Predictors of Acute Malnutrition Among 6 - 23 Months Children in Hidhebu Abote Woreda, Oromia, Ethiopia

Introduction: Malnutrition is major public-health problem throughout the developing world and is an underlying factor in over 50% of the 10–11 million children under 5 years of age who die each year. Although the prevalence of malnutrition is generally high in Ethiopia, there were no enough documented predictors. Therefore; this study was undertaken to identify predictors of acute malnutrition among 6 - 23 months in HidhebuAbote Woreda, Oromiya Regional State, Ethiopia.  Methods: Community based unmatched case-control study design was utilized. Children of 6-23 months in the Woreda were screened by weight for height and 288 children (144 cases and 144 controls) were selected by simple random sampling technique. Results: The mean age of the cases and controls were 13.38 (+ 4.68) and 14.41 (+ 5.44) month respectively. There were more males in the cases 68 (47.5%) than in the controls 58 (40.5%). Cases with malnutrition were more likely to: have mothers who did not graduate as model by the health extension program (AOR= 7.246), have spring and /or river as source of drinking water (AOR= 5.349), initiate breastfeeding late (AOR= 4.248), not exclusively breastfed(AOR= 4.586), not given  colostrums(AOR=2.706), be bottle fed (AOR=3.111) and have illness during the last two weeks before the survey (AOR=4.136) compared to controls.Conclusion: Finally this study identified that distal, intermediate and proximal factors associated with Acute Malnutrition among 6 - 23 months Children in the study area. Therefore, those factors associated with Acute Malnutrition would be emphatically considered during development of child health and Nutritional programs by police makers in collaboration with others responsible bodies. Federal ministry of health would be better to give greater emphases to address under two years child Nutritional status to improve through health education by using mass media and community mobilization in more comprehensive manner by integrated to health extension program of model family graduation package about child nutritional and optimal child feeding practices based on the final guideline and improving water and sanitation including home based treatment of water using ‘Wuha’ Agar. Key words: Acute Malnutrition 6 - 23 Months Children Hidhebu Abote Wored

Modern contraceptive utilization and associated factors among postpartum women in Kena Woreda, Konso Zone, South Ethiopian Regional State, Ethiopia, 2023: mixed type community based cross-sectional study design

Abstract Background Even though family planning 2020 has made remarkable progress about solving the issue of unmet need for family planning, 70% of women in a developing countries who do not want to conceive are not using it. There are limited research that provided detail information regarding barriers of modern contraceptive utilization during postpartum period in the study area. In addition, previous study also recommended that to conduct using mixed quantitative and qualitative design for further investigations to answer these “why” questions and narrow these gaps. Objective This study aimed to assess postpartum modern contraceptive utilization and associated factors among postpartum women in Kena woreda, Konso zone, South Ethiopian Regional State, Ethiopia, 2023. Methods A mixed type community based cross-sectional study design was conducted among 605 women in Kena woreda, from September 1–30/2023 out of 628 sampled mothers. Multistage sampling technique was used to select study participant and data was collected using semi-structured pretested questionnaire and entered in to Epi data version 3.1 and then exported to STATA version 14 for analysis for quantitative. The association between variables was analyzed using bivariate and multivariable binary logistic regression and level of significant determined with adjusted odd ratio at 95% CI and P-value less than < 0.05. After translation and transcription, manual thematic analysis was applied to the qualitative data. Results The prevalence of modern contraceptive use among women during postpartum period in Kena woreda was found to be 39.01% [95% CI: 35.18–42.96%]. Menses resumed (AOR = 1.63; 95% CI: 1.02, 2.59), linked to the family planning unit during their child`s immunization (AOR = 2.17; 95% CI: 1.45, 3.25), family planning counselling during antenatal care visit (AOR = 1.63; 95% CI: 1.10, 2.42) and good knowledge towards modern contraceptive (AOR = 1.53; 95% CI: 1.03, 2.26) were factors associated with postpartum contraceptive utilization. Partner oppose, myths and misconception, need for excess family size, religious prohibition, fear of side effect,menses not resumed, lack of counselling and privacy room, and lack of transportation to health facility were barriers to modern postpartum contraceptive utilization.   Conclusions and recommendations The utilization of postpartum contraceptives was found to be lower than the target set by the 2020/21 national reproductive health strategy plan, which aimed to increase contraceptive method usage to 50%. Menses resumed, family planning counselling during antenatal care visit, linked to the family planning unit during child immunization and good knowledge were factors associated to modern postpartum contraceptive utilization. Strengthening service integration and family planning counseling during antenatal care visits and encourage mothers to start using modern family planning methods before menses resume are important. Overcoming barriers including partner opposition, myths, religious beliefs, fear of side effects, lack of counseling at health facilities, and transportation challenges is essential