Time to first birth and its predictors among reproductive-age women in Ethiopia: multilevel analysis using shared frailty model.

OBJECTIVE: To determine the time to first birth and its predictors among reproductive-age women in Ethiopia. DESIGN, SETTING AND PARTICIPANTS: Nationwide secondary data analysis using mini Ethiopian Demographic and Health Survey, 2019. A stratified, two-stage cluster sampling technique was used to select the sample. Among 9012 women of age 15-49 years, 8885 completed the interview yielding a response rate of 99%. MAIN OUTCOMES MEASURED: Time to first birth was determined. Kaplan-Meier method was used to estimate the time to first birth. The lognormal inverse Gaussian shared frailty model was used to model the data at a 95% CI. CI and adjusted time ratio (ATR) were reported as effect size. Statistical significance was declared at p-value<0.05. RESULTS: The overall median time to give first birth was 18 years (IQR: 15, 21). Age 20-29 (ATR=1.08; 95% CI, 1.05 to 1.12), Age>29 years (ATR=1.08; 95% CI, 1.05 to 1.11), northern regions (ATR=1.06; 95% CI, 1.03 to 1.08), rural residence (ATR=0.95; 95% CI, 0.93 to 0.98), never using contraceptive methods (ATR=0.98; 95% CI, 0.96 to 0.99), sex of household head (ATR=1.01; 95% CI, 1 to 1.03), poorest wealth index (ATR=1.04; 95% CI, 1.02 to 1.06) and richest wealth index (ATR=1.07; 95% CI, 1.04 to 1.1) were the significant predictors of time to first birth among reproductive-age women. CONCLUSION: In Ethiopia, women often gave birth to their first child at a younger age than what is recommended. Explicitly, women aged 20-29 and over 29, living in the northern region, leading a household as females, and belonging to the poorest or wealthiest wealth index tended to have a slightly delayed first childbirth. On the other hand, women in rural areas and those who had never used contraception were more likely to have an early first birth. The findings indicated the necessity of implementing targeted measures for rural Ethiopian women, especially those lacking knowledge about contraception.

Antenatal care component utilization and associated factors among pregnant women in Ethiopia: Multilevel analysis of Ethiopian Mini Demographic and Health survey 2019.

INTRODUCTION: Maternal and neonatal health are among the top prioritised agendas of global health care with due emphasis given to developing countries, where the burden is profound. Antenatal care accompanied by its recommended components is highly beneficial for both maternal health and birth outcome. OBJECTIVE: The objective of this study was to identify the proportion of pregnant women who received adequate Antenatal care components and associated factors among Ethiopian women. METHODS AND MATERIALS: We used a nation-wide data from Mini Ethiopian Demographic and Health Survey (MEDHS) of 2019. All women of age 15-49 and who had at least one ANC visit, who were either permanent residents of the selected households or visitors who slept in the household the night before the survey, were eligible to be interviewed. Since we utilised multilevel logistic regression model, the STATA output had two components, the fixed effect and the random effect. In our model, the fixed effect part was displayed by odds ratio while the random effect was addressed by variance and intra-cluster correlation (ICC). RESULTS: From the total women with at least one antenatal care (ANC) visit 55.41% (95% CI 53.60%, 57.20%) of them received adequate components of the care. In the final model after adjusting for the cluster and individual level variables, attending primary (AOR = 1.45; 95% CI: 1.15 to 1.84), secondary (AOR = 2.21; 95% CI: 1.51 to 3.24) and higher education (AOR = 2.42; 95% CI: 1.38 to 4.26) were significantly associated with higher odds of receiving adequate components of ANC. Similarly, wealth index of middle (AOR = 1.51; 95% CI: 1.06, 2.14), richer (AOR = 1.92; 95% CI: 1.32, 2.80), and richest (AOR = 3.86; 95% CI: 2.35, 6.33) compared to poorest index and having two or more ANC visits were significantly associated with receiving adequate components of ANC. On the other hand, being from Oromia region, from female headed household and protestant religion were negatively associated with receiving adequate components of ANC. CONCLUSION: The proportion of women who received adequate ANC component was much lower compared to the universal recommendation for every woman on ANC visit. Educational status, wealth index, number of ANC visit, region of residence and type of health facility were significantly associated with the odds of receiving adequate components of ANC. The government should pay attention to those without any formal education, encouraging pregnant women to receive the optimum number of ANC visits, and devising techniques to address those in poorest wealth index so that the proportion of adequate components of ANC will be increased.

Determinants of Knowledge, Attitude and Practice towards preventive measures of COVID-19 among adult residencies in Silte zone, Southern Ethiopia.

Introduction: coronavirus infectious disease-2019 (COVID-19) is currently a global health threat and an international public health emergency. There is a strong need to reinforce community knowledge, attitude and practice (KAP) to control the spread of the virus. The study aimed to identify the determinants of KAP towards preventive measures of COVID-19 among adult residencies. Methods: a community-based cross-sectional study design was employed in the communities of Silte zone, Southern Ethiopia. A total of 853 participants were selected using multistage stratified sampling technique. We used structured interview administered questionnaire. The KAP level was presented in descriptive and the associated variables conducted in binary logistic regression model. Results: overall, 81.7% had good knowledge, 78.4% had a positive attitude, and 43.9% had good practices. Being a female (Adjusted Odd Ratio (AOR): 2.3; 95% Confidence Interval (CI): 1.6-3.3), age between "31-40" (AOR: 1.99; 95% CI: 1-3.8) and able to read and write (AOR: 2.6; 95% CI: 1.7-3.7) were significantly associated factors of good knowledge towards COVID-19. Being urban resident (AOR: 1.8; 95% CI: 1.2-2.6) was significantly associated variable with positive attitude towards COVID-19. Being a government employee (AOR: 1.7; 95% CI: 1.1-2.7), able to read and write (AOR: 4.5; 95% CI: 3-6.7) and having good knowledge regarding COVID-19 (AOR: 2.4; 95% CI: 1.6-3.7) were significantly associated factors with good preventive practice towards COVID-19. Conclusion: alarmingly low preventive practice towards COVID-19 pandemic was indicated. Therefore, health education and promotion programs aimed at mobilizing and improving COVID-19-related practice are urgently needed, especially for those who are illiterate, having rural residency, or generally among underprivileged populations.

Prevalence and Associated Factors of Common Mental Disorders Among Adult Residents in Silte Zone, Southern Ethiopia.

INTRODUCTION: Mental health problems appear to be increasing in importance in Africa. Mental and substance use disorders were the leading cause of yearly lived with disability in Sub-Saharan Africa. Evidence from previous studies shows considerable variation in the prevalence of these disorders. The most acceptable explanation for this wide variation is likely to be the fact that socio cultural factors are major determinants of mental disorders. Therefore a mental disorder has to be understood in a specific setting to develop effective and tailored interventions. OBJECTIVE: The objective of this study was to determine the prevalence and associated factors of common mental disorders among adult residents in Silte Zone, southern Ethiopia. METHODS: Community based cross-sectional study was conducted in the study area. A total of 1178 adults were selected by using a three-stage systematic sampling technique. The Self-Reporting Questionnaire (SRQ-20) was used to determine the prevalence of common mental disorders. Data were analyzed by using SPSS version 20. Both bivariate and multiple logistic regression analyses were employed to identify factors associated with common mental disorders. RESULTS: The prevalence of common mental disorders among adults found to be 39.7%. Increased age (OR = 1.114; 95% CI = 1.095, 1.134), being female (OR = 9.421; 95% CI = 5.947, 14.926), poor social support (OR = 1.987; 95% CI = 1.358, 2.907) and having life threatening experience (OR = 2.162; 95% CI = 1.825, 2.562) were significantly associated with common mental disorders. CONCLUSION: In the study, the magnitude of common mental disorders remains high in the study area. Increased age, being female, poor social support and having life-threatening experience were significantly associated with common mental disorders.

Assessment of knowledge, attitude and practice toward COVID-19 and associated factors among health care workers in Silte Zone, Southern Ethiopia.

INTRODUCTION: COVID-19 is a pandemic respiratory disease caused by the highly contagious novel coronavirus (SARS-CoV 2). The disease is now quickly spreading around the world, resulting in ongoing coronavirus pandemic. Healthcare workers are more susceptible to COVID-19 infection than the general population due to frequent contact with infected individuals. OBJECTIVE: This study was aimed to assess knowledge, attitude and practice towards COVID-19 and associated factors among health care workers. METHODS: Facility-based cross-sectional study design was conducted among health care workers in Silte Zone. A total of 379 health professionals were selected using multistage stratified sampling technique. Self-administered questionnaire was used to collect data. Binary logistic regression model was used to see association between outcome and independent variables. RESULTS: This study found 74.9%, 84.2% and 68.9% prevalence of adequate knowledge, positive attitude and good practice respectively. Working in comprehensive specialized hospital (AOR = 4.46, 95% CI = 1.46-13.62).having MSC degree (AOR = 10.26, 95% CI = 2.27-46.44), and training on COVID-19 (AOR = 6.59, 95% CI = 2.97-14.65) were strongly associated with knowledge of health care workers. On the other hand, older age (AOR = 3.35, 95% CI = 1.07-10.50), training on COVID-19 (AOR = 3.73, 95% CI = 1.82-7.63), Work experience (AOR = 3.78, 95% CI = 1.46-9.80) and Knowledge (AOR = 5.45, 95% CI = 2.60-11.43) were significantly associated with attitude, whereas source of information from friends or colleagues (AOR = 3.13, 95% CI = 1.28-7.66), working in primary hospital (AOR = 0.36, 95% CI = 0.21-0.620) and having good knowledge (AOR = 1.80, 95% CI = 1.03-3.14) were strongly associated with good practice of health care workers. CONCLUSION: This study found majority of health care workers had good level of knowledge and positive attitude toward COVID-19, but lower proportion of health care workers practices sufficiently in the study area. Type of health facilities, level of education, training on COVID-19, work experience, type of source of information were significantly associated with knowledge, attitude and practice of health care workers. Stakeholders need to focus on interventions that increase preventive practices of health care workers.

Prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte zone, Southern Ethiopia.

BACKGROUND: Maternal undernutrition is highly prevalent in underdeveloped countries. Hence, this study was intended to determine the prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte Zone. METHOD: Facility-based cross-sectional study was conducted from July to January 2019. Systematic random sampling technique was used to select 422 study participants from 11 randomly selected health facilities. Data was collected by using a structured-interviewer administered questionnaire. Mid upper arm circumference (MUAC) was measured by standard non stretchable MUAC tape. Data was entered into a computer using Epi data 3.1 and edited, cleaned, and analyzed using SPSS version 20. Both bivariate and multiple logistic regression analyses were employed to identify factors associated with maternal undernutrition. RESULT: In this study, the overall prevalence of undernutrition among study subjects was 21.8%. Age greater than 31 years of women (AOR = 0.15; 95% CI: 0.03, 0.93), Birth intervals > 2 years (AOR = 0.18; 95% CI: 0.04, 0.76), good nutritional knowledge (AOR = 0.34; 95% CI: 0.17, 0.67), and having no dietary change as a result of current pregnancy AOR = 6.02; 95% CI: 2.99, 12.14) were significantly associated with undernutrition. CONCLUSIONS: The prevalence of undernutrition among pregnant women was 21.8%. Current estimate is lower than previously reported in the study area but higher than reported in developed country. Age of women, Birth intervals, and Dietary change as a result of current pregnancy and Nutrition knowledge were important risk factors/ predictors of undernutrition (MUAC < 23 cm). Interventions targeting maternal nutrition education and child spacing with giving special emphasis to adolescent pregnant women are recommended.