Intentions on contraception use and its associated factors among postpartum women in Aksum town, Tigray region, northern Ethiopia: a community-based cross- sectional study.

BACKGROUND: Increased access to contraceptive methods has been established as a cost-effective strategy for developing countries to reduce maternal and child mortality. Intentions to contraceptive uptake appear to be best predictors of actual contraceptive practice than the unmet need. However, intention to contraceptive use in Ethiopia particularly among postpartum women is not well assessed. Therefore, the objective of this study was to assess intention to use modern contraceptive and to identify factors associated among postpartum women in Aksum town. METHODS: A community -based analytical cross-sectional study design was done to collect the data from 604 postpartum mothers using a structured questionnaire. The data was collected from March 25 to April 24, 2015. A multivariable logistic regression was conducted to assess factors associated with intentions to use contraceptive methods. Factors influencing intentions on contraceptive methods use were assessed by computing adjusted odds ratios (AOR) at 95% confidence interval (CI) with statistical significant p- value < 0.05. RESULTS: Intention to use modern contraceptive was 84.3%. Resumed sexual intercourse (AOR = 1.78; 95% CI: 1.34, 3.92) and women whose their husband approved family planning to use (AOR = 1.57; 95% CI: 2.02, 5.57) were more likely to have intention on contraceptive use. In addition, those women who knew at least one method of modern contraceptive (AOR = 5.17; 95% CI: 1.69, 15.82) were more likely to had intention to use modern contraceptive during extended postpartum period compared to their counterparts. CONCLUSION AND RECOMMENDATION: More than eight in ten study participants have intention to use contraceptive in the Aksum town. Resumed sexual intercourse, husband's approval of family planning and knew at least one method of contraceptive are the three major predictors to be an areas when considering interventions to increase of intention on contraceptive. Therefore, this study highlighted that; in order to increase intention and adoption of contraceptive, the family planning services providers and programmers should continue the promotion of partner involvement and increasing family planning knowledge through printed media and mass media.

A preliminary survey of major diseases of ruminants and management practices in Western Tigray province, northern Ethiopia.

BACKGROUND: Despite the highest population, the productivity of Ethiopian livestock is low, and the direct contribution to the national economy is limited. Poor genetic potential, shortage of feed in quantity and quality, poor health care and management practices are the main contributors to low productivity and production. Data on animal disease and management practices are not in place, in this regard; we estimate the burden of animal health ailments and management practices in ruminants via simple cross-sectional study design in randomly selected peasant associations in western Tigray of northern Ethiopia. RESULTS: A preliminary disease survey in ruminants and their management practices comprising of cattle, sheep and goats was undertaken to evaluate the existence, burden of ruminant diseases and management practices. A total of 121 randomly selected household respondents of Maikhadrah and Bakhar (26.2%), Dansha (19.7%), Adi-Hirdi (18.0%), Adi-Remets and Inda-Selassie (36.1%) sub-districts were inspected throughout the study period. Most (81%) of farmers feed their animals on free grazing in the open environment travelling from highlands and midlands to lowlands in search of adequate feed (different species of grasses) and crop residues during the wet season up to the beginning of the dry season. Majority of farmers (43.8%) had veterinary access from governmental veterinary officers. Thirty-four (33.9%) of the respondents got veterinary access from illegal drug dealers in mini shops or market. Among the major disease constraints identified; Tick infestation (89.3%), lice infestation (68.6%) mange mite infestation (77.7%) lumpy skin disease (LSD) (42.1%), trypanasomiasis (62.8%) bovine pasteurellosis (52.1) mastitis (13.2%), sheep and goat pox (15.7), abortion (19.0%), dystocia (24.8%), retained fetal membrane (25.6%), prolapsed uterus (13.2%) delayed heat period (38.8%) were most endemic ailments directly affecting livestock production and farmers livelihood. CONCLUSION: In conclusion management practices in livestock production is poor to a large extent. Burden and endemicity of livestock diseases are substantially higher. The data obtained could be the source of facts for planners in animal health service delivery system in this sub region.

Predictors of postpartum contraceptive use in rural Tigray region, northern Ethiopia: a multilevel analysis.

BACKGROUND: Postpartum family planning services is one of the recommended public health intervention aimed at reducing maternal and child morbidity and mortalities. However, there is a paucity studies in rural Tigray region. Therefore, determining the level and associated factors of contraceptive use among postpartum women has the potential to contribute in achieving the Ethiopian Health Sector Transformation Plan and to the Sustainable Development Goals on maternal and infant survival. METHODS: A community-based cross-sectional study was done among 1109 postpartum women from March 29, 2017 to April 29, 2017. Face -to-face interview was used for data collection. The collected data were entered and cleaned using EPI - INFO version 7statistical software and later exported to and analyzed using STATA version 12. Mixed-effects multilevel logistic regression analysis was used to identify the individual and community-level factors associated with contraception adoption. A two side p-value< 0.05 was considered to be statistically significant. RESULTS: The level of contraceptive use was 38.3%. Individual-level variables such as women belong to fourth (AOR = 1.2; 95% CI: 1.1-3.2) and fifth (AOR = 1.5; 95% CI: 1.3-2.5) wealth quintiles were identified as key predictors of contraception use. In addition, partner secondary (AOR = 2.3; 95% CI: 1.8-3.5) and diploma (AOR = 1.2; 95% CI, 1.1-2.6) educational-level and postnatal care (AOR = 2.0; 95% CI: 1.9, 4.3) were also significantly affected contraception use. Community-level variables such as high community-level antenatal care services use (AOR = 2.1; 95% CI: 1.9-4.2) and proximity of women to health facility (AOR = 3.0; 95% CI: 2.7-4.6) were also determinants of contraception uptake. CONCLUSIONS: The status of contraceptive use in rural Tigray region was found to be low. It was found that both individual and community-level variables showed a marked determinant on postpartum contraception use. This study suggested that in order to increase contraceptive use the government should focus on increasing postnatal care, antenatal care services use and reduction of poverty level are important avenues for intervention.

Visceral leishmaniasis treatment outcome and its determinants in northwest Ethiopia.

OBJECTIVES: Poor treatment outcomes of visceral leishmaniasis (VL) are responsible for the high mortality rate of this condition in resource-limited settings such as Ethiopia. This study aimed to identify the proportion of poor VL treatment outcomes in northwest Ethiopia and to evaluate the determinants associated with poor outcomes. METHODS: A hospital-based retrospective study was conducted among 595 VL patients who were admitted to Kahsay Abera Hospital in northwest Ethiopia from October 2010 to April 2013. Data were entered into Epi Info version 7.0 and exported to SPSS version 20 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of VL treatment outcomes. Adjusted odds ratio (aORs) with 95% confidence intervals (CIs) were used, and p-values <0.05 were considered to indicate statistical significance. RESULTS: The proportion of poor treatment outcomes was 23.7%. Late diagnosis (≥29 days) (aOR, 4.34; 95% CI, 2.22 to 8.46), severe illness at admission (inability to walk) (aOR, 1.63; 95% CI, 1.06 to 2.40) and coinfection with VL and human immunodeficiency virus (HIV) (aOR, 2.72; 95% CI, 1.40 to 5.20) were found to be determinants of poor VL treatment outcomes. CONCLUSIONS: Poor treatment outcomes, such as death, treatment failure, and non-adherence, were found to be common. Special attention must be paid to severely ill and VL/HIV-coinfected patients. To improve VL treatment outcomes, the early diagnosis and treatment of VL patients is recommended.