Agumasie Semahegn

Complementary feeding practice of mothers and associated factors in Hiwot Fana Specialized Hospital, Eastern Ethiopia

Introduction Malnutrition remains one of the main public health problems. Over one third of under-five mortality is caused by under nutrition related to inadequate complementary feeding. This study was aimed to assess of complementary feeding practice and associated factors. Methods Cross sectional study design was conducted to assess complementary feeding practice of mothers to their young children in Hiwot Fana specialized hospital in January 2013. Systematic sampling method was used to select 200 mothers to child pair to assess their timely initiation of complementary feeding and associated factors. Data were collected by using semi-structured questionnaire for face to face interview method. Descriptive statistics, binary and multiple logistic regressions were used for data analysis. Results The prevalence of timely initiate of complementary feeding was 60.5%. Nineteen percent of mothers were initiate complementary before 6 months. The reason for too early initiation of complementary feeding was lack of knowledge and perceive inadequate breast milk production by mothers 17(47.2%), 11(30.6%) respectively. Mothers have male child three times more likely timely initiate complementary feeding than female child (AOR 2.9,95% CI 1.2-7.3). This might be due to traditional gender norm that discriminate female feeding “female eat little talk little” this might start at early age life. Conclusion More than half of them initiated complementary feeding timely which was low. The main reason reported by the mothers for early initiation of complementary feeding was lack of knowledge. Mothers who have male child were three times more likely timely initiate complementary feeding than female child. Information about importance of timely initiation of complementary feeding should be implemented via information education and behavioral change communications, and integrating with health extension package is recommended.

Domestic violence and its predictors among married women in reproductive age in Fagitalekoma Woreda, Awi zone, Amhara regional state, North Western Ethiopia

BackgroundViolence against women is one of the most systematic and prevalent human rights abuses in the world. It is a form of discrimination and deeply rooted in power imbalances and structural inequality between women and men. Documenting the extent of the problem and associated factors is essential to develop public health interventions to tackle violence against women. Therefore, the objective of this study was to determine magnitude of domestic violence and identify its predictors among married women in the reproductive age in north western Ethiopia.MethodsCommunity-based cross-sectional study was conducted from February 15 to March 15, 2011 among 682 married women and 46 key informants. Systematic sampling technique was used to select respondents for the quantitative method. Purposive sampling was used to select in-depth interview key informants for and focus group discussants. Data were analyzed using SPSS window version 16.0. Binary logistic regression and multivariable logistic regression analysis were carried out to determine the prevalence and identify independent predictors of domestic violence against women. Statistical association was measured by adjusted odds ratios and 95% confidence intervals. Statistical significance was declared at P < 0.05.ResultThe prevalence of domestic violence was 78.0%. About 73.3%, 58.4% and 49.1% of women reported different forms of psychological, physical and sexual violence, respectively. Alcohol consumption by husband (AOR = 1.9, 95%CI = 1.3, 2.8), being pregnant (AOR = 2.1, 95% CI = 1.4, 3.4), decision making power (AOR = 2.3, 95% CI = 1.5, 3.4) and annual income (AOR = 1.9, 95% CI = 1.1, 3.3) were predictors of domestic violence.ConclusionThe prevalence of domestic violence was very high as compared to other studies. Women’s husband alcohol consumption, decision making power annual household income and being pregnant are some of the predictors of domestic violence against women.

Adolescent - parent communication on sexual and reproductive health issues among high school students in Dire Dawa, Eastern Ethiopia: a cross sectional study

BackgroundSexual and reproductive health communications are most likely promoting healthy sexual development and reduce sexual risks. Communication is the principal means for parents to transmit sexual values, beliefs, expectations and knowledge to their adolescents. However, there is a paucity of evidence about adolescent parent communication in Ethiopia. This study aimed to determine adolescent-parent communication on sexual and reproductive health issues and associated factors among high school students in Dire Dawa, Eastern Ethiopia.MethodsInstitution based cross sectional study was conducted among high school students in Dire Dawa administrative council from February to March 2011. Simple random sampling technique was used to select 695 students from 9–12 grades. Qualitative data were collected through focus group discussion separately for female and male parents. Data were entered in Epi info version 3.5.1 and analyzed by SPSS version 16.1. Logistic regression with OR and 95% confidence interval was used to identify the independent predictors of adolescent parent communication.ResultsThirty seven percent of students had ever discussed on at least two sexual and reproductive health topics with their parents. Of which, majority of student preferred to discuss with their peers than parent. Condom use during first intercourse was associated with having communication about sexual and reproductive health [AOR = 1.9, 95% CI: 1.0, 3.8]. Cultural taboo, shame and lack of communication skill were reasons that hinder communication between parent and adolescent about sexual matters.ConclusionCommunication on sexual and reproductive health issue between adolescent and their parent was low. School based education is important to improve adolescent parent communication about sexual and reproductive health issues.

Prevalence and factors affecting use of long acting and permanent contraceptive methods in Jinka town, Southern Ethiopia: a cross sectional study

Introduction In Ethiopia, knowledge of contraceptive methods is high though there is low contraceptive prevalence rate. This study was aimed to assess prevalence and associated factors of long acting and permanent contraceptive methods in Jinka town, southern Ethiopia. Methods Community based cross sectional survey was conducted to assess the prevalence and factors affecting long acting and permanent methods of contraceptives utilization from March to April 2008. Eight hundred child bearing age women were participated in the quantitative study and 32 purposively selected focus group discussants were participated in the qualitative study. Face to face interview was used for data collection. Data were analyzed by SPSS version 13.0 statistical software. Descriptive statistics and logistic regression were computed to analyze the data. Results The prevalence of long acting and permanent contraceptive method was 7.3%. Three fourth (76.1%) of the women have ever heard about implants and implant 28 (50%) were the most widely used method. Almost two third of women had intention to use long acting and permanent methods. Knowledge of contraceptive and age of women have significant association with the use of long acting and permanent contraceptive methods. Conclusion The overall prevalence of long acting and permanent contraceptive method was low. Knowledge of contraceptive and age of women have significant association with use of long acting and permanent contraceptive. Extensive health information should be provided.

Induced Abortion and Associated Factors in Health Facilities of Guraghe Zone, Southern Ethiopia

Unsafe abortion is one of the major medical and public health problems in developing countries including Ethiopia. However, there is a lack of up-to-date and reliable information on induced abortion distribution and its determinant factors in the country. This study was intended to assess induced abortion and associated factors in health facilities of Guraghe zone, Southern Ethiopia. Institution based cross-sectional study was conducted in eight health facilities in Guraghe zone. Client exit interview was conducted on 400 patients using a structured questionnaire. Bivariate and multivariate logistic regression analysis was performed to identify factors associated with induced abortion. Out of 400 women, 75.5% responded that the current pregnancy that ended in abortion is unwanted. However, only 12.3% of the respondents have admitted interference to the current pregnancy. Having more than four pregnancies (AOR = 4.28, CI: (1.24–14.71)), age of 30–34 years (AOR = 0.15, CI: (0.04–0.55)), primary education (AOR = 0.26, CI: (0.13–0.88)), and wanted pregnancy (AOR = 0.44, CI: (0.14–0.65)) were found to have association with induced abortion. The study revealed high level of induced abortion which is underpinned by high magnitude of unwanted pregnancy. There is requirement for widespread expansion of increased access to high quality family planning service and post-abortion care.

Childhood overweight, obesity and associated factors among primary school children in dire dawa, eastern Ethiopia; a cross-sectional study

BackgroundObesity in children is increasing worldwide. Malnutrition has become a double burden challenge of public health concern in developing countries. Childhood obesity increases the risk of chronic disease in childhood as well as adulthood. However, information is very scarce about childhood obesity in developing countries specifically in Ethiopia. Therefore, we aimed to assess childhood overweight, obesity and associated factors among primary school children at Dire Dawa, Eastern Ethiopia.MethodsA school based cross-sectional study was conducted in Dire Dawa from 1st to 30th March, 2016. Study participants were selected using multistage sampling method. Pre-tested self-administered questionnaire, face to face interview technique and anthropometric measurements were used to collect data by eight well trained data collectors. Data were coded, cleaned and entered into EpiData software version 3.5.1, and exported into SPSS (version 21.0) statistical software, for data analysis. Bivariate and multivariate logistic regression were carried out to identify associated factors with childhood overweight and obesity. Statistical significance was declared using Adjusted Odds Ratio (AOR) at 95% CI and p-value less than 0.05.ResultsThe prevalence of overweight and obesity were 14.7% (95% CI: 11.7, 18.0) and 5.8% (95% CI: 3.6, 8.0), respectively. Children who were from private school (AOR = 3.4, 95% CI: 1.4, 8.5), from families belonged to high socioeconomic class (AOR = 16.9, 95% CI: 6.5, 23.9), preferred sweetened foods (AOR = 2.3, 95% CI: 1.1, 5.1), had not engaged in regular physical exercise (AOR = 3.8, 95% CI: 1.5, 9.8), had experienced sedentary life style like spent their free time watching TV (AOR = 3.6, 95% CI: 1.6, 7.9), play computer game (AOR = 4.6, 95% CI:1.4,15.4), and were not having close friends (AOR = 2.9, 95% CI: 1.4, 6.2) were significantly associated with overweight/obesity risk.ConclusionOverweight/obesity in children is on alarming stage in the study area. Therefore, more attention should be given to creating awareness about healthy diet and improving life style through school and public media in collaboration with concerned bodies.

Psychotropic medication non-adherence and associated factors among adult patients with major psychiatric disorders: a protocol for a systematic review

BackgroundEvidence from the global burden of diseases show that psychiatric disorders are a growing public health concern. Maintaining adherence to medication is the most essential, but challenging course in the pharmacological treatment modality for major psychiatric disorders. Nevertheless, there is a paucity of abridged evidence on the level of psychotropic medication non-adherence and associated factors. Therefore, we aim to systematically summarize existing primary studies finding to estimate the level and identify associated factors of psychotropic medication non-adherence among adult patients with major psychiatric disorders.MethodsWe will search studies using computerized search engines, main electronic databases and other relevant sources. PubMed (Medline), EMBASE, CINAHL, PsycINFO, Web of Science, WHO Global Health Library, and direct Google search will be searched to retrieve studies written in English language before December 2017. Observational studies (cross-sectional, case-control, cohort or longitudinal, survey and surveillance reports) on major psychiatric disorders (schizophrenia, major depressive and bipolar disorders) among adult patients will be eligible. Data will be extracted independently by two authors. Data synthesis and statistical analysis will be carried out. Pooled estimate will be done to quantify the level of psychotropic medication non-adherence using Comprehensive Meta-Analysis software.DiscussionPsychiatric disorders remain a public health, social and economic concern worldwide. Management of major psychiatric disorders is highly affected by medication non-adherence. Thus, undertaking an integrated and multifaceted approach is necessary to reduce the burden of medication non-adherence, and enhance the quality of patients’ life. Evidence is required to design appropriate intervention to prevent psychotropic medication non-adherence.Protocol registrationPROSPERO: 2017: CRD42017067436.

Unsafe abortion and associated factors among reproductive aged women in Sub-Saharan Africa: a protocol for a systematic review and meta-analysis

BackgroundUnsafe abortion is a neglected public health problem contributing for 13% of maternal death worldwide. In Africa, 99% of abortions are unsafe resulting in one maternal death per 150 cases. The prevalence of unsafe abortion is associated with restricted abortion law, poor quality of health service, and low community awareness. Hence, the aim of this systematic review and meta-analysis is to identify and summarize the available evidence to generate an abridged evidence on the prevalence of unsafe abortion and its associated factors in Sub-Saharan Africa.MethodsThe development of the systematic review methodology has followed the procedural guideline depicted in the preferred reporting items for systematic review and meta-analysis protocol statement. Observational studies that have been conducted from January 1, 1994, up to December 31, 2017, in Sub-Saharan African countries will be included in the systematic review and meta-analysis. MEDLINE (via PubMed), EMBASE, CINAHL, and PopLine will be searched to retrieve available studies. Relevant studies will be retrieved using the search strings applied to different sources. The Joanna Briggs Institute quality assessment tool will be used to critically appraise the methodological robustness and validity of the finding to avoid erroneous data due to confounded or biased statistics. Data extraction template will be prepared to record abstracted information from selected studies. The selection of relevant studies, data extraction, and quality assessment of studies will be carried out by two authors. Meta-analysis using Mantel–Haenszel random effects model will be carried out. The presence of heterogeneity between studies will be checked using the I2 value.DiscussionUnsafe abortion is not yet reduced significantly in Sub-Saharan Africa, and maternal death rate due to unsafe abortion remains high. Currently, there is a gap in availability of abridged evidence on unsafe abortion and this negatively influenced the current service delivery. This finding will help stakeholders to design appropriate strategy. The finding of this systematic review and meta-analysis will be helpful to inform policy-makers, programmers, planners, clinician’s decision making, researchers, and women clients at large.Systematic review registrationPROSPERO 2017: CRD42017081437.

Delayed initiation of antenatal care and associated factors in Ethiopia: a systematic review and meta-analysis

BackgroundAntenatal care uptake is among the key indicators for monitoring the progress of maternal outcomes. Early initiation of antenatal care facilitates the timely management and treatment of pregnancy complications to reduce maternal deaths. In Ethiopia, antenatal care utilization is generally low, and delayed initiation of care is very common. We aimed to systematically identify and synthesize available evidence on delayed initiation of antenatal care and the associated factors in Ethiopia.MethodsStudies published in English from 1 January 2002 to 30 April 2017 were systematically searched from PubMed, Medline, EMBASE, CINAHL and other relevant sources. Two authors independently reviewed the identified studies against the eligibility criteria. The included studies were critically appraised using the Joanna Briggs-MAStARI instrument for observational studies. Meta-analysis was conducted in RevMan v5.3 for Windows using a Mantel–Haenszel random effects model. The presence of statistical heterogeneity was checked using the Cochran Q test, and its level was quantified using the I2 statistics. Pooled estimate of the proportion of the outcome variable was calculated. Pooled Odd Ratios with 95% CI were calculated to measure the effect sizes.ResultThe pooled magnitude of delayed antenatal care in Ethiopia was 64% (95% CI: 57%, 70%). Maternal age (OR = 0.70; 95% CI: 0.53, 0.93), place of residence (OR = 0.29, 95% CI: 0.16, 0.50), maternal education (OR = 0.49; 95% CI: 0.38, 0.63), husband’s education (OR = 0.44; 95% CI: 0.23, 0.85), maternal occupation (OR = 0.75; 95% CI: 0.61, 0.93), monthly income (OR = 2.06; 95% CI: 1.23, 3.45), pregnancy intention (OR = 0.49; 95% CI: 0.40, 0.60), parity (OR = 0.46; 95% CI: 0.36, 0.58), knowledge of antenatal care (OR = 0.40; 95% CI: 0.32, 0.51), women’s autonomy (OR = 0.38; 95% CI: 0.15, 0.94), partner involvement (OR = 0.24; 95% CI: 0.07, 0.75), pregnancy complications (OR = 0.23; 95% CI: 0.06, 0.95), and means of identifying pregnancy (OR = 0.50; 95% CI: 0.36, 0.69) were significantly associated with delayed antenatal care.ConclusionImproving female education and women’s empowerment through economic reforms, strengthening family planning programs to reduce unintended pregnancy and promoting partner involvement in pregnancy care could reduce the very high magnitude of delayed antenatal care in Ethiopia.Trial registrationCRD42017064585.