Magnitude of maternal near-misses and associated factors in Arsi Zone public hospitals in Oromia, Ethiopia, 2022.

Background: Investigation of maternal near-misses is useful for monitoring and evaluating the quality of obstetrics care services. Despite its importance, data has been limited in Arsi Zone public hospitals. Objective: To assess the magnitude of maternal near-miss and associated factors in Arsi Zone public hospitals, Ethiopia, 2022. Method: Institution-based cross-sectional study design was conducted on 327 study participants from December 2021 to June 2022. The study participants were selected through systematic random sampling. Trained data collectors used pre-tested structured questionnaires to collect data from study participants. Pertinent data were also extracted from clients' logbook. The data were entered to Epi Data version 3.1 and exported to SPSS version 25.0 for analysis. Multivariable logistic regression were employed to control for possible confounders where a significance level was set to a P-value of 5 %. Result: A total of 326 study participants responded, resulting in a 99.7 % response rate. The magnitude of maternal near-miss was 34.4 % [95 % CI (29.2-39.8)]. Hypertensive disorders (35 %), hemorrhage (35 %), ruptured uterus (11 %), unsafe abortion (8 %), obstructed labour (7 %), and infection/sepsis (4.5 %) were the direct while anemia (20 %) was one of the indirect causes of maternal near-misses. ANC visit received (AOR = 2.5, 95 % CI: 1.04-5.84), First ANC booked trimester (AOR = 0.26, 95 % CI: 0.1-0.9), delay in seeking care (AOR = 3.1, 95 % CI: 1.2-8.1), delay two (AOR = 2.7, 95 % CI: 1.0-6.8) and mode of delivery (AOR = 2.8, 95 % CI: 1.3-6.1) were factors associated with maternal near-misses. Conclusion: The prevalence of maternal near-miss was high. To improve the identified factors and minimize their consequences, appropriate interventions are required at all levels to improve the quality of obstetrics care services aimed at improving positive pregnancy outcomes.

Precancerous cervical lesion screening acceptance among women in Eastern Ethiopia.

OBJECTIVE: This study assessed perceived barriers, precancerous cervical lesion screening acceptance, and associated factors among women in Eastern Ethiopia. SETTING: This study was conducted in Hiwot Fana Specialized Hospital and Jugal Hospital. STUDY DESIGN: This study is a facility-based cross-sectional study. STUDY PARTICIPANTS: This study included 1181 women aged 25-49 years. Bivariate and multivariable logistic regression was used to evaluate the relationship between variables and control confounders. RESULTS: Nearly half of the participants (587 or 49.7%) agreed to be screened for precancerous cervical lesions. Seventy-six per cent of those checked were negative for visual inspection with acetic acid, 18.5% were positive, and 5.7% had cancer-like lesions. In multivariable analysis, fear of discomfort from the screening procedure, having a male screener, and embarrassment were the perceived barriers that were inversely associated with screening acceptance. CONCLUSIONS: The uptake of the screening service in the study area was not satisfactory, indicating that the programme was underutilised in the area.

Prevalence of Dysmenorrhea and Associated Factors Among Haramaya University Students, Eastern Ethiopia.

Purpose: Dysmenorrhea is the most common gynecological problem among adolescents and a common cause of school absenteeism. Previously, there was no study conducted on prevalence of dysmenorrhea and associated factors among university students in Ethiopia. Therefore, the aim of this study was to assess prevalence and associated factors of dysmenorrhea among Haramaya university undergraduate regular students in Eastern Ethiopia. Materials and Methods: An institution-based cross-sectional study design was conducted from February to March 2020. A multistage random sampling technique was applied and a total of 569 participants were included into the study. The total sample size was proportionally allocated based on the total number of students in each departments, and simple random sampling technique was employed to select participants. The data were entered to EPI­info version 3.5.4 and then exported to Statistical Package for Social Science version 23.0 software for analysis. The associations between independent variables and outcome variable were explored using bivariate and multivariable logistic regression models. The results of these analysis were reported as odds ratios with 95% confidence intervals. Results: The prevalence of dysmenorrhea in this study was 356 (64.7%) 95% CI [60.7%, 68.7%]. Premenstrual syndrome (AOR = 5.20:95% CI [2.82, 9.61]), early menarche (AOR = 4.67:95% CI [2.33, 9.37]), history of anxiety (AOR = 4.08:95% CI [2.31, 7.19]), taking of ≥4 glass of tea per day (AOR = 5.69:95% CI [1.49, 21.77]), usually eating fat and oil (AOR = 2.03:95% CI [1.15, 3.59]) and usual use of meat food (AOR = 3.61:95% CI [2.03, 6.39]) were positively and independently associated with the occurrence of dysmenorrhea. Conclusion: Dysmenorrhea was a common problem among Haramaya University female students. History of anxiety, early menarche, premenstrual syndrome, tea consumption, usual use of fat and oil containing food and usual use of meat food were significantly associated to dysmenorrhea. We recommend Haramaya University to provide accessible and appropriate medical treatment and counseling service for dysmenorrhea affected students.

Prevalence of Abnormal Cervical Lesions and Associated Factors Among Women in Harar, Eastern Ethiopia.

PURPOSE: The primary objective of this study was to determine the prevalence of abnormal cervical lesions and associated factors and the secondary objective was to assess adherence to post-cryotherapy treatment recommendations, among women in Harari region, eastern Ethiopia. MATERIALS AND METHODS: This study was conducted in two public hospitals in Harar city from January 1 to May 30, 2019. A facility-based descriptive cross-sectional study was conducted and a total of 1181 women were included in the study. Structured face-to-face interviews with women aged 25-49 years were used to collect information on precancerous cervical lesion screening and adherence to post-cryotherapy treatment. Visual inspection with acetic acid (VIA) method was used to screen women for precancerous cervical lesions. The collected data were entered into Epi Info software and then exported to SPSS software for analysis. Logistic regression analysis was used to check the association between independent variables and abnormal cervical lesions. RESULTS: The prevalence of abnormal cervical lesions among the participants screened was 24.5% (95% CI = 20.8-27.9%). Having no formal education (AOR = 2.68, 95% CI = 1.32-5.46), lack of awareness of cervical cancer, (AOR = 2.65, 95% CI = 1.68-4.23) and having a husband with history of multiple sexual partners (AOR = 1.75, 95% CI = 1.13-2.7) were independently associated with abnormal cervical lesions. From the respondents who received cryotherapy treatment prior to the study, the majority, 92.9% (95% CI = 76.5-99.1), adhered to the post-cryotherapy treatment recommendations. CONCLUSION: We found that the prevalence of abnormal cervical lesions in this area was high. Having no formal education, lack of awareness of cervical cancer and having a husband with history of multiple sexual partners were independently associated with having abnormal cervical lesions. The federal ministry of health and other stakeholders should focus on the primary prevention method (HPV vaccination) at an earlier stage to reduce the prevalence of abnormal cervical lesions in the study area. Harari regional health bureau should provide awareness creation activities and special attention should be given to uneducated women.

Knowledge of Cervical Cancer and Associated Factors Among Women Attending Public Health Facilities in Eastern Ethiopia.

PURPOSE: This study was done to assess women's knowledge of cervical cancer and associated factors. MATERIALS AND METHODS: We conducted a facility-based cross-sectional study in eastern Ethiopia from January 1 to May 30, 2019. A convenient sampling technique was used to include 1181 women in this study. Information on socio-demographic characteristics, sexual history, knowledge and awareness of women was collected using face-to-face interview. The data were cleaned, coded and entered into EPI­info version 3.5.4 and then exported to Statistical Package for Social Science version 23.0 software for analysis. The associations between independent variables and outcome variables were assessed using bivariate and multivariable logistic regressions. The results of these analyses were reported as odds ratios with 95% confidence intervals. We declared statistically significant variables at a p-value less than 0.05. RESULTS: Nearly half (574, 48.6%) of the participants have ever heard about cervical cancer. One hundred and thirty-nine (24.2%) of them did not know any of the risk factors. The majority of them mentioned bleeding after intercourse (329, 57.4%) as a symptom of the disease. Overall knowledge assessment revealed that 288 (55.7%) participants had adequate knowledge about cervical cancer. Participants' age in the range of 40-49 years (AOR: 2.58, 95% CI 1.99-5.57), having educational level above 12th grade (AOR: 12.11, 95% CI 4.57-32.09) and receiving information about the disease from healthcare professionals (AOR: 2.72, 95% CI 1.69-4.37) were independently associated with adequate knowledge of cervical cancer. CONCLUSION: The knowledge of women towards cervical cancer in our study area was inadequate. The respondents' age, educational status and source of information were independently associated with study participants' knowledge of cervical cancer. Young women with no formal education should get special focus in prevention strategies and we also recommend regular and effective counselling, and education about cervical cancer at health institutions.

Factors associated with long-acting family planning service utilization in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Even though the modern contraceptive use was improved in Ethiopia, the utilization of long-acting family planning services is still low because of numerous factors. The aim of this systematic review was to synthesize logical evidence about factors associated with long acting family planning service utilization in Ethiopia. METHODS: The participants of the study were married women of reproductive age in Ethiopia. This search included all published and unpublished observational studies written in the English language conducted before April 30, 2018, in Ethiopia. Electronic and non-electronic sources were used. PubMed, MEDLINE (EBSCO), CINHAL (EBSCO), Embase (EBSCO), POPLINE and the search engines like Google, Google Scholar Mednar and world cat log were used. The overall selected search results were 15 studies. Each study was evaluated using the Joanna Briggs Institute Quality Assessment Tool for Observational Studies. Data synthesis and statistical analysis were conducted using ReviewManagerVersion5.3.5. RESULTS: Women's inadequate knowledge level [OR, 0.29; 95% CI: 0.10, 0.83, P = 0.02], women's age between 15 and 34 [OR, 0.82; 95% CI: 0.53, 0.93, P = 0.01], not having electronic media [OR, 0.65; 95% CI: 0.53, 0.79, P < 0.0001] and women from rural area [OR = 0.65;95% CI:0.50, 0.81, P = 0.0009] were less likely associated in the use of long-acting family planning services. The odds of utilizing long acting family planning methods were high among non-government- employed women and husband [OR, 1.77; 95% CI: 1.29, 2.43, P = 0.0004], [OR, 1.69; 95% CI: 1.33, 2.15, P < 0.0001] respectively. Having no previous exposure to any modern family planning method [OR = 2.29; 95%CI: 1.83, 2.86, P < 0.00001] and women having no discussion with husband [OR = 1.92 (95%CI: 1.50, 2.45) P < 0.00001] were more likely associated in the utilization of long-acting family planning services. CONCLUSION: Lack of information and knowledge, having discussion with husband, being women of younger age, having less than five living children, being government-employed women and husband, not having electronic media, and being residents in rural area were significant barriers for underutilization of long acting family planning methods in Ethiopia. Hence, the investigators suggest that key stakeholders should design interventions strategies to avert attitudinal, cultural and informational barriers towards long-acting family planning methods. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: 2018: CRD42018096373.The online version of this article (10.1186/s40834-019-0095-z) contains supplementary material, which is available to authorized users.

Infant feeding practice and associated factors among HIV positive mothers in Debre Markos Referral Hospital East Gojam zone, North West Ethiopia.

INTRODUCTION: The dilemma posed between lifesaving benefit and risk of transmission through breast feeding complicates infant feedings among communities grossly affected by HIV/AIDS. According to the world health organization's guideline which was revised in 2010, exclusive breast feeding and exclusive replacement feeding are the recommended infant feeding practices for HIV positive mothers. The aim of this study was to assess infant feeding practice and associated factors among HIV positive mothers in Debre Markos Referral Hospital, North West Ethiopia. METHODS: An institutional based cross sectional study was conducted from May to September 2013. A Randomly selected 260 HIV positive mothers were included. The data were collected by using a pretested and structured questionnaire. Bivariate and multivariate analysis were performed to check association and to control confounders. RESULTS: From a total of 260 HIV positive mothers, 85.8% of them were feeding their children based on the recommended feeding way of infant feeding practice with the remaining percentage 14.2% were practicing mixed feeding. In multivariate analysis mothers attending high school and above AOR = 5.3 [95% CI = 1.25-22.1], having antenatal care follow up AOR = 5.5 [95% CI = 1.5-20.16], being on anti-retro viral therapy AOR = 6.5 [95% CI = 1.88-22.51] and disclosure of HIV status AOR = 7.1 [95% CI = 1.26-39.76] were found to be independently associated with infant feeding practice. CONCLUSION: This study revealed that large proportion of HIV positive mothers had followed the recommended infant feeding practice and significantly high number of mothers had practiced mixed feeding. Educating mothers, increasing ANC utilization, counseling mothers to start ART, encouraging and supporting mothers to disclose their HIV status were recommended.