Knowledge and attitude of women towards maternity waiting homes and associated factors among women who gave birth in the last twelve months in Dega Damot district, northwest Ethiopia.

Background: Maternal waiting homes have been identified as one strategy to reduce maternal and perinatal mortality by bringing women living in hard-to-reach areas closer to a health facility that provides emergency obstetric care. Even if utilization of maternal waiting homes is repeatedly assessed, there is a scarcity of evidence in Ethiopia regarding women's knowledge and attitude towards maternal waiting homes. Objective: This study aimed to assess women's knowledge and attitude towards maternity waiting homes and associated factors among women who gave birth in the last twelve months in northwest Ethiopia. Methods: A community-based cross-sectional study was conducted from January 1st to February 30th, 2021. A total of 872 participants were selected by using a stratified cluster sampling technique. Data were collected by face-to-face interviews using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI data version 4.6 and analysis was done through SPSS version 25. The multivariable logistic regression model was fitted and the level of significance was declared at a p-value of ≤0.05. Result: Women's adequate knowledge and positive attitude towards maternal waiting homes were 67.3% (95% CI: 64-70) and 73% (95% CI: 70-76), respectively. Had antenatal care visit, the shortest distance to reach the nearby health facility, had history of maternal waiting homes utilization, always involved in health care decision, and sometimes involved in health care decisions were significantly associated with women's knowledge regarding maternal waiting homes. Moreover, secondary and above educational level of women, short distance to reach the nearby health facility and had antenatal care visit were significantly associated with women's attitude towards maternity waiting homes. Conclusion: About two-third of women had adequate knowledge and nearly three-fourth of women had a positive attitude towards maternity waiting homes. It is better to improve the accessibility and utilization of maternal health services Furthermore, it is better to promote women's decision making power and create motivation to have better academic achievement of women.

Anxiety and associated factors in Northwest Ethiopian pregnant women: a broad public health concern.

Introduction: Pregnancy-related anxiety is a prevalent mental health issue that mostly affects women in low-income countries such as Ethiopia. It has been linked to unfavorable pregnancy outcomes, such as miscarriage, prematurity, and low birth weight. However, it has often received less attention, and community-based evidence lacks its prevalence and associated factors. Thus, the purpose of this study was to assess the prevalence and associated factors of anxiety in Northwest Ethiopian pregnant women in Gondar city. Methods: A community-based cross-sectional study was conducted from 1 July to 30 August 2021 in Gondar city. A cluster sampling technique was used to select a sample of 872 pregnant women, and in-person interviews were conducted to gather data. Descriptive and analytical statistical procedures were carried out. Results: Of the participants, pregnancy-related anxiety was reported in 29.4% (95% CI: 26.3, 32.4) of women. The likelihood of having anxiety was higher among women who had known medical illness (AOR = 3.16; 95% CI: 1.8, 5.35), loneliness (AOR = 2.52; 95% CI: 1.34, 4.73), depression (AOR = 2.38; 95% CI: 1.48, 3.85), poor social support (AOR = 1.93; 95% CI: 1.21, 3.07), and intimate partner violence (AOR = 2.87; 95% CI: 2.04, 4.04). Conclusion: In this study, three out of ten women have suffered from anxiety. It is strongly advised to identify and treat known medical illnesses early in pregnancy, enhance social support, diagnose and treat depression, and limit intimate partner violence through multimodal and integrative activities with concerned bodies.

Self-harm among post-natal mothers in Northwest Ethiopia: Implication for policy and practice.

Introduction: Self-harm is a global public health concern affecting thousands of women. However, it is an under-reported and neglected aspect of maternal health, particularly in developing countries. In Ethiopia, there is a paucity of evidence regarding self-harm, and it is rarely given attention. Therefore, this study aimed to assess the proportion of self-harm and associated factors among postnatal mothers in Gondar city, Northwest Ethiopia. Method: A community-based cross-sectional study was conducted from 1 July, 2021, to 30 August, 2021, in Gondar city. A cluster sampling technique was conducted to select 858 women who gave birth in the last 12 months. The data were collected using a structured questionnaire through face-to-face interviews. The data were entered into EpiData version 4.6 and exported to SPSS 25 for analysis. The multivariable logistic regression analysis was fitted to identify factors associated with the outcome variable. The level of significant association was determined at a p-value of ≤ 0.05. Result: The proportion of postnatal self-harm was found to be 8.5% (95% CI: 6.7,10.5). Having lower family income (AOR: 2.41, 95% CI: 1.05,5.56), having unplanned pregnancy (AOR: 2.70, 95% CI: 1.53,4.79), experiencing adverse birth outcomes (AOR: 3.11, 95% CI: 1.10,8.83), birth not attended by health provider (AOR: 4.15, 95% CI: 1.76,9.79), experiencing intimate partner violence (AOR: 1.93, 95% CI: 1.12,3.32), and poor decision-making power (AOR: 1.70, 95% CI: 1.02, 2.84) were the variables significantly associated with self-harm. Conclusion: This study revealed that the proportion of self-harm among postnatal mothers was prevalent. Factors like monthly income of a family, planned pregnancy, birth outcome, birth assistant, intimate partner violence, and decision-making power show an association with maternal self-harm. Antenatal and postnatal self-harm screening as part of the continuum of maternal healthcare is important. Self-harm is also a danger for women who have experienced intimate partner violence or have low socioeconomic economic status, all of which require exceptional mental health assessment.

Low husband involvement in maternal and child health services and intimate partner violence increases the odds of postpartum depression in northwest Ethiopia: A community-based study.

BACKGROUND: Depression is the most common mental health problem that affects women during pregnancy and after child-birth. Postpartum depression, in particular, has both short and long-term effects on the lives of mothers and children. Women's health is a current global concern, but postpartum depression is a neglected issue in the maternal continuum of care and is rarely addressed. Therefore, this study aimed to assess postpartum depression and associated factors in Gondar city, northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted from August 1st to 30th, 2021 in Gondar city. A cluster sampling technique was employed to select 794 postpartum women. Data were entered by EPI DATA version 4.6 and exported to SPSS version 25 for further analysis. The multivariable logistic regression analysis was carried out to identify factors associated with postpartum depression. The adjusted odds ratio with its 95% confidence interval at a p-value of ≤ 0.05 was used to declare the level of significance. RESULTS: A total of 794 women were included in the analysis, giving a response rate of 98.5%. The prevalence of postpartum depression was 17.25% (95% CI: 14.5, 20.2). Younger maternal age (AOR = 2.72, 95% CI: 1.23, 5.85), low average monthly income (AOR = 2.71, 95% CI: 1.24, 5.91), low decision-making power (AOR = 2.04, 95%CI: 1.31, 3.18), low husband/partner involvement in MNCH care service (AOR = 2.34, 95%CI: 1.44, 3.81), unplanned pregnancy (AOR = 3.16 95% CI: 1.77, 5.62), and experience of intimate partner violence (AOR = 3.13; 95% CI: 1.96, 4.99) were significantly associated with increased odds of postpartum depression. CONCLUSION: In this study, nearly 1/5th of the study participants had postpartum depression. Thus, it is important to integrate maternal mental health services with the existing maternal health care services. It is also crucial to advocate the need for husband's involvement in MNCH care services and ensure women's decision-making power in the household. Moreover, community-based sexual and reproductive health education would be better to reduce risk factors of postpartum depression.

Husband Involvement in Maternal, Neonatal, and Child Health Care among Women who Have a Child Less Than one Year in Gondar City, Northwest Ethiopia, 2021.

Background: Improving maternal, neonatal and child health is one of the major components of Sustainable Development Goal and countries implement different strategies to achieve this goal. In spite of this, maternal, neonatal and child mortality remains a public health burden in the developing countries, including Ethiopia. World Health Organization recommend active involvement of men during pregnancy, child birth and the postpartum period as an effective strategy to improve maternal as well as newborn health. Therefore, this study aimed to assess husband involvement in maternal, neonatal and child health care among women who have child less than one year in Gondar city, northwest Ethiopia. Methods: A community-based cross-sectional study was conducted among 870 married women who have a child less than one year in Gondar city. A cluster sampling technique was employed to select study participants. Data were entered into Epi Data version 4.6 and exported to SPSS version 25 for analysis. Multivariable logistic regression was done and adjusted odds ratio with a 95% confidence interval was used to report the association between covariates and the outcome variable. Results: Husband involvement in Maternal, Neonatal and Child Health (MNCH) care was 66.2% (95%CI: 63, 69.3). Maternal age (18-25years) and (26-35years), having diploma and above education, husband occupation (government employee), (merchant) and (self-employed), planned pregnancy and cesarean delivery were significantly associated with husband involvement in MNCH care. Conclusion: In this study, nearly two thirds (66.2%) of women had husband involvement in MNCH care. Therefore, it is important to improve women's educational attainment and actions should be taken to prevent unplanned pregnancy.

Consistent condom use and its associated factors among human immunodeficiency virus-positive pregnant women in Ethiopia.

Background: Consistent condom use plays a significant role in the successful protection of the transmission of human immunodeficiency virus (HIV) infection in couples with sero-discordant HIV status, mother-to-child-transmission (MTCT), and acquiring other strains in HIV-positive concordant pairs. Limited data and information about this issue are available in low-resource setting countries, including the study setting. Therefore, this study aimed to assess the level of consistent condom use and its associated factors among HIV-positive pregnant women. Materials and methods: An institution-based cross-sectional study was done from 17 October 2020 to 1 March 2021. A total of 423 HIV-positive pregnant women were involved in this study and selected using a systematic random sampling technique. Data were collected using a semi-structured, pretested, and interviewer-administered questionnaire and then entered into EPI INFO version 7 and analyzed using Statistical Package for Social Sciences (SPSS) version 21. Logistic regressions were performed to identify factors. P-Value ≤ 0.05 denotes statistical significance. Results: The prevalence of consistent condom use among HIV-positive pregnant women was 14.2% [95% confidence interval (CI) 10.9%, 17.5%]. Women having a higher educational status [adjusted odds ratio (AOR) = 6.33, 95% CI 1.96, 20.42], women having a CD4 count > 600 cells/mm (AOR = 4.78, 95% CI 2.08, 10.97), women testing positive for HIV during the non-pregnant state (AOR = 5.99, 95% CI 3.01, 11.94), and women disclosing their HIV status to sexual partners (AOR = 4.85, 95% CI 1.71, 13.71) were found to be statically significant with women's consistent condom use. Conclusion: In this study, consistent condom use among HIV-positive pregnant women was low. Women having educational status of college and above studies, women testing positive for HIV during the non-pregnant state, women disclosing their HIV status to a sexual partner, and women having a CD4 count > 600 cells/mm had better consistent condom use. Hence, giving more emphasis on health education and counseling service about HIV testing before pregnancy, and disclosing their HIV status to their sexual partners and about the need for consistent condom use during pregnancy would be important.

Prevalence and associated factors of poor sleep quality among postpartum women in North West Ethiopia: a community-based study.

INTRODUCTION: Although sleep disturbance is a community problem, there is limited study in Ethiopia. Therefore, this study aimed to identify the prevalence and factors affecting postpartum poor sleep quality in women. METHOD: A community-based cross-sectional study was conducted from July 1st to August 30th, 2021 in Gondar city. The cluster sampling method was used to address 858 study participants. The Pittsburgh Sleep Quality Index (PSQI) 19-item self-report measure of sleep quality over the past month was used to measure maternal sleep quality during the postpartum period and a global PSQI score of 5 or more was used to indicate poor sleep quality. Binary logistic regression was used to identify variable association and 95% confidence level and adjusted Odds Ratio were used to declare association. RESULT: Poor sleep quality prevalence during postpartum period was 24.0% (95%CI: 21.3-26.9). factors significantly associated with poor sleep quality were family size [AOR = 1.76; 95% CI: (1.14-2.73)], unplanned pregnancy [AOR = 2.11; 95%CI: (1.17-3.80)], had a family history of mental illness [AOR = 3.70; 95%CI: (2.15-6.37)], had known medical disorders [AOR = 2.59; 95%CI: (1.51-4.43)], having intimate partner violence [AOR = 2.58; 95%CI: (1.78-3.75)], and women who can read and write and who complete secondary school [AOR = 2.60; 95% CI: (1.20-5.66)] and [AOR = 2.02; 95%CI: (1.16-3.53)] respectively. On the other hand, being housewife, merchant, and government-employed [AOR = 0.32; 95%CI: (0.14-0.73)], [AOR = 0.13; 95%CI: (0.05-0.34)], and [AOR = 0.38; 95%CI: (0.14-0.98)] respectively were identified to be factors significantly associated with poor sleep quality. CONCLUSION: Poor sleep quality prevalence is high in the community of Gondar city. Thus, setting strategies to increase women's educational level, providing health education programs to create awareness on the consequence of intimate partner violence which could reduce the violence; increasing screening for medical disorders before or during maternity period, preventing unplanned pregnancy with effective family planning method, and employing women in a certain organization will have a great role in reducing poor sleep quality.

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.

Prevalence and factors associated with maternal loneliness during the postpartum period in Gondar city.

Background: Mental health problems have increased worldwide, particularly in developing countries. Currently, loneliness is widely understood as a painful subjective experience when the social connections a person has do not meet their interpersonal needs in respect to the quality or quantity of friendship or social interaction. It has been linked to unpleasant health consequences for both the mother and child. Therefore, this study aimed to assess maternal loneliness during the postpartum period and associated factors in Gondar city. Methods: A community-based cross-sectional study was conducted from July 1st to August 30th, 2021 in Gondar city. A cluster sampling technique was employed to select 858 postpartum women. Data were entered into epidemiological data (EPI data) version 4.6 and exported to SPSS 25 for further cleaning and analysis. The multivariable logistic regression analysis was fitted to identify factors associated with maternal loneliness during the postpartum period. The adjusted odds ratio (AOR) with its 95 % confidence interval (CI) was performed and the level of significance was claimed based on a p-value of ≤0.05. Results: A total of 858 women were included in the analysis, giving a response rate of 98.4%. Two-fifths (40.9%) of the study participants have experienced loneliness during the postpartum period (95% CI: 37.6, 44.2). Low household decision-making power (AOR = 11.2; 95% CI: 7.59, 16.4) and poor social support (AOR = 2.44; 95 CI: 1.58, 3.76) were significantly associated with maternal loneliness. Conclusion: In this study, 4 out of 10 women have experienced loneliness during the postpartum period. Thus, it highlights the potential risks of the mother's loneliness on her postnatal well-being, particularly if the woman has poor social support and low household decision-making power. Encouraging women to be involved in all aspects of the household decision-making and promoting the need for social support for all women during the postpartum period may be optimal initial targets to reduce the impact of loneliness.

Nearly Half of Women Have Experienced Intimate Partner Violence During Pregnancy in Northwest Ethiopia, 2021; The Role of Social Support and Decision-Making Power.

Background: In developing countries, intimate partner violence is increasing alarmingly, though attention to this issue is rarely given. It has devastating effects on the general wellbeing of women, pregnancy outcomes, and the long-term health of children, and this needs to be addressed. Hence, this study was designed to assess intimate partner violence and associated factors in northwest Ethiopia. Methods: A community-based cross-sectional study was conducted from July 1st to August 30th, 2021, among 858 postpartum women in Gondar city. A cluster sampling technique was employed to select the study participants. EPI DATA version 4.6 and SPSS 25 were used for data entry, cleaning and analysis, respectively. A bivariable and multivariable logistic regression model was fitted to identify factors associated with intimate partner violence. 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. Results: In this study, 48.6% of women indicated having experienced intimate partner violence during pregnancy (95% CI: 45.3, 51.7). The odds of intimate partner violence during pregnancy were significantly higher among women who were not able to read and write (AOR = 4.96; 95% CI: 2.15, 11.41), were private workers (AOR = 1.78; 95% CI: 1.05, 3.02), and had low decision-making power (AOR = 1.43; 95% CI: 1.06, 1.95), a poor social support (AOR = 1.99; 95% CI: 1.32, 3.02), and unsupported pregnancy by family (AOR = 2.32; 95% CI: 1.26, 4.24). Whereas a family size of ≥ 5 (AOR = 0.73; 95% CI: 0.54, 0.98) appeared to be a protective factor for intimate partner violence. Conclusion: The magnitude of intimate partner violence was unacceptably high in the study area and connected to poor women's empowerment and social determinants of health. Thus, it is important to focus on interventions that improve women's access to social support and allow them to participate in all aspects of household decision-making through community-based structures and networks. It is also important to encourage women to improve their educational status and arrange risk-free employment opportunities.

Knowledge and Attitude towards COVID-19 Vaccination and Associated Factors among College Students in Northwest Ethiopia,2021.

Background: It is imperative to ensure optimal vaccine uptake at the population level to combat the deadly COVID-19 pandemic disease. However, refusal of the COVID-19 vaccine, poor knowledge, and a negative attitude towards vaccination are the challenges of the world. College students are among the high-risk subgroups of the population to COVID-19 infection and the main source of information and trust in vaccines to the society. Also, their judgement on vaccine affect the public attitude towards vaccination. Therefore, this study aimed to assess knowledge and attitude towards COVID-19 vaccination and associated factors among college students in Gondar city, northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted among 626 study participants in Gondar city. A multistage sampling technique was used to recruit the study participants. A pretested self-administered questionnaire was used to collect the data. Bivariable and multivariable logistic regression analyses were performed to assess factors associated with knowledge and attitude towards COVID-19 vaccination. The level of significance was claimed based on a p-value < 0.05. Results: In this study, 46.8% (95% CI: 43.3, 50.6) of study participants had good knowledge and 50% (95% CI: 45.9, 53.7) had a positive attitude towards COVID-19 vaccination. Having comorbidity disease and being male were significantly associated with good knowledge. In addition, being married, being a health science student, being exposed to mass media, having a good knowledge of COVID-19 vaccination, and having paternal primary education were significantly associated with a positive attitude towards COVID-19 vaccination. Conclusion: In general, knowledge and attitude towards COVID-19 vaccination among college students are low. Comorbidity disease and sex were predictors of COVID-19 vaccination knowledge, whereas, marital status, category of college students, mass media, paternal education and knowledge about COVID-19 vaccination were predictors of COVID-19 vaccination attitude. Alleviating participants' concerns and improving their confidence through health education is crucial.

Adherence to COVID-19 preventive practice and associated factors among pregnant women in Gondar city, northwest Ethiopia, 2021: Community-based cross-sectional study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) causes more than five million deaths worldwide. Pregnant women are at high risk for infection due to the physiologic change in the immune and cardiopulmonary system and also it increases the risk of severe disease, intensive care unit admission, and receive mechanical ventilation when compared with non-pregnant women. It is associated with adverse maternal and neonatal outcomes. So pregnant women need to have adhered to preventive measures to prevent COVID-19 related consequences. Therefore, this study aimed to assess adherence toCOVID-19 preventive practice and associated factors among pregnant women in Gondar city, northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted from July 1st to 30th, 2021, in Gondar city. A cluster sampling technique was employed to select 678 pregnant women. Data were collected using a pre-tested, face-to-face interviewer-administered questionnaire. Data were entered into EPI DATA version 4.6 and exported to SPSS version 25 for analysis. Both bivariable and multivariable logistic regression analysis was fitted to identify associated factors. Adjusted odds ratio with a 95% confidence interval was used to report the association between covariates and the outcome variable. RESULTS: The prevalence of good adherence to COVID-19 preventive practice was 44.8% (95% CI: 41.3, 48.7). Maternal age (≤24 years) [AOR = 2.89, 95% CI: 1.37, 6.10], maternal education (secondary school) [AOR = 2.95, 95% CI: 1.58, 5.53] and (college and above) [AOR = 4.57,95% CI: 2.42, 8.62], having ANC follow up [AOR = 2.95, 95% CI: 1.35, 6.46] and adequate knowledge towards COVID-19 [AOR = 1.70, 95% CI: 1.20, 2.41] were significantly associated with good adherence to COVID-19 preventive practice. CONCLUSION: In this study, adherence towards COVID-19 preventive practice in pregnant women is low. Hence, it is important to strengthen women's awareness about COVID-19 through different media and health education. In addition, empowering women to attain ANC and special consideration should be given to women who had no formal education.