Prevalence of female genital mutilation and associated factors among women and girls in Africa: a systematic review and meta-analysis.

BACKGROUND: Female genital mutilation (FGM) has zero health benefits. It can lead to short- and long-term risks and complications, including physical, sexual, and mental health and well-being of girls and women. It is a worldwide public health issue with more than 80% prevalence in Africa. It is a global imperative to strengthen work for the elimination, and the United Nations Sustainable Development Goal (SDG) strives to eliminate FGM and monitor the progress made. However, one of a challenge in tracking progress is establishing baseline prevalence data within regions and countries. Therefore, this review aimed to pool the prevalence of FGM in Africa and identify the promoting factors among women and girls. METHODS: This review was conducted according to the PRISMA checklist guideline. Both published and unpublished studies conducted from 2012 onwards were eligible. Studies written in non-English languages were excluded. To retrieve relevant studies; PubMed/Medline, Google Scholar, Science Direct, African Journals Online databases, and African Index Medicus (AIM) were searched using a combination of searching terms. The Newcastle-Ottawa Assessment Scale (NOS) tool was used to assess the quality of each included study. The Cochran's Q chi-square and I2 statistical tests were used to evaluate the heterogeneity of the included studies. The Funnel plot and Egger's regression test (p value < 0.05) were used to evaluate meh publication bias. We used STATA for analysis and the overall and subgroup pooled effect size was estimated using the random effect model with DerSimonian and Laired pooled effect method. The overall prevalence of FGM and the adjusted odds ratio (AOR) with 95%CI (confidence interval) for contributing factors were calculated and presented using a forest plot. RESULT: This study included 155 primary studies conducted on the prevalence and/or factors associated with FGM in Africa. The pooled prevalence of FGM was 56.4% (95%CI 49.7-63.6). The primary factors promoting the practice of FGM were family history of circumcision (AOR = 13.71, 95%CI 9.11-20.62), being a Muslim religion follower (AOR = 3.51, 95%CI 2.61-4.71), poor wealth index (AOR = 1.38, 95%CI1.27-1.51), higher age (AOR = 2.95, 95%CI 2.49-3.38), not attending formal education (AOR = 3.28, 95%CI 2.62-4.12), and rural residency (AOR = 2.27, 95%CI 1.84-2.80). CONCLUSION: The prevalence of FGM in Africa was found to be high. This study also observed a variation in FGM prevalence across regions and countries and a slight temporal decline over the study period. As the global community enters the final decade dedicated to eliminating FGM, there remains much to be done to achieve the elimination goal.

Prevalence of female genital mutilation and associated factors among daughters aged 0-14 years in sub-Saharan Africa: a multilevel analysis of recent demographic health surveys.

Background: Female genital mutilation (FGM) is a harmful traditional practice involving the partial or total removal of external genitalia for non-medical reasons. Despite efforts to eliminate it, more than 200 million women and girls have undergone FGM, and 3 million more undergo this practice annually. Tracking the prevalence of FGM and identifying associated factors are crucial to eliminating the practice. This study aimed to determine the prevalence of FGM and associated factors among daughters aged 0-14 years. Methods: The most recent Demographic Health Survey Data (DHS) datasets from sub-Saharan African countries were used for analysis. A multilevel modified Poisson regression analysis model was applied to identify factors associated with FGM. Data management and analysis were performed using STATA-17 software, and the pooled prevalence and adjusted odds ratio (AOR) with a 95% confidence interval (CI) were reported. Statistical significance was set at p ≤ 0.05. Results: The study included a weighted sample of 123,362 participants. The pooled prevalence of FGM among daughters aged 0-14 years in sub-Saharan Africa was found to be 22.9% (95% CI: 16.2-29.6). The daughter's place of birth (AOR = 0.54, 95% CI: 0.48-0.62), mother's age (AOR = 1.72, 95% CI: 1.4-2.11), father's education (AOR = 0.92, 95% CI: 0.87-0.98), mother's perception about FGM (AOR = 0.42, 95% CI: 0.35-0.48), FGM as a religious requirement (AOR = 1.23, 95% CI: 1.12-1.35), mother's age at circumcision (AOR = 1.11, 95% CI: 1.01-1.23), residing in rural areas (AOR = 1.12, 95% CI: 1.05-1.19), and community literacy level (AOR = 0.90, 95% CI: 0.83-0.98) were factors associated with FGM. Conclusion: The high prevalence of FGM among daughters aged 0-14 years in sub-Saharan Africa indicates the need for intensified efforts to curb this practice. Addressing the associated factors identified in this study through targeted interventions and policy implementation is crucial to eradicate FGM and protect the rights and well-being of girls.

Factors associated with anemia among pregnant women attended antenatal care: a health facility-based cross-sectional study.

Anemia is characterized by a decline in the number or size of red blood cells and Hb concentration, which results in impairment capacity to transport oxygen. It is a major cause of indirect maternal mortality. Anemia is largely preventable and easily treatable, if detected in time; however, it remains one of the leading causes of maternal morbidity and mortality, especially in developing countries. This study aimed to assess factors associated with anemia among pregnant women who attended antenatal care. Methods: A health facility-based cross-sectional study was conducted from 1 February 2020 to 2 March 2020 among 420 pregnant women. The data were collected by systematic random sampling technique, entered into a computer using EpiData 3.5, and analyzed using the Statistical Package of Social Sciences 23.0 version. Bivariate and multivariable logistic regression analyses were done to estimate the crude and adjusted odds ratio with a CI of 95% and a P-value of less than 0.05 considered statistically significant. Frequency tables, figures, and descriptive summaries were used to describe the study variables. Results: The overall prevalence of anemia was 32.9% (95% CI: 28.6-37.4), and it was higher in rural than urban pregnant women (45 vs. 23%), respectively. In multivariable analysis women who are found in the age group of greater than or equal to 30 years (AOR=3.45, 95% CI=1.22-9.78), rural residency (AOR=3.51, 95% CI=1.92-6.42), low family income (AOR=3.10, 95% CI=1.19-8.08), multiparty (AOR=2.91, 95% CI=1.33-6.38), a short interpregnancy gap (AOR 3.32, 95% CI=1.69-6.53), not taking iron and folate (AOR=4.83, 95% CI=2.62-9.90), third trimester of pregnancy (AOR=3.21, 95% CI=1.25-8.25), poor minimum dietary diversity score (AOR=3.54, 95% CI=1.58-7.95), undernourished (AOR=4.9, 95% CI=2.19-7.64), poor knowledge of anemia (AOR=3.19, 95% CI=1.72-5.93), consumption of coffee always after meal per day (AOR=3.24, 95% CI=1.42-7.42), having a history of irregular menstruation, and antepartum hemorrhage were significantly associated with anemia in pregnant women. Conclusion: This study showed that the prevalence of anemia in pregnant women in this study area was a moderate public health problem. The author suggest emphasizing the education and counseling of women on the advantage of taking the supplemented iron and folic acid. Health care providers should have to advise women to stay for at least 2 years before the next pregnancy to reduce the risk of adverse maternal and infant outcomes. Awareness creation in the community on the utilization of insecticide-treated bed nets is also needed.

Alcohol consumption and its determinants among pregnant women in Gozamin district, Amhara, Ethiopia, 2020.

Objective: Alcohol consumption during pregnancy can cause many major severe illnesses to both mothers and their offspring. Despite this, many pregnant women consume both homemade and manufactured alcoholic beverages. We conducted this study to assess the prevalence and determinants of alcohol consumption among pregnant women in Gozamin district, Amhara, Ethiopia, in 2020. Methods: Community-based cross-sectional study was employed from 1 to 30 November, 2020. The participants were recruited using a stratified multi-stage sampling technique. A structured and pretested interviewer-administered questionnaire was utilized for data collection. The collected data were entered into Epi-data Version 3.1 and exported to SPSS Version 25 for further analysis. The model fitness was checked by Hosmer and Lemeshow's goodness of fit test. Then, logistic regression models were considered to determine the associations of independent variables with the outcome variable. Variables with p < 0.25 in bivariable logistic regression were considered for multivariable logistic regression. Finally, variables with p < 0.05 in multivariable logistic regression were considered as determinants of alcohol consumption. Result: A total of 555 pregnant women participated in this study, making the response rate of 97.4%. The prevalence of alcohol consumption among the participants was 45.6% (95% confidence interval = 41.4-49.2). The determinants of alcohol consumption among the participants were highest wealth index (adjusted odds ratio = 3.21; 95% CI = 1.68-6.14), pre-pregnancy alcohol consumption (adjusted odds ratio = 3.67; 95% confidence interval = 2.36-5.71), poor social support (adjusted odds ratio = 3.08; 95% confidence interval = 1.60-5.94), and unplanned pregnancy (adjusted odds ratio = 1.66; 95% confidence interval = 1.04-2.66). Conclusion: In this study, the prevalence of alcohol consumption was high among the pregnant women. Our findings suggest introduction of policies and interventions that can help reduce alcohol consumption during pregnancy. The health education priority should be creation of awareness about the negative health impacts of alcohol on the health of pregnant mothers and their offspring.

Women living with HIV and dual contraceptive use in Ethiopia: systematic review and meta-analysis.

BACKGROUND: Despite different preventive strategies that have been implemented in the country, the prevalence of HIV/AIDS is still significantly increasing in Ethiopia. The concurrence of HIV and unintended pregnancy makes the use of dual contraception a back bone for the simultaneous protection against HIV, and unintended pregnancy. As a result, this systematic review and meta-analysis aimed to assess the prevalence and associated factors of dual contraceptive use among women living with HIV in Ethiopia. METHOD: We used databases; (PubMed, Google Scholar, EMBASE, Cochrane Library, African Online Journals, and Hinary), other gray and online repository accessed studies were searched using different search engines. For critical appraisal of studies Newcastle-Ottawa Quality Assessment Scale (NOS) was used. The analysis was done using STATA 11 software. The Cochran Q test and I2 test statistics were used to assess the heterogeneity. To detect publication bias funnel plot and Egger's test were used. The pooled prevalence of dual contraception use and the odds ratio (OR) with a 95% confidence interval was presented by using forest plots. RESULT: Eleven studies were included in this review, with a total of 4083 women living with HIV in Ethiopia. The pooled prevalence of dual contraception use in Ethiopia was 34.08% (95%CI: 20.77-47.38). Having open partner discussion (OR = 3.96, 95%CI:2.3,6.8), provision of post test counseling (AOR = 4.38, 95%CI:2.93,6.54), disclosed HIV status to sexual partners (OR = 5.9, 95%CI:4.19,8.33), partner involvement in post-test counseling (OR = 3.52, 95%CI:2.37,5.23), and being on highly active antiretroviral therapy (HAART) (OR = 2.9, 95%CI:1.56,5.46) were the determinant factors of dual contraceptive use in Ethiopia. CONCLUSION: The overall prevalence of dual contraceptive use among women living with HIV in Ethiopia was low. Having open partner discussion, provision of post-test counseling, disclosed HIV status to sexual partner, partner involvement in post-test counseling, and currently on highly active antiretroviral therapy (HAART) were the associated factors of dual contraceptive use. Therefore, efforts should be made to provide post-test counseling, and initiate partner involvement in post-test counseling. Moreover, promoting open partner discussion, counseling to disclose HIV status to their sexual partner and to start HAART will be helpful in enhancing the use of dual contraceptive method use.

Association between antenatal care utilization pattern and timely initiation of postnatal care checkup: Analysis of 2016 Ethiopian Demographic and Health Survey.

BACKGROUND: Despite significant public health intervention, maternal mortality remains high in low- and middle-income countries, including Ethiopia. Effective postnatal care is a critical service to reduce maternal mortality. In Ethiopia, only 17% of mothers received postnatal care services in 2016. OBJECTIVE: This study examined the association between antenatal care and timely postnatal care checkup among reproductive-age women in Ethiopia. METHODS: The study used the 2016 Ethiopian Demographic and Health Survey data. The current study included 4,081 women who give birth in the two years preceding the survey. Chi-square test and multivariable logistic regression analyses were used to examine the association between antenatal care and timely initiation of postnatal care. RESULTS: Postnatal care services within 2 days of delivery were received by 16.5% of women. Women who had at least four timely antenatal care visits had higher odds of timely postnatal checkups compared to women who had no antenatal care [adjusted Odds Ratio (aOR): 2.50; 95% CI 1.42-4.42]. Women who had at least four antennal care visits without timely initiation also had higher odds of postnatal check-up than their counterparts (aOR: 2.46; 95%CI: 1.22-4.97). Other factors significantly associated with timely initiation of PNC were secondary and above education (aOR: 1.64; 95%CI: 1.03-2.60), perceived distance to the nearby health facility as a significant barrier (aOR: 1.55; 95%CI: 1.15-2.09), primiparous (aOR: 0.34; 95%CI: 0.19-0.61) and institutional delivery (aOR: 14.55; 95%CI: 2.21-95.77). CONCLUSION: The prevalence of timely initiation of postnatal care in Ethiopia is very low. Women who received recommended antenatal care services had higher odds of timely initiation of postnatal care. Thus, strengthening the existing maternal and child health programs to adhere to the recommended ANC care guidelines may improve the timely initiation of postnatal care.

Utilization and its factors of post abortion modern contraceptive in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Providing post-abortion care service is a widely accepted to reduce maternal morbidity and mortality by promoting, preventing and treating maternal and neonatal health, identifying the utilization and its factor of post abortion contraceptive is crucial. Therefore we tried to review post abortion contraceptive utilization and its factors in Ethiopia. METHODS: A review was performed by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic and a comprehensive literature searching mechanism were used without any restriction, through Google scholar, PubMed, EMBASE, Scopus, Web of Sciences, and Grey literature databases for reporting utilization of post abortion family planning. Pilo-tested were performed in random sample studies and a standardized data extraction form was used. All statistical analyses were done using STATA version 14 software for windows, and meta-analysis was used with a random-effects method. The results are presented using texts, tables and forest plots with measures of effect and 95% confidence interval. RESULTS: Among 1221 records, 11 studies were taken in the meta-analysis with 4336 Participants that full fill the inclusion criteria. The pooled prevalence of post abortion contraceptive in Ethiopia was 74.56% (95% CI (73.31%, 75.81%)). Married women (OR 2.01 (95% CI (1.52, 2.66), I2: 0.0%)), women who were counseled (OR 5.36 (95% CI (3.10, 9.29), I2: 79.5%)), women whose educational level tertiary and above (OR 2.28 (95% CI (1.66, 3.17), I2: 0.0%)), women who had ever used contraceptive (OR 3.76 (95% CI (2.19, 6.47), I2: 67.8%)) and those women's age 15-24 years old (OR 8.35 (95% CI (2.74, 14.74), I2: 87.4)) were statistically significant. CONCLUSION: According to World Health Organization (WHO) guideline, "after a miscarriage or induced abortion, the recommended minimum interval to next pregnancy is at least 6 months in order to reduce risks of adverse maternal and perinatal outcomes".. According to this post abortion contraceptive utilization in Ethiopia is not optimal. Marital status, education, Counsel, previously exposed and age were significantly associated. Therefore, the Ministry of Health should work target fully to address those problems to maintain maternal and child health in Ethiopia.

Pelvic Fractures and Associated Injuries in Patients Admitted to and Treated at Emergency Department of Tibebe Ghion Specialized Hospital, Bahir Dar University, Ethiopia.

BACKGROUND: Pelvic fractures are high-risk injuries that require careful evaluation due to significant patient morbidity and mortality associated with damage to major blood vessels, nerves, and organs. Thus, the aim of this study was to assess pelvic fractures and associated injuries among patients presented at the emergency department of Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia. METHODS: This is a cross-sectional study with a retrospective facility-based data collection technique. All patients who were managed for pelvic fracture from September 2018 to February 2021 were included. The patient's chart number was collected from the orthopedics surgery morning register sheet and their case folders were retrieved from the medical record department. We used a structured and pretested checklist, and chart review for data collection. The collected data were cleaned, coded, and entered into Epi Info version 7 and exported to SPSS version 24 for analysis. Binary logistic regression analysis was used to identify factors associated with a pelvic fracture. RESULTS: We studied 64 cases of pelvic fracture during the study period. Pelvic was common among males with a ratio of 7:1 and young population (15-35 years). The most common associated injuries were lower extremity 23 (35.9%), abdominal injuries 16 (25.0%), and urethral injury in 13 (20.3%). Moreover, most patients with pelvic fracture have Tile A fracture 56.3%, Tile C in 20 (31.3%), and Tile B in 8 (12.5%) patients. The road traffic accident was the most common cause of pelvic fracture in 56.3%, followed by fall down accident (28.1%), and bullet injury (12.5%). CONCLUSION: The incidence of pelvic fracture was high in the study area. It reflects the need for strong and multi-sectoral collaboration to prevent pelvic fracture. Additionally, it needs a careful, systematic management approach for survival, healing, and to address the associated complexities and the polytrauma nature.

Childbirth at home and associated factors in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Maternal mortality remains a major challenge to health systems worldwide. Although most pregnancies and births are uneventful, approximately 15% of all pregnant women develop potentially life-threatening complications. Childbirth at home in this context can be acutely threatening, particularly in developing countries where emergency care and transportation are less available. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of home childbirth and its associated factors among women in Ethiopia at their last childbirth. METHOD: For this review, we used the standard PRISMA checklist guideline. This search included all published and unpublished observational studies written only in English language and conducted in Ethiopia. PubMed/Medline, Hinari, EMBASE, Google Scholar, Science Direct, Scopus, Web of Science (WoS), ProQuest, Cochrane Library, African Journals Online, Ethiopian's university research repository online library were used. Based on the adapted PICO principles, different search terms were applied to achieve and access the essential articles from February 1-30, 2020. The overall selected search results were 40 studies. Microsoft Excel was used for data extraction and Stata version 11.0 (Stata Corporation, College Station, Texas, USA) for data analysis. The quality of individual studies was appraised by using the Joanna Briggs Institute (JBI) quality appraisal checklist. The heterogeneity of the studies was assessed by the Cochrane Q and I2 test. With the evidence of heterogeneity, subgroup analysis and sensitivity analysis were computed. The pooled prevalence of childbirth at home and the odds ratio (OR) with a 95% confidence interval was presented using forest plots. RESULT: Seventy-one thousand seven hundred twenty-four (71, 724) mothers who gave at least one birth were recruited in this study. The estimated prevalence of childbirth at home in Ethiopia was 66.7% (95%CI: 61.56-71.92, I2 = 98.8%, p-value < 0.001). Being from a rural area (adjusted odds ratio (AOR) 6.48, 95% confidence interval (CI): 3.48-12.07), being uneducated (AOR = 5.90, 95% CI: 4.42-7.88), not pursuing antenatal (ANC) visits at all (AOR = 4.57(95% CI: 2.42-8.64), having 1-3 ANC visits only (AOR = 4.28, 95% CI: 3.8-8.26), no birth preparedness and complication readiness plan (AOR = 5.60, 95% CI: 6.68-8.25), no media access (AOR = 3.46, 95% CI: 2.27-5.27), having poor knowledge of obstetric complications (AOR = 4.16: 95% CI: 2.84-6.09), and walking distance more than 2 hours to reach the nearest health facility (AOR = 5.12, 95% CI: 2.94-8.93) were the factors associated with giving childbirth at home. CONCLUSION: The pooled prevalence of childbirth at home was high in Ethiopia. Being from a rural area, being uneducated, not pursuing ANC visits at all, having 1-3 ANC visits only, no media access, having poor knowledge of obstetric complications, not having a birth preparedness and complication readiness plan, and walking time greater than 2 hours to reach the nearest health facility increased the probability of childbirth at home in Ethiopia.

Incidence, causes, and maternofetal outcomes of obstructed labor in Ethiopia: systematic review and meta-analysis.

BACKGROUND: Obstructed labor is a preventable obstetric complication. However, it is an important cause of maternal mortality and morbidity and of adverse outcomes for newborns in resource-limited countries in which undernutrition is common resulting in a small pelvis in which there is no easy access to functioning health facilities with a capacity to carry out operative deliveries. Therefore, this systematic review and meta-analysis aimed to estimate the incidence, causes, and maternofetal outcomes of obstructed labor among mothers who gave birth in Ethiopia. METHOD: for this review, we used the standard PRISMA checklist guideline. Different online databases were used for the review: PubMed, Google Scholar, EMBASE, Cochrane Library, HINARI, AFRO Library Databases, and African Online Journals. Based on the adapted PICO principles, different search terms were applied to achieve and access the essential articles. The search included all published and unpublished observational studies written only in the English language and conducted in Ethiopia. Microsoft Excel 16 was used for data entrance, and Stata version 11.0 (Stata Corporation, College Station, Texas, USA) was used for data analysis. RESULTS: I included sixteen (16) primary studies with twenty-eight thousand five hundred ninety-one (28,591) mothers who gave birth in Ethiopia. The pooled incidence of obstructed labor in Ethiopia was 12.93% (95% CI: 10.44-15.42, I2 = 98.0%, p < 0.001). Out of these, 67.3% (95% CI: 33.32-101.28) did not have antenatal care follow-up, 77.86% (95% CI: 63.07-92.66) were from the rural area, and 58.52% (95% CI: 35.73- 82.31) were referred from health centers and visited hospitals after 12 h of labor. The major causes of obstructed labor were cephalo-pelvic disproportion 64.65% (95% CI: 57.15- 72.14), and malpresentation and malposition in 27.24% (95% CI: 22.05-32.42) of the cases. The commonest complications were sepsis in 38.59% (95% CI: 25.49-51.68), stillbirth in 38.08% (95% CI: 29.55-46.61), postpartum hemorrhage in 33.54% (95% CI:12.06- 55.02), uterine rupture in 29.84% (95% CI: 21.09-38.58), and maternal death in 17.27% (95% CI: 13.47-48.02) of mothers who gave birth in Ethiopia. CONCLUSION: This systematic review and meta-analysis showed that the incidence of obstructed labor was high in Ethiopia. Not having antenatal care follow-up, rural residency, and visiting hospitals after 12 h of labor increased the incidence of obstructed labor. The major causes of obstructed labor were cephalo-pelvic disproportion, and malpresentation and malpresentation. Additionally, the commonest complications were sepsis, stillbirth, postpartum hemorrhage, uterine rupture, and maternal death. Thus, promoting antenatal care service utilization, a good referral system, and availing comprehensive obstetric care in nearby health institutions are recommended to prevent the incidence of obstructed labor and its complications.

Prevalence of rhesus D-negative blood type and the challenges of rhesus D immunoprophylaxis among obstetric population in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Transplacental or fetomaternal hemorrhage (FMH) may occur during pregnancy or at delivery and lead to immunization to the D antigen if the mother is Rh-negative and the baby is Rh-positive. This can result in hemolytic disease of the fetus and newborn (HDFN) in subsequent D-positive pregnancies. Therefore, the aim of this systematic review and meta-analysis was to estimate distribution of ABO and Rh (D) blood groups among pregnant women in Ethiopia. METHOD: We searched PubMed, Google Scholar, EMBASE, Cochrane Library, HINARI, AFRO Library Databases, and African Online Journal databases for all available studies using the following keywords: "High rhesus (Rh(D)) negative frequency", "ABO blood group distribution", "haemolytic disease of the newborn (HDN)", "rh isoimmunization", "anti-RhD immunoglobulin", "D-negative pregnancies", "Frequency", "ABO and Rh blood group distribution", "feto-maternal hemorrhage", "rhesus D negative pregnant mothers", "kleihauer-betke test (KBT)", "Neonatal Hyperbilirubinemia", "non-sensitized RhD-negative pregnant women", "antenatal anti-D immunoglobulin prophylaxis", "Hemolytic disease of the newborn (alloimmunization), Ethiopia. The search string was developed using "AND" and "OR" Boolean operators. All published and unpublished observational studies reporting the distribution of ABO and Rh (D) blood groups among pregnant women in Ethiopia were included. The study participants were all pregnant women in Ethiopia, and the main outcome measure of this systematic review and meta-analysis was Rhesus D-negative blood type and ABO blood group distribution among pregnant women in Ethiopia. The data was extracted by the author (AAA) by using a standardized JBI data extraction format. Microsoft Excel (2016), and Stata version 11.0 (Stata Corporation, College Station, Texas, USA) software were used for data entry and analysis, respectively. The random effect model was used for estimating the pooled effects, and the publication bias was assessed by visual inspection of the funnel plots and objectively by using the Egger's test (i.e. p < 0.05). RESULTS: One hundred thirty-two articles were identified through electronic database searching. Of which, 34 were excluded due to duplication, 65 through review of titles and abstracts, and 22 full-text articles were excluded for not reporting the outcome variable and other reasons. Finally, 7 were included to estimate the distribution of ABO and Rh (D) blood groups among pregnant women in Ethiopia. The pooled distribution of Rh-negative blood group among pregnant women in Ethiopia was 10.8% (95%CI: 7.53-14.07, I2 = 85%, p < 0.001). In the ABO system, type O was the most prevalent 39.9% (37.51-42.38), followed by A (30.59% (26.00-35.18)), B (23.04% (20.03-26.05)), and AB the least (4.82%(3.17-6.47)), in the pattern O > A > B > AB. CONCLUSION: The pooled distribution of Rh-negative blood group among pregnant women in Ethiopia was high. Rh alloimmunization remains a major factor responsible for perinatal morbidity in Ethiopia and may result in the compromise of the woman's obstetric care due to the unaffordability of anti-D immunoglobulin. There is the urgent need for the implementation of universal access to anti-D immunoglobulin for the Rh-negative pregnant population in Ethiopia.

Uptake of cervical cancer screening service and associated factors among age-eligible women in Ethiopia: systematic review and meta-analysis.

BACKGROUND: Cervical cancer is the leading cause of cancer deaths among women in developing countries. Since cervical cancer is a preventable disease, screening is an important control and prevention strategy, recommended by the World Health Organization (WHO) for all women aged 30 years and older, and even earlier for some high-risk women. Therefore the aim of this study was to assess the uptake of cervical cancer screening among age-eligible women in Ethiopia. METHOD: Review identification was performed through the search of online databases PubMed, Google Scholar, HINARI, EMBASE, Science Direct, Cochrane library, African Journals, and other gray and online repository accessed studies were searched using different search engines. For critical appraisal of studies, Newcastle-Ottawa Quality Assessment Scale (NOS) was used. The analysis was conducted by using STATA 11 software. To test the heterogeneity of studies, the Cochran Q test and I2 test statistics were used. To detect publication bias of the studies, the funnel plot and Egger's test were used. The pooled prevalence of cervical cancer screening and the odds ratio (OR) with a 95% confidence interval were presented using forest plots. RESULT: Twenty-four studies with a total of 14,582 age-eligible women were included in this meta-analysis. The pooled national level of cervical cancer screening among age-eligible women in Ethiopia was 13.46% (95%CI:11.06,15.86). Knowledge on cervical cancer and screening (OR = 4.01,95%CI:2.76,5.92), history of multiple sexual partners (OR = 5.01, 95%CI:2.61,9.61), women's age (OR = 4.58, 95%CI:2.81,7.46), history of sexually transmitted disease (OR = 4.83,95%CI:3.02,7.73), Perceived susceptibility to cervical cancer (OR = 3.59, 95%CI:1.99,6.48), getting advice from health care providers (OR = 4.58, 95%CI:3.26, 6.43), women's educational level (OR = 6.68,95%CI:4.61,9.68), women's attitude towards cervical cancer and screening (OR = 3.42, 95%CI:2.88,4.06) were the determinant factors of cervical cancer screening uptake among age-eligible women in Ethiopia. CONCLUSION: The pooled prevalence of cervical cancer screening was remarkably low among age-eligible women in Ethiopia. Thus, to increase the uptake of cervical cancer screening among age-eligible women regularly, it is better to create awareness programs for early detection and treatment of cervical cancer, and educational interventions that teach the step-by-step practice of cervical screening to increase women's attitude for screening. Additionally, it is better to inform every woman is susceptible to cervical cancer, especially after starting sexual intercourse, and screening remains fundamental in the fight against cervical cancer before becoming invasive. Moreover, counseling and improving the confidence of women by health care providers to undergo screening is recommended.

Essential Newborn Care and Associated Factors Among Obstetrical Care Providers in Awi Zone Health Facilities, Northwest Ethiopia: An Institutional-Based Cross-Sectional Study.

BACKGROUND: Each year, millions of newborns die as a result of birth asphyxia, infections, and complications of preterm birth. This burden of death is disproportionately concentrated in low-income countries including Ethiopia. As a result, the care given immediately after birth is crucial for making a successful transition from intrauterine to extrauterine function and to reduce neonatal mortality. METHODS: Facility-based cross-sectional study design was carried out on a sample size of 208 obstetrical care providers. A simple random sampling technique was used to select the study subjects. The data were collected through Interview-administered questionnaires and observational checklists. The data were entered into Epi-info version 7 and exported to SPSS 23 for analysis. RESULTS: A total of 201 obstetric care providers participated in the study, making a response rate of (96.6%). This study revealed that 62.7% of obstetric care providers practiced essential newborn care properly. The factors significantly associated were received in-service training (AOR = 2.7, 95% CI: 1.35, 5.51), level of education (AOR = 0.46, 95% CI: 0.22, 0.96), midwifery profession (AOR = 3.1, 95% CI: 1.35, 7.39), having good knowledge of essential newborn care (AOR = 2.1, 95% CI: 1.03, 4.49), availability of drugs for essential newborn care (AOR = 2.3, 95% CI: 1.16, 4.72), and availability of medical equipment to perform essential newborn care (AOR = 2, 95% CI: 1.01, 3.96). CONCLUSION: The practice of essential newborn care was generally low. Having in-service training, midwifery profession, a good knowledge of essential newborn care, availability of drugs, level of education, and availability of medical equipment for essential newborn care were the determinant factors for essential newborn care practice. Improvement in essential newborn care practices could be attained through modifiable proven interventions like provision of in-service training, availed drugs, and medical equipment for essential newborn care.

Partograph utilization as a decision-making tool and associated factors among obstetric care providers in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Globally, a total of 13.6 million women have died due to maternal causes from 1990 to 2015. Majority of these deaths occurred in resource-limited countries. Among the causes of these deaths, obstructed and prolonged labor covers the highest percentage, which could be prevented by cost-effective and affordable health interventions like partograph use. Therefore, this systematic review and meta-analysis aimed to assess the level of partograph utilization among obstetric care providers and its associated factors in Ethiopia. METHOD: For this review, we used the standard PRISMA checklist guideline. Different online databases were used for the review: PubMed/Medline, Google Scholar, EMBASE, Cochrane Library, HINARI, WHO Afro Library Databases, and African Online Journals. Based on the adapted PICO principles, different search terms were applied to achieve and access all the essential articles. Microsoft Excel was used for data entry and Stata version 11.0 (Stata Corporation, College Station, TX, USA) for data analysis. RESULT: Nineteen studies were included in this systematic review and meta-analysis with a total of 6237 obstetric care providers. The overall pooled prevalence of partograph utilization was 59.95% (95% CI 46.8-73.09, I2 = 99.4%, P < 0.001). Being in midwifery profession (adjusted odds ratio (AOR) 3.97; 95% confidence interval (CI) 2.63-5.99, I2 = 28.8%, P = 0.198), presence of supervision (AOR = 3.21; 95% CI 2.22-4.66, I2 = 0.0%, P = 0.742), Basic Emergency Obstetric and Newborn Care (BEmONC) training (AOR = 2.90; 95% CI 2.19-3.84, I2 = 36.9%, P = 0.13), knowledge of partograph (AOR = 2.5; 95% CI 1.6-3.8, I2 = 64.58%, P = 0.024), on-the-job refresher training on partograph (AOR = 5.7; 95% CI 2.5-12.9, I2 = 87.8%, P < 0.001), favorable attitude (AOR = 2.12; 95% CI 1.48-3.04, I2 = 0.0%, P = 0.58), and working at health center (AOR = 3.50; 95% CI 2.49-4.92, I2 = 49.1%, P = 0.08) were the determinant factors for partograph use among obstetric care providers in Ethiopia. CONCLUSION: The overall pooled prevalence of partograph utilization among obstetric care providers was low. Therefore, supportive supervision, providing Basic Emergency Obstetric and Newborn Care training, on-the-job refresher training on partograph, and promoting midwifery profession are strongly recommended to increase the use of partograph.