Home based postpartum care and determinants in Ethiopia: A multilevel analysis.

INTRODUCTION: Neonatal mortality remains a persisting public health challenge in Ethiopia. Timely intervention to neonatal morbidity and early neonatal care visit could reduce the burden of mortality. Studies related to home based postnatal care is limited in Ethiopia. Therefore, this study aimed to assess home based postnatal care visits and determinants in Ethiopia. METHODS: A secondary data analysis using 2016 EDHS data was conducted among 7590 women who had live births two years preceding the survey. A multilevel mixed-effect logistic regression analysis model was used and those variables with a P-value ≤ of 0.05 in multivariable analysis were considered as predictors. Results: Home based postpartum care by health care providers was 6.3% and 67.9% of women gave birth at home. Women perceived that distance is not big problem [AOR = 1.37; 95% CI: 1.06, 1.68], richer wealth index [AOR = 1.69; 95% CI: 1.15, 2.48], attending antenatal care visit [AOR = 2.17; 95% CI:1.57, 2.99], giving birth in health institution [AOR = 2.07; 95% CI:1.53, 2.80], giving birth by cesarean section [AOR = 3.41; 95% CI: 2.33, 4.99], and having awareness about neonatal danger sign [AOR = 3.68; 95% CI: 2.90,4.70] were factors associated with home based postpartum care. CONCLUSION: Home based care by health care providers was low. Therefore, measures should be taken in increasing the number of nearby health care facility, strengthen the continuum of care on antenatal care follow-up, institutional delivery and improve mother's knowledge about neonatal danger sign.

Burden of obstructed labor in ethiopia: A systematic review and meta-analysis.

BACKGROUND: Obstructed labor is a major cause of maternal and neonatal morbidity and mortality mainly in low-income countries, particularly in Ethiopia. In Ethiopia, the prevalence and determinant factors of obstructed labor described by different studies were highly inconsistent. Therefore, this study aimed to determine the pooled prevalence and determinants of obstructed labor in Ethiopia. METHODS: International databases (PubMed, Hinari, Google scholar, Cochrane library, and web of science) and Ethiopian universities' digital libraries were used to search relevant articles. Both cross-sectional and case control studies were included. A total of 15 studies were included in this study. All the necessary data were extracted by two authors independently using Microsoft excel and exported to STATA Version 11 for analysis. Heterogeneity of the studies was assessed by using I2 test. The funnel plot and Egger's test were used to assess publication bias between the studies. The pooled prevalence of obstructed labor was estimated using random effects model. Furthermore, the associations between determinant factors and obstructed labor were examined using both random and fixed effect models. RESULTS: A total of 15 studies with 34632 study participants were involved in this meta-analysis. The overall prevalence of obstructed labor was 11.79% with 95% CI (9.78, 13.80). In this study, maternal age between 15-19 years [OR=8.03, 95% CI=4.21, 15.30], malpresentation [OR=7.73, 95% CI=3.78, 15.83], lack of Ante Natal Care follow-up [OR=4.37, 95%CI=1.51, 12.67] and fetal weight ≥4kg [OR=5.83, 95% CI=2.74, 12.41] were associated with obstructed labor. CONCLUSION: The overall prevalence of obstructed labor was high in Ethiopia. Maternal age between 15-19 years, malpresentation, lack of Ante Natal Care follow-up and fetal Wight ≥4kg were determinants of obstructed labor. Hence, this study implies the need to develop plans and policies to improve Ante Natal Care follow and labor and delivery management at each level of the health system. Besides to this, fetal malpresentation and macrosomia should be recognized and intervene early during labor and delivery.

Determinants of maternal knowledge of neonatal danger signs among postnatal mothers visiting neonatal intensive care unit, north Central Ethiopia, 2019: a cross-sectional study.

BACKGROUND: Sick neonates can be early readmitted if and only if their mothers have good knowledge of the key neonatal danger signs at first discharge. Thus, it was aimed to assess the level and determinants of maternal knowledge on these signs at first discharge from NICU. METHODS: A hospital based cross sectional study design was employed at Debre Tabor General Hospital, South Gondar Zone. A sample of 363 participants was included to the study from September 2018 to February 2019 through systematic selection of every other eligible mother baby pair. Data were collected through face to face interview at time of discharge from NICU. Knowledge score of neonatal danger signs was computed by adding the total number of correct spontaneous responses to 9 key danger signs with a minimum score of 0 and maximum of 9 [0 when a mother named none of the key danger signs and 9 when the mother named all the signs]. Mothers who scored ≥3 points were considered to have good knowledge whereas those scoring less than 3 points had poor knowledge. RESULTS: 224(61.70%) mothers had good knowledge of neonatal danger signs at discharge from NICU. Secondary and above level of education [AOR = 4.62], receiving danger sign information during stay at NICU [AOR = 3.64], four and above antenatal visits [AOR = 3.04], well preparedness of birth [AOR = 13.70], institutional delivery [AOR = 6.46] and good knowledge of essential newborn care [AOR = 4.41] were significant factors. CONCLUSIONS: At discharge time, maternal knowledge of neonatal danger signs wasn't comparable to their exposure of NICU environment. Therefore, danger sign education should be routinely given during maternal stay at NICU. Moreover, existing efforts should be enhanced to improve number of antenatal visits, institutional delivery rate and postnatal services along the continuum of maternal and child health care in South Gondar Zone.