Geospatial variations and determinants of contraceptive utilization among married reproductive age women in Ethiopia: spatial and multilevel analysis of Ethiopian Demographic and Health Survey, 2019

IntroductionContraception is the most effective method of preventing unwanted pregnancies and their associated disadvantages. It is critical to recognize one's desire to utilize contraceptives before drafting and implementing a good family planning program, especially in developing nations like Ethiopia.ObjectiveThis study aimed to identify the geospatial variations and determinants affecting the utilization of contraceptives among married reproductive age women in Ethiopia.MethodThis study was based on an extensive national survey, the Ethiopian Demographic and Health Survey. A total weighted sample of 5,743 married reproductive-age women was included. Because of the hierarchical nature of the DHS data, a spatial analysis multilevel logistic regression model was used to study individual and community-level factors that may influence contraceptives. The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyze the purely spatial clusters of contraceptive usage. ArcGIS version 10.3 was used to visualize the distribution of contraceptives. A 95% confidence interval and a p-value of less than 0.05 were used to declare statistical significance.ResultThe overall utilization of contraceptives was discovered at 41.25% (39.98, 42.53). Participants age range of 25–34 years [AOR = 0.80, CI: (0.66, 0.96,)] and 35–49 years [AOR = 0.50, CI 95%:(0.66, 0.96)] times less likely to use contraceptives than 15–24 years old respectively. Having primary [AOR = 1.47, CI 95%: (1.25, 1.73)], secondary [AOR = 1.42, CI 95%: (1.09, 1.83)] and higher education level [AOR = 1.92, CI 95%: (1.41, 2.60)], middle wealth [AOR = 1.48, CI 95%: (1.14, 1.90)], richer [AOR = 1.41, CI 95%: (1.07, 1.86)] and richest [AOR = 2.17, CI 95%: (1.52, 3.11)], having 1–4 ANC follow up have [AOR = 1.60, CI 95%: (1.26, 2.03)], gave birth at age of 35–44 [AOR = 0.29, CI 95%: (0.22, 0.37)], having 3–5 children [AOR = 1.26, CI 95%: (1.03, 1.52)], being from community of high level women education [AOR = 1.61, CI 95%: (1.21, 2.15)] were associated positively. Participants from Amhara, Oromia, Benishangul and SNNPR regions have revealed [AOR = 2.40, CI 95%: (1.53, 3.77)], [AOR = 1.64, CI 95%: (1.05, 2.56)], [AOR = 1.62, CI 95%: (1.01, 2.62)] and [AOR = 2.04, CI 95: (1.31, 3.19)], in contrast, Somali and Afar regions have shown [AOR = 011, CI 95%: (0.05, 0.22)] and [AOR = 0.31, CI 95%: (0.18, 0.54)] times less likely to use contraceptive services than Tigray Region respectively. The spatial analysis of contraceptive usage discovered that the northern, central and southern parts of the country had higher utilization of contraceptives than the eastern and northeastern of the country.ConclusionThe study revealed that contraceptive usage among married women is comparatively low, with wide regional variation. Raising awareness among mothers about the importance of antenatal care and assisting mothers who are financially disadvantaged or do not have access to health facilities will aid in providing better family planning services. Improving contraceptive information dissemination at community and regional levels is key to averting potential barriers

Myopia and its associated factors among pregnant women at health institutions in Gondar District, Northwest Ethiopia: A multi-center cross-sectional study

BackgroundMyopia is the most common form of uncorrected refractive error with a growing burden worldwide. It is the principal complaint of most women during pregnancy. Although myopia has led to several consequences across the standard life of pregnant women, there is no previous study in Ethiopia regarding this topic. Thus, this study determined the prevalence of myopia and identifies its associated factors among pregnant women attending antenatal care units at governmental health institutions in Gondar City District, Northwest Ethiopia.MethodsAn institution-based cross-sectional study design was conducted from 08 February to 08 April 2021. From the selected health centres, study participants were recruited by systematic random sampling technique. A pre-tested, structured-interviewer-administered questionnaire consisting of socio-demographic variables, obstetric and clinical-related variables was used to collect the required data. Non-cycloplegic refraction was performed using trial lenses, trial frames, and retinoscopy in a semi-dark examination room. EpiData 3 and STATA 14 were used for data entry and statistical analysis respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of myopia. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with myopia. Model fitness was checked by Hosmer and Lemeshow goodness of test (at p > 0.05)ResultsA total of four-hundred and twenty-three pregnant women participated with a 100% response rate in this study. The overall prevalence of myopia among pregnant women was 26.48% (95% CI: 22.48–30.91). Eighty-Eight (20.81%) and Eighty-Four (19.85%) of the study participants had myopia in their right and left eyes respectively. The prevalence of myopia was significantly associated with age (AOR = 1.17; 95% CI: 1.09–1.28), the third trimester of gestation (AOR = 2.05, 95% CI: 1.08–3.90), multi & grand multipara (AOR = 3.15; 95% CI: 1.59–6.25), and history of contraceptive use (AOR = 3.30; 95% CI: 1. 50–7.28).ConclusionThe finding of our study shows that there is a higher prevalence of myopia among pregnant women in our study area. Further prospective analytical studies regarding visual systems among pregnant women, particularly as a result of pregnancy, are strongly recommended

Institutional delivery service utilization and associated factors in fragile and conflict-affected situations in Sekota town, Northern Ethiopia, 2022: A community-based cross-sectional study

Background: Conflict-affected areas are considered to contribute a substantial proportion of worldwide maternal deaths. However, research on maternal health care in conflict-affected countries is very limited. In the absence of recent data, it is impossible to monitor progress made in mitigating the effect of conflict on maternal survival. As a result, this study targeted to assess institutional delivery services usage and influencing factors in a fragile and conflict-affected situation in Sekota town, Northern Ethiopia. Methods: A community-based cross-sectional study was employed among 420 mothers in Sekota town, Northern Ethiopia from July 15th to 30th, 2022. The desired sample size was determined using a single population proportion formula. The data were collected by using interviewer administered structured questionnaire; entered via EpiData version 4.6 and analyzed using SPSS version 25 software. To identify the associated factors, a bivariable and multivariable logistic regression model was applied. The level of significance was declared at a p-value of <0.05. An adjusted odds ratio with a 95% confidence interval was considered to see the strength of the association between dependent and independent variables. Results: Of the total respondent, 202 (48.1%), 95% CI: (43.0%, 53.0%) mothers utilized institutional delivery service. The use of institutional delivery services was associated with the maternal educational level of secondary school and above (AOR = 2.06, 95% CI: 1.08–3.93), antenatal care during the most recent pregnancy (AOR = 5.24, 95% CI: 3.01–9.11), being informed on birth preparedness and complication readiness (AOR = 1.93, 95% CI: 1.23–3.02) and displacement of the respondents from their usual place of residence due to conflict (AOR = 0.41, 95% CI: 0.21–0.68). Conclusion: Institutional delivery service utilization was very low in the study setting. Healthcare for women in conflict-prone areas requires critical attention and should be given priority during the conflict. More prospective research is needed to fully understand and reduce the impact of conflict on maternal and neonatal health care

Prevalence of married women’s decision-making autonomy on contraceptive use and its associated factors in high fertility regions of Ethiopia: a multilevel analysis using EDHS 2016 data

Abstract Background Women's independence in reproductive health is crucial to the health of mothers and children. Couples are, however, restricted from discussing their relationship openly. Regarding this, information about women’s decision-making autonomy is low in developing countries including Ethiopia. Therefore, this study was aimed to assess married women’s decision-making autonomy on contraceptive use in high fertility regions of Ethiopia. Methods The study was based on secondary data analysis of the Ethiopian Demographic and Health Survey 2016 data. A total weighted sample of 1157 reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of decision making autonomy on contraceptive use. Statistical significance was determined using Adjusted Odds Ratio (AOR) with 95% confidence interval. Results Overall prevalence of decision making autonomy on contraceptive use was observed to be 17.2% (15.1, 19.5). Women's age 25–34 (AOR = 3.19; 95% CI:1.55, 6.54), and 35–49 (AOR = 3.59; 95% CI: 1.5, 8.36), secondary and above educational level (AOR = 3.38; 95% CI: 1.07, 10.67), being married before 18 years (AOR = 0.42; 95% CI:0.26, 0.68), being Muslim in religion (AOR = 0.47; 95% CI: 0.23, 0.98), women being in urban area (AOR = 2.73; 95% CI: 1.97, 6.35), and community media exposure (AOR = 1.85; 95% CI: 1.15, 2.48) were associated with decision making autonomy on contraceptive use. Conclusion Women’s decision-making autonomy on contraceptive use in this study was low. Age of mothers, educational status of mothers, age at first marriage, residence, religion, and community media exposure were significant factors. Therefore, the government should promote women’s autonomy on contraceptive use as an essential component of reproductive health rights through mass media, educating, with particular attention for, youth women, and women living in rural settings

Comparison of Kaplan-Meier survival curves for hypothermia with the log rank test of neonates with RD admitted to the NICU in UOGCSH, 2021.

Comparison of Kaplan-Meier survival curves for hypothermia with the log rank test of neonates with RD admitted to the NICU in UOGCSH, 2021.</p

Cox-Snell Residual Graph for the goodness of model fitness that shows the hazard function follows the 45˚ closed to the baseline, in UOGCSH, 2021.

Cox-Snell Residual Graph for the goodness of model fitness that shows the hazard function follows the 45˚ closed to the baseline, in UOGCSH, 2021.</p

This is a check list and questionnaire (English version).

(DOCX)</p

Comparison of Kaplan-Meier survival curves for Apgar score (1min) with the log rank test of neonates with RD admitted to the NICU in UOGCSH, 2021.

Comparison of Kaplan-Meier survival curves for Apgar score (1min) with the log rank test of neonates with RD admitted to the NICU in UOGCSH, 2021.</p

Multilevel analysis of intimate partner violence and associated factors among pregnant women in East Africa: Evidence from recent (2012–2018) demographic and health surveys

Abstract Background Globally, intimate partner violence (IPV) during pregnancy is the most common and major public health problem. It has a negative effect on the lives of both mother and fetus. Despite its prominence, many countries in East Africa have paid little attention to this issue. This study assessed the prevalence and associated factors of intimate partner violence among pregnant women in East African countries. Methods The study adopted a secondary method data analysis that utilized recent Demographic and Health Surveys of 10 countries in East Africa between 2012 and 2018. A total of 23,521 women who gave birth in the 5 years preceding the survey were included. A multilevel mixed-effect logistic regression model was fitted to identify factors associated with IPV. Variables with a p-value < 0.05 were declared as significant factors associated with IPV. Results The overall prevalence of IPV in East Africa was 37.14 (95% CI 36.53, 37.76). Women with age 25–34 (AOR = 1.20;95%CI; 1.06, 1.36), 35–39 (AOR = 1.40;95%CI; 1.24, 1.58), and 40–49 (AOR = 1.66;95%CI; 1.43, 1.95), women with no education (AOR = 1.27;95%CI; 1.16, 1.39), women with no occupation (AOR = 1.36; 95%CI; 1.27, 1.47), women from households with the poorest (AOR = 1.51; 95%CI: 1.33, 1.71), poorer (AOR = 1.40;95% CI:1.24, 1.58), middle (AOR = 1.32;95%CI:1.17, 1.48), and richer (AOR = 1.26;95%CI: 1.13, 1.40), husband drinks alcohol (AOR = 2.54; 95%CI 2.39, 2.71), ≥ 5 number of living children (AOR = 1.28; 95%CI: 1.31, 2.57) and rural areas (AOR = 1.14; 95%CI: 1.03, 1.25) were significantly associated with IPV. Conclusion More than one-third of pregnant women experienced intimate partner violence in East Africa. Promoting the educational status of women, the economic capacity of women, and the healthy behavior of the husband by reducing alcohol consumption, with particular attention to rural women and violence during pregnancy, is vital to reduce the prevalence of IPV

Cox-Snell Residual Graph for the goodness of model fitness that shows the hazard function follows the 45° closed to the baseline, in UOGCSH, 2021.

Cox-Snell Residual Graph for the goodness of model fitness that shows the hazard function follows the 45° closed to the baseline, in UOGCSH, 2021.</p