Breast feeding techniques and associated factors among lactating primipara mothers during the postpartum period in Debre Markos health institutions, North West Ethiopia.

BACKGROUND: Breastfeeding technique is a combination of positioning, attachment, and breast milk suckling. Breastfeeding problems are caused by incorrect breastfeeding practices, which lead to premature discontinuation of breastfeeding. Therefore, this study aimed to determine the proportion of breastfeeding techniques and associated factors among lactating primiparous mothers during the postpartum period in the Debre Markos town health facility in 2021. METHODS: An institutional-based cross-sectional study was conducted from November 1st to December 30, 2021. A systematic sampling technique was utilized to select study participants. An observational checklist developed by WHO and an interviewer-administered questionnaire were used to collect data from 409 mothers. The collected data were entered into Epi-Data version 4.6.0.4 statistical software and then exported to SPSS version 24.0 for cleaning and analysis. Binary and multivariable logistic regression was carried out to identify the factors associated with the practice of effective breastfeeding techniques. A variable that has a p-value of ≤0.2 was transferred to a multivariable for further analysis. The strength of association was identified using an adjusted odds ratio with a 95% confidence interval, and a p-value <0.05 was taken as statistically significant. RESULTS: The proportion of practicing effective breastfeeding techniques among lactating primipara mothers was 29.1% (CI: 24.7, 33.3). Baby aged ≥29 days, mothers who were living in urban, mothers who attended college or higher education, mothers who have heard about BFT practices, mothers who received counseling on BFT after delivery, and mothers whose breast nipples had everted were variables that were significantly associated with the practice of effective breastfeeding techniques. CONCLUSION: The findings of this study revealed that the practice of effective breastfeeding techniques among lactating primipara mothers was lower in the study area. Therefore, healthcare providers should have to counsel mothers on how to position and attach their infants during breastfeeding. PRACTICE IMPLICATION: The provision of breast-feeding method counseling to nursing mothers is one way to enhance the practices of breast feeding.

Short birth interval and associated factors among women who gave birth in the last three years in Dembecha district, Northwest Ethiopia.

BACKGROUND: Maternal and child mortality remains a major public health problem in Ethiopia. Improving short birth interval practice is a main strategy to reduce neonatal mortality, maternal mortality, adverse pregnancy outcomes, high fertility rate, and enhance economic development efforts. However, there has been limited study done regarding short birth intervals in the study area. Therefore, this study aimed to assess short birth intervals and associated factors among women who gave birth in the last three years in Dembecha district, Northwest Ethiopia, 2019. METHOD: A community-based cross-sectional study was conducted among 880 reproductive-age multipara mothers using a stratified cluster sampling technique. The data were collected by face-to-face interviews through pretested and semi-structured questionnaires. Bivariable and multivariable logistic regression model was fitted. Variables with a p-value ≤0.05 were considered statistically significant factors. Adjusted odds ratio with a 95% confidence interval was used to report the association between predictors and the outcome variable. RESULTS: The prevalence of short birth interval was found to be 43.4% (95% CI: 40.2, 46.9). Husband education (able to read and write) [AOR:2.81,(95% CI:1.04,7.85)], wealth index (lowest quartile) [AOR:3.75,(95% CI:2.35,5.97), residence (urban) [AOR:3.20,(95% CI:1.62,6.33)],age at first marriage (15-17 years old) [AOR: 1.65,(95% CI:1.15, 2.26),and non-use of contraceptive [AOR: 8.78, (95% CI: 6.18, 12.47) were statistically significant variables. CONCLUSION: The study revealed that the prevalence of short birth intervals among multipara women is found to be high. Husband education, wealth index, urban residence, age at first marriage, and non-use of contraceptives were variables significantly associated with short birth intervals. Hence, to overcome the problem the focus should be on increasing family planning utilization, avoiding early marriage, strengthening paternal education, and improving family income.

Knowledge and Attitude Towards Short Birth Interval among Rural Women who Gave Birth in the Last Three Years at Dembecha District, Northwest Ethiopia, 2019.

Background: A woman can have fewer children when intervals between consecutive births are optimal. This has great importance for the well-being of women, pregnancy outcomes, and the long-term health of children under the age of five. We can save 2millon of the 11 million deaths of children under the age of five per year by avoiding short birth intervals. It is affected by the knowledge and attitude of women, particularly rural women, who had a high fertility rate. To our deep review, this is the first study done in Ethiopia. Hence, this study aimed to assess knowledge and attitude towards short birth intervals and associated factors among rural women who gave birth in the last three years at Dembecha district, northwest Ethiopia. Method: A community-based cross-sectional study was conducted from September 20 to October 20, 2019. A cluster sampling technique was employed to select the study participants and data were collected using a pre-tested, semi-structured, interviewer-administered questionnaire. Bivariable and multivariable logistic regression model was fitted to identify factors associated with knowledge and attitude towards short birth interval. The level of significant association was declared using the adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p-value of <0.05. Result: From the total study participants, 66.4% (95% CI: 63.0-70.0) had good knowledge and 45.9% (95% CI: 42.3-49.8) had a positive attitude towards short birth intervals. In multivariable logistic regression: marital status, antenatal care follow-up, maternal occupation, and wealth status were significantly associated with knowledge. In addition, antenatal care follow-up and maternal occupation were significantly associated with attitude. Conclusion: Majority of the participants had poor knowledge and a positive attitude towards short birth intervals. Hence, interventions should be done to optimize women's knowledge and attitude towards short birth intervals by enhancing antenatal care utilization.

Long-Term Effects of Obstetric Fistula on the Overall Quality of Life among Survivors Who Had Undergone Obstetric Fistula Repair, Central Gondar Zone, Northwest Ethiopia, 2020: A Community-Based Study.

INTRODUCTION: Childbirth is a special time in the lives of women and families at large. It can also be a time of great tragedy. International reports show that, annually, more than 500,000 women die from pregnancy and childbirth complications globally. For every woman who dies in childbirth, majorities remain alive, but scarred by permanent disabilities. Obstetric fistula is, without a doubt, the most severe of pregnancy-related disabilities. OBJECTIVE: This research is aimed at assessing the long-term effects of obstetric fistula on the overall quality of life among fistula survivors in central Gondar zone. METHODS: A community-based cross-sectional study was conducted among women who had undergone obstetric fistula repair, 1-4 years after the surgery, in the central Gondar zone. The participants were reached through appointments that were made by the researchers using census approach after having the participants' contact lists (specific residence and cell phone numbers), and research interviews have taken place at the respondents' home or residence using an adapted and validated tool. Data entry and analysis were done using Epi Info version 7 and SPSS version 20, respectively. RESULTS: A total of 182 fistula survivors were interviewed giving a 94.8% response rate. This study indicated that 84.1% (95% CI: 78.8, 89.4) of respondents had a poor overall quality of life. Maternal age (>30 years) (AOR = 3.8, 95% CI: 2.6, 12.3), marital status (divorced survivors) (AOR = 2.7, 95% CI: 1.3, 8.5), and urinary incontinence (AOR = 1.9, 95% CI: 2.4, 11.2) were positive predictors for poor overall quality of life. The majority of fistula survivors, 82.4%, were stigmatized which could make reintegration into the community challenging for them. Healthcare providers have to implement counseling to women for social reintegration and the possibility of gainful societal activities after repairing.

Birth preparedness and complication readiness practice and associated factors among pregnant women in Northwest Ethiopia: 2018.

BACKGROUND: Birth-preparedness and complication readiness is a comprehensive strategy aimed at promoting the timely utilization of skilled maternal and neonatal health care. Pregnancy-related complications both on the mother and the newborn could be largely alleviated if there is a well-consolidated birth preparedness and complication readiness plan developed during pregnancy and implemented at the time of delivery. OBJECTIVE: To determine the prevalence of birth preparedness and complication readiness practice (BPCR) and associated factors among pregnant women in North Gondar Zone, Northwest Ethiopia, 2018. METHODS: A community based cross-sectional study was conducted among pregnant women in North Gondar Zone from March 2017 to February 2018. A multistage clustered sampling technique was used to enroll a total of 1620 participants. The data were collected by face to face interviews using pretested and semi-structured questionnaires at baseline and following delivery. The data were entered using EPI-data version 3.1 and analyzed using STATA version 14 software. Bivariate and multivariable logistic regression model was fitted to assess factors with BPCR practice. Adjusted odds ratio (AOR) with 95% confidence interval was used to determine the association between covariates and the outcome variable. RESULTS: From a total of 1620 pregnant women only 1523 (94.0%) mothers were followed at the end line. The prevalence of BPCR plan during pregnancy was 66.1% [95% CI: 63.8, 68.5] and the practice at the time of delivery was 73.5% [95% CI 71.3, 75.7]. Of the total respondents who mentioned having a BPCR plan, 76.4% practiced at the time of delivery. Frequency of ANC visits [AOR = 1.97; 95% CI: 1.67, 2.32], larger number of family in the household [AOR = 1.14; 95%CI: 1.00, 1.30], highest wealth asset [AOR = 1.87; 95%CI: 1.16, 3.01], Multigravidity [AOR = 0.30; 95% CI: 0.15, 0.62], husband involvement in decision making [AOR = 2.2; 95% CI: 1.25, 3.82], counseled on BPCR [AOR = 2.35; 95% CI: 1.51, 3.68], were found to be significantly associated with BPCR practice. CONCLUSION: BPCR practice at the time of delivery was higher than previous studies conducted in the country. However, BPCR practice was found to be lower than the standard that every woman should practice the plan at the time of delivery. Intersectoral collaborative interventions required to improve the economic status and living standard of families in the community as well as various awareness creation strategies should be implemented to support women to attend ANC follow-up visits.

Factors and outcomes associated with the induction of labor in referral hospitals of Amhara regional state, Ethiopia: a multicenter study.

BACKGROUND: Induction of labor is an artificial initiation of uterine contractions after fetal viability with the aim of vaginal delivery prior to the onset of spontaneous labor. Prevalence of induction of labor is increasing worldwide with subsequent increase in failure rate. However, there is limited evidence on labor induction in Ethiopia. Therefore, this study was aimed at assessing the prevalence and associated factors of failed induction of labor among women undergoing induction of labor at referral hospitals of Amhara national regional state, Ethiopia, 2016. METHOD: A multicenter cross-sectional study was conducted at referral hospitals found in Amhara national regional state from February 01 to September 30, 2016. Multistage sampling technique was employed to select a total of 484 women who underwent labor induction. Pre-tested structured questionnaires and checklists were used to collect the data. Data were entered into EPI info version 7 and analyzed using SPSS version 20 software. Stepwise Binary Logistic regression model was fitted to identify factors associated with failed induction of labor. The level of significance was determined based on the adjusted odds ratio with 95% confidence interval at the p-value of ≤0.05. RESULT: The prevalence of failed induction of labor among women undergoing induction of labor was 31.4% (95% CI: 27.0, 36.0). Failed induction of labor was independently predicted by a Bishop score of ≤5 (AOR = 2.1; 95% CI: 1.3, 3.6), prolonged latent first stage of labor (AOR = 2.0; 95% CI: 1.2, 3.5), induction with oxytocin alone (AOR = 4.2; 95% CI: 2.2, 8.1), nulliparity (ARO = 1.9; 95% CI: 1.2, 2.9), post term pregnancy (AOR = 4.1; 95% CI: 1.8, 9.3) and hypertensive disorder of pregnancy (AOR = 2.4; 95% CI: 1.5, 5.1). CONCLUSION: Failed induction of labor was high in the study area compared to the reports of previous studies done in Ethiopia. The majority of the determinants of failed induction of labor were connected with unjustifiable and inconsistent indication of induction of labor. Thus, preparing standardized practical guidelines and preventing unjustifiable case selection may help reduce the current high failure rates.

Utilization of cervical cancer screening and associated factors among women in Debremarkos town, Amhara region, Northwest Ethiopia: Community based cross-sectional study.

INTRODUCTION: Cervical cancer is the most common type of malignancy among all malignancies for women worldwide with 266 000 deaths every year. Even though there is a proven importance of cervical cancer screening, the death of women due to cervical cancer in Ethiopia is high. We, therefore, did this study to investigate the utilization of cancer screening and its associated factors among women in Debremarkos town, Amhara region, Ethiopia. METHODS: A community-based cross-sectional study was conducted among women from 30-49 years in Debremarkos town, from July 1 to August 30, 2018. A multistage sampling procedure was used to select 822 women in the study. We used EPI info version 7 for data entry and SPSS version 24 software for cleaning and analysis. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with the utilization of cervical cancer screening. Variables with a p-value of less than 0.05 were taken as significant variables. RESULT: The study revealed that 44 (5.4%) of women have been screened for cervical cancer. Women's age [AOR:3.126(1.246,7.845)], marital status (AOR:3.41(1.299,8.972)], educational status(secondary education level [AOR: 4.578(95% CI: 1.19, 17.65)] and College and above education level [AOR:7.27,95%CI: 2.07,25.513)]), started sexual intercourse for the first time below 16 years[AOR:3.021(1.84,4.97)], history of multiple sexual partners [AOR:2.51(1.040, 6.06)], history of sexually transmitted disease [AOR:4.04(1.68, 9.72),], knowledge on cervical cancer screening [AOR:4.02(2.07,7.77)] and attitude towards cervical cancer screening [AOR:3.23(2.52,4.12)] were significant factors for utilization of cervical cancer screening. CONCLUSION: This study showed the magnitude of the utilization of cervical cancer screening is very low. Women's age, marital status, educational status, age at first sex history of multiple sexual partners and sexually transmitted disease, knowledge and attitude were important factors of screening. Therefore, intervention programs that are aimed at improving cervical cancer screening practice among women should focus on the identified factors.

Appropriate complementary feeding practice and associated factors among mothers having children aged 6-24 months in Debre Tabor Hospital, North West Ethiopia, 2016.

OBJECTIVE: This study was aimed to assess appropriate complementary feeding practice and associated factors among mothers having children aged 6-24 months in Debre Tabor Hospital, North West Ethiopia, 2016. RESULTS: In this study, 37.2% of mothers had appropriate complementary feeding practice. Mothers' level of education above grade 12 (AOR = 2.96, CI 1.2-7.62), husbands' occupation (AOR = 4.01, CI 1.3-12.44), mothers 'having exclusive breast feeding practice (AOR = 6.12, CI 3.04-12.3), health education about exclusive breast feeding during antenatal care visit (AOR = 5.59, CI 1.24-25.17) and advice on appropriate complementary feeding practice during antenatal care visit (AOR = 6.34, CI 1.5-26.91), and mothers who have got under 5 unit service due to infant and young children illness (AOR = 0.44, CI 0.22-0.89) were statistically significant variables for appropriate complementary feeding practice.

Premarital sexual intercourse and associated factors among adolescent students in Debre-Markos town secondary and preparatory schools, north west Ethiopia, 2017.

OBJECTIVE: To assess the magnitude and factors associated with premarital sexual intercourse among adolescent students of the secondary and preparatory school in Debre-Markos town, northwest Ethiopia, 2017. RESULTS: Among secondary and preparatory school adolescent students, 31.3% reported pre-marital sexual intercourse. This shows that premarital sexual intercourse among secondary and preparatory school adolescents is high. Significantly associated factors were: being male (AOR = 1.9, 95% CI 1.21, 2.93), having pocket money (AOR = 3.1, 95% CI 2, 4.81), adolescents who did not discuss sexual issue with close friends (AOR = 8.6, 95% CI 5.27, 13.91) and peer pressure (AOR = 7.7, 95% CI 3.73, 15.69).

The role of counseling on modern contraceptive utilization among HIV positive women: the case of Northwest Ethiopia.

BACKGROUND: Over 90% of the children with Human Immunodeficiency Virus are infected through the mother to child transmission process according to literatures. Preventing unintended pregnancy by using contraceptive methods is crucial for reducing maternal and child mortality and morbidity. Here we set out to assess the prevalence and associated factors of modern contraceptive utilization among sexually active reproductive age women attending Anti-Retroviral Therapy clinics in Amhara Region referral hospitals in 2016. METHODS: An institution based cross sectional study was carried out from April to July 2016 surveying women of reproductive age attending the Anti-Retroviral Therapy clinics in the five Amhara Region referral hospitals. A pretested and semi-structured questionnaire was used to collect data. EpiInfo7 and SPSS version 20 soft wares were used for data entry and analysis, respectively. Significant associations were identified on the basis of the adjusted odds ratio, with 95% Confidence Interval, and p value ≤0.05, was taken as statistically significant. RESULT: The proportion of women utilizing modern contraceptives was 47.7% with (95% CI: 43, 52.5%), the male condom being the most (64.2%) utilized method. The use of the contraceptive methods was most prevalent among women 15-24 years of age (AOR = 6.5, 95% CI: 2-10) and age of 25-34 (AOR = 3, 95% CI: 1.6-5.5), having an urban residence (AOR = 0.095, 95% CI: 0.03-0.28), having discussed contraceptives with partner (AOR = 7, 95% CI: 5.3-11.9), receiving counseling from health care providers (AOR = 4.8, 95% CI: 1.8-7), previous history of contraceptive utilization (AOR = 5.6, 95% CI: 2.6-8.3), and with CD4 count >500mm3/dl (AOR = 2.4, 95% CI: 1.3-4.3). CONCLUSION: The proportion of women utilizing contraceptive has been low in Amhara Region referral hospitals. Encouraging patients to discuss about contraception with partners and repeated counseling by health care providers may strengthen contraceptive utilization.

Prevalence and associated factors of dysmenorrhea among secondary and preparatory school students in Debremarkos town, North-West Ethiopia.

BACKGROUND: Dysmenorrhea is one of the most common gynecologic disorders and a frequently observed cause of anxiety and discomfort among female adolescents. Its prevalence varies between 16% and 91% in women of reproductive age. Its population statistics are too scant in Ethiopia. This study was aimed to determine the prevalence and associated factors of dysmenorrhea among secondary and preparatory school students in Debremarkos town, 2016. METHODS: Institutional based cross-sectional study was employed from Sept.26 to Oct.17, 2016 among secondary and preparatory school students in Debremarkos town. Self-administered questionnaire was used to collect data from 539 individuals selected by simple random sampling technique. Data were checked, coded and entered into Epi-data version 3.1 and exported to SPSS version 20 for analysis. Univariate, bivariate and multivariable analysis were carried out. Binary logistic regression model was computed and P value < 0.05 was considered as significant. All ethical procedures were considered. RESULTS: The prevalence of dysmenorrhea was 69.3%. Age, AOR (95% CI) =1.38(1.15, 1.65), family history of dysmenorrhea, AOR (95% CI) = 9.79(4.99, 19.20), physical activity, AOR (95% CI) =0.39(0.13, 0.82), sugar intake, AOR (95% CI) =2.94 (1.54, 5.61), early menarche AOR (95% CI) =4.10(1.21,13.09), late menarche AOR (95% CI) =0.50 (0.27, 0.91), heavy menstrual periods AOR (95% CI) =2.91(1.59, 5.35) and sexual intercourse AOR (95% CI) =0.24 (0.10.0.55) had statistically significant association with the occurrence of dysmenorrhea. CONCLUSIONS: Age, positive family history of dysmenorrhea, physical activity, excessive sugar intake, early menarche, late menarche, sexual intercourse and heavy menstrual periods had a statistically significant association with the occurrence of dysmenorrhea.