Undernutrition among exclusive breastfeeding mothers and its associated factors in Southwest Ethiopia: A community-based study.

BACKGROUND: An exclusive breastfeeding period is a time when the infant's feeding depends on only breast milk. Inadequate maternal nutrition during this period could lead to insufficient infant feeding, which can further lead to childhood undernutrition and developmental restrictions. Evidently, the burden of maternal undernutrition was higher in resource-limited countries, including Ethiopia. OBJECTIVES: This study aimed to assess the proportion of undernutrition among exclusive breastfeeding mothers and its associated factors in Southwest Ethiopia. DESIGN: The study used a community-based cross-sectional design. METHODS: The study was conducted among 442 nursing mothers from 10 to 30 June 2022. The participants were selected using multistage sampling techniques. An interviewer-administered structured questionnaire was used to collect information. Statistical software EpiData version 3.1 and SPSS version 20 were used for data entry and analysis, respectively. The factors associated with undernutrition were identified using a binary logistic regression analysis. In the bivariable analysis, a p-value of less than 0.25 was used to include the variable in the multivariable analysis, whereas p-value less than 0.05 was an odds ratio used to declare an independent association at a 95% confidence interval. RESULTS: The proportion of undernutrition among the participants was found to be 24.8% in the study area. Poor intake of extra meals (adjusted odds ratio = 2.104; 95% confidence interval: 1.208, 3.664), poor dietary diversity habits (adjusted odds ratio = 3.605; 95% confidence interval: 2.112, 6.153), a lack of nutrition information (adjusted odds ratio = 1.853; 95% confidence interval: 1.070, 3.212), and household food insecurity (adjusted odds ratio = 4.424; 95% confidence interval: 2.639, 7.417) were identified as factors enhancing undernutrition among exclusive breastfeeding mothers in the area. CONCLUSION: A quarter of exclusive breastfeeding mothers were undernourished in the area. Poor dietary diversity habits, poor intake of extra meals, a lack of nutrition information, and household food insecurity were found to be the factors determining undernutrition. Hence, it is important to reinforce nutrition intervention programs, including maternal nutrition education and counseling.

A study identified undernutrition among exclusive breastfeeding mothers in Southwest EthiopiaAdequate nutrition for a nursing mother is crucial for the health of both the baby and the mother. Frequent breastfeeding, especially in exclusive breastfeeding (EBF) mothers, increases the physiological demand for nutrients. Consequently, inadequate nutrition during this period can lead to undernutrition. Undernutrition during this crucial period can result in the detriment of a newborn's growth and development. The problem is common in resource-limited settings, including Ethiopia. The study was conducted to assess the magnitude of undernutrition in the general nursing period. However, this problem, in particular the EBF period, was poorly studied before including the study area. A community-based cross-sectional study was conducted to assess the prevalence of undernutrition and its associated factors among EBF mothers in southwest Ethiopia. Accordingly, of the total of 435 participants involved in the study, about 108 (24.8%) of EBF mothers were undernourished. The participants' poor intake of extra meals (adjusted odds ratio (AOR) = 2.104; 95% confidence interval (CI): 1.208, 3.664), poor dietary diversity habits (AOR = 3.605; 95% CI: 2.112, 6.153), a lack of nutrition information (AOR = 1.853; 95% CI: 1.070, 3.212), and household food insecurity (AOR = 4.424; 95% CI: 2.639, 7.417) were identified as factors enhancing undernutrition among EBF mothers in the area. Generally, the study identified about one-fourth of EBF mothers as undernourished in the area. Hence, the concerned bodies need to strengthen nutritional information dissemination to the community. Moreover, food supplementation should be planned for food-insecure households in the area.

Determinants of low birth weight among newborns delivered at Mettu Karl comprehensive specialized hospital, southwest Ethiopia: a case-control study.

Low birth weight is a newborn delivered with birth weight of less than 2500 g regardless of gestational age is called. It is a significant issue affecting over 30 million infants worldwide. Thus, the study determine factors associated with low birth weight among newborns delivered at Mettu Karl Comprehensive Specialized Hospital, Southwest Ethiopia. A facility-based case-control study was conducted with 336 newborns (112 cases and 224 controls) from September 12 to December 23, 2022. The study population was newborns with birth weights of 2500 g to 4000 g as controls and newborns with birth weights < 2500 g were cases. Simple random sampling techniques were used to recruit study participants with a ratio of 1 to 3 cases to controls, respectively. Data was collected by interviews and a checklist. Data were entered and analysed using SPSS version 23. Binary and multivariate logistic regression analyses were computed to identify factors associated with low birth weight, a p-value less than 0.05 was used to declare the strength of statistical significance. A total of 327 newborns were contacted, yielding a 97% response rate. MUAC < 23 cm (AOR = 2.72, 95% CI 1.24 to 6.19), inadequate diet diversification (AOR = 4.19, 95% CI 2.04 to 8.60), lack of iron and folic acid supplementation (AOR = 2.94, 95% CI 1.25 to 6.88), history of hypertension (AOR = 2.55, 95% CI 1.09 to 6.00), and lack of nutritional counselling (AOR = 4.63, 95% CI 2.22 to 9.64) were determinants of low birth weight. Low birth weight is linked to residence, maternal MUAC, hypertension history, and ANC visit. Lifestyle modifications, early detection, management, and nutrition information can reduce risk.

Determinant of Implanon discontinuation among women in southwest Ethiopia: unmatched case control study.

BACKGROUND: Over 4.5 million women worldwide have used Implanon. It plays an important role in reducing unwanted conceptions, lowering maternal mortality, and enhancing child survival. As a result, the availability of family planning programmes encourages women to begin using contraception and encourages women who are already using family planning to continue using it. The purpose of this study was to investigate the factors that lead to implanon cessation among women in southwest, Ethiopia. METHODS: A facility-based unmatched case-control study was conducted from February 01 to March 02, 2023. It included 348 participants, 174 cases, and 174 controls. The cases were selected consecutively, and the controls were selected using a systematic random sampling method. Data was collected through a structured, face-to-face interview and entered into Epi-data version 4.6 and SPSS version 25.0 for analysis. The confidence interval (CI) of 95 and the strength of the association were measured using an adjusted odds ratio. A p-value of less than 0.05 was considered statistically significant. RESULT: Women whose husbands have formal education [AOR = 0.33, 95% CI (0.121-0.0944)], women who have been counseled individually [AOR = 3.403 (1.390-8.3.32)], women who have been counseled for less than 5 min [AOR = 3.143, 95% CI (1.303-8.046)], and women who discuss Implanon insertion with their partner [AOR = 0.289, 95% CI (0.143-0.585)] were significantly associated with Implanon discontinuation. CONCLUSION: Implanon discontinuation was predicted by the husband's education, the number of women counselled alone, the length of counselling, a conversation with the spouse, satisfaction with the service, and implanon side effects. The health care provider should increase counselling services, especially the length of implanon pregnancy, in accordance with the national family planning recommendations, to reduce early implanon removal.

Determinants of long act reversible contraceptive utilization among HIV positive reproductive age women attending ART clinic in South West Ethiopia.

BACKGROUND: Identifying the determinants of long-acting contraceptive utilization and managing the sexual and reproductive health of HIV-infected women is critical to reducing HIV transmission and maternal mortality. However, the determinants of long-acting contraceptive utilization have not been well understood in resource-limited settings like Ethiopia. The aim of this study was to identify determinants of long-acting reversible contraceptive utilization among HIV-positive women on ART in southwest Ethiopia. METHODS: A facility-based, unmatched case control study was conducted from July 24 to August 28, 2021, in south-west Ethiopia. The study participants were HIV positive women, with a sample size of 109 cases and controls. An interviewer administered a questionnaire, and a check list was used for data collection. A systemic random sampling technique was used to collect data from cases and controls. Bivariate and multivariable logistic regressions were employed to determine the determinants of LARC utilization among HIV-positive women. To demonstrate the strength of the determinant, the odds ratio was calculated with 95% confidence intervals, and a P-value less than 0.05 was used to declare statistical significance. RESULT: A total of 324 women (108 cases and 216 controls) of reproductive age who were HIV positive were interviewed, with a response rate of 99.0%. urban residence (AOR = 2.67, 95%CI: 1.23- 5.77), having formal education (AOR = 2.93, 95% CI:1.36, 6.34), being counseled by health care provider (AOR = 5.42,95% CI: 2.67-11.03), no future fertility intention (AOR = 2.87, 95% CI:1.44-5.70), having CD4 count less than 500 cell/mm3 (AOR = 4.18,95% CI:2.12-8.23), having information of HIV transmission from mother to child (AOR = 3.65,95% CI:1.49-8.95),not using condom during sexual intercourse (AOR = 4.86,95% CI:2.46-9.62),,having knowledge towards LARC (AOR = 2.38,95% CI:1.24-4.58) and attitude towards LARC (AOR = 6.41,95%CI:3.16-13.0) were independent determinants of LARC utilization among HIV positive women. CONCLUSION AND RECOMMENDATION: Women being counseled by a health care provider, having no future fertility intention, and having a CD4 count less than 500 cells/mm3 were found to be determinants of long-acting contraceptive method utilization among HIV-positive reproductive-age women. Also, our study supports the WHO Strategic Concepts for Improving the Links between Family Planning and HIV/AIDS Policy, Programs, and Services. It is recommended that Health care providers should use these factors as base line during family planning counseling and service delivery.

Determinants of Intrauterine Contraceptive Device Discontinuation Among Women Using Family Planning, in Southwest Ethiopia: Unmatched Case-Control Study.

Background: Although the intrauterine contraceptive device is an effective, reliable, safe, and recommended contraceptive method, it is still underutilized and has a high discontinuation rate in Ethiopia. The study aims to assess determinants of the discontinuation of IUCDs among women using family planning in Ilu Aba Bor Zone. Methods: A facility-based unmatched case-control study was conducted from September to October, 2021 among 168 (56 cases and 112 controls) IUCD-user women in public health facilities in south-west Ethiopia. Pretested, structured and interviewer administered questionnaires were used for data collection. The data were coded, cleaned and entered to Epi-data version 3.1 and exported to SPSS version 23 for advanced analysis. A binary logistic regression was used to estimate the degree of association between the outcome variable and independent variables. Finally, variables with a p-value less than 0.05 at 95% confidence interval were declared as statistically significant with outcome variable. Results: A total of 168 (163) respondents participated in the study, with a response rate of 97%. The mean (+SD) age of the respondents was 31.36 ± 5.916. Regarding the educational status of respondents about 36 (64.3%) of cases and 90 (84.1%) of controls have formal education, and about 42 (75%) of cases' husbands and 97 (90.65%) of controls' husbands have formal education, respectively. Experiencing side effects (AOR = 2.36; 95% CI: 1.01, 5.55), lack of follow up (AOR = 4.069; 95% CI: l.30, 12.69), and planning for next pregnancy (AOR 4.14; 95% CI: 1.58, 10.88) were found to be the main determinants of intrauterine device discontinuation. Conclusion: The findings of the study showed that lack of follow-up after insertion of the IUCD, experiencing side effects, and having a plan for the next pregnancy were found to be the main determinants of intrauterine device discontinuation. Hence, arranging recommended regular follow-up and treating side effects are very important to sustain intrauterine device utilization.

Early implanon discontinuation and associated factors among women ever used implanon in Mettu district, Oromia regional state, southwest Ethiopia, 2021.

BACKGROUND: Implanon is an effective form of long-acting reversible contraceptive used to prevent conception with a clinical failure rate of less than one per 100 users. However, in sub-Saharan countries the utilization of implanon was very low. Regardless of low utilization; its early discontinuation is very common in most developing countries including Ethiopia. OBJECTIVES: To assess the prevalence of early implanon discontinuation and associated factors among women ever used implanon in Mettu district. METHODS: A community based cross-sectional study design was conducted from October 11 to December 4, 2020 G C. A total of 430 women were included in the study by systematic random sampling technique. Data were entered into epi data version 3.1 and analyzed by SPSS version 25.0. Descriptive analysis was computed to describe descriptive results. Logistics regression was computed to see the relative effect of factors on the outcome variable. Adjusted odds ratio was calculated with 95% confidence intervals to show strength of association and p-value < 0.05 was used to declare statistical significance. The finding of the study was presented using narrations, tables and chart. RESULT: The total proportion of early implanon discontinuation among 430 mothers was 19.3%. Women who did not counseled about the presence of alternatives methods [AOR = 2.28: 95% CI (1.22-4.26)], women who experienced dizziness after insertion of implanon [AOR = 1.90: 95% CI (1.06-3.43)] and being having menstrual disturbance after insertion of implanon [AOR = 2.17: 95% CI (1.16-4.08)] were significantly associated with early implanon discontinuation. Women who were counseled about the advantage of implanon [AOR: 0.49: 95% CI (0.28-0.87)] were protective from early implanon discontinuation. CONCLUSION AND RECOMMENDATION: Early implanon discontinuation among mothers was found to be high. Hence, effective counseling on advantages and side effects of implanon and proper management of the side effects should be made to increase implanon retention.

Worldwide, a large number of women become exposed to the risk of conception after contraceptive discontinuation. Besides its low utilization, the discontinuation rate of implanon in developing country was high including Ethiopia. There is no study conducted in south western Ethiopia which shows the magnitude and associated factors of early implanon discontinuation. Therefore, this article provides level of early implanon discontinuation and factors associated with early discontinuation within 1 year's duration. In this study, a cross-sectional design and interviewer administered questionnaire was employed among 430 women's of ever used implanon in Mettu district woreda Ilu Aba Bor Zone. The finding of this study revealed that, Women who did not counseled on the presence of alternatives methods, women who experienced dizziness after insertion of implanon and being having menstrual disturbance after insertion of implanon were significantly associated with early implanon discontinuation. Women who were counseled about the advantage of implanon were protective from early implanon discontinuation. In conclusion, the finding of this study reported a high magnitude of early implanon discontinuation as compared to other previous studies.