged from health facilities in Harar, Eastern Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 390 women receiving abortion care services. At discharge, data about contraceptive acceptance and related maternal characteristics were collected. A binary logistic regression model was used to assess the association between independent and dependent variables (postabortion contraceptive utilization). Analysis was done with SPSS 22. Statistical significance was considered at P < 0.05. RESULT: The overall prevalence of postabortion contraceptive utilization was 81.5% (95% CI: 77.9, 85.4). Being unmarried (AOR, 0.05; 95% CI (0.02, 0.16)), having no history of previous abortion (AOR, 0.11; 95% CI (0.04, 0.34)), being multigravida (AOR 8.1; 95% CI (2.20, 13.40), lacking desire to have an additional child (AOR, 6.3; 95% CI (2.65, 15.34), and history of family planning use (AOR, 17.20; 95% CI (6.5, 38.60)) were determinants of postabortion contraceptive utilization before being discharged from the health facilities. CONCLUSION: Postabortion contraceptive utilization in Harar health facilities still needs improvement as per the WHO and national recommendations. Therefore, the family planning provision strategies should be convincing and friendly, especially for unmarried mothers, and those who had no history of abortion should be counseled in friendly and systematically convincing schemes for enabling them to take the service before discharge from the health facility.