Trends and determinants of under–five mortality in Ethiopia: Could the MDG four be met?

The survival status of children is one of the indicators of socioeconomic development of any given country. A number of developing countries are, however, unable to tackle causes of child morbidity and mortality due to poor public health measures and a lack of access to healthcare facilities. The main objective of this study is to identify determinants of under-five mortality in Ethiopia, and assess if MDG 4 is attainable using three rounds of the Demographic and Health Surveys conducted in 2000, 2005 and 2011. Data were analysed using tabular and graphical methods, and discrete–time event history model is fitted to identify factors associated with under-five survival. Results of the study reveal that Ethiopia is on track to achieve the MDG on child mortality but requires making extra efforts to reduce the excessive neonatal mortality. Significant differences in under-five mortality still prevail across the administrative regions in Ethiopia although the national strategy for child survival was developed and implemented in 2005. Enhancing the capacity of health workers to manage obstetric care and antenatal care would ensure higher chances of survival of under-five children in the future

Co-occurrence of iron, folate, and vitamin A deficiency among pregnant women in eastern Ethiopia: a community-based study

Abstract Background It is well known that the magnitude of undernutrition in Ethiopia is unacceptably high. The burden of co-occurrence of iron, folate, and vitamin A deficiency, on the other hand, has received less attention. Thus, in this study, we looked at the prevalence of iron, folate, and vitamin A deficiency in pregnant women in eastern Ethiopia. Methods A community-based cross-sectional study was conducted among 397 pregnant women in Haramaya district, eastern Ethiopia. An interview-assisted questionnaire and blood serum were collected from pregnant women using standard techniques and shipped to an EPHI for micronutrient analysis. Factors associated with the co-occurrence of iron, folate, and vitamin A deficiency were identified using binary and multiple logistic regressions. Results According to this study, 81.6% of the participants were deficient in at least one micronutrient, and 53.53.2% were deficient in two or more. Women who did not receive iron-folic acid supplementation (AOR = 2.44; 95% CI = 1.52–3.92), did not attend Antenatal care (ANC) follow up (AOR = 2.88; 95% CI = 1.81–4.61), and reported low consumption of diversified diet (AOR = 2.18 (95% CI = 1.35–3.51) had a higher risk of co-occurrence of iron, folate, and vitamin A deficiency. Conclusion This study found that more than half of pregnant women were in multiple micronutrients, indicating a major public health issue. In addition to the IFA supplementation programs that are already in place, there is a need for multiple micronutrient supplementation

Serum folate deficiency and associated factors among pregnant women in Haramaya District, Eastern Ethiopia: a community-based study

Objectives We aimed to estimate the prevalence of folate deficiency and contributing factors among pregnant women.Design A community-based, cross-sectional study.Setting Haramaya District, Eastern Ethiopia.Participants Four hundred and forty-six pregnant women participated in the study.Primary outcome measure The prevalence of folate deficiency and risk factors.Results Overall, the prevalence of folate deficiency was 49.3% (95% CI 44.6% to 54.1%). Pregnant women with iron deficiency anaemia were 2.94 times more likely to develop folate deficiency (adjusted OR (AOR)=2.9, 95% CI 1.9 to 4.7). Respondents with good knowledge of folate-rich foods (AOR=0.3, 95% CI 0.1 to 0.7) and those who took iron and folic acid supplementation (AOR=0.6, 95% CI 0.4 to 0.9) during their pregnancy were less likely to develop folate deficiency.Conclusions In this study, a considerable proportion of pregnant women had folate deficiency during their pregnancy. Therefore, it is critical that nutritional treatment, education and counselling be strengthened to facilitate iron and folic acid supplementation during pregnancy

Setting up child health and mortality prevention surveillance in Ethiopia.

BACKGROUND: Mortality rates for children under five years of age, and stillbirth risks, remain high in parts of sub-Saharan Africa and South Asia. The Child Health and Mortality Prevention Surveillance (CHAMPS) network aims to ascertain causes of child death in high child mortality settings (>50 deaths/1000 live-births). We aimed to develop a “greenfield” site for CHAMPS, based in Harar and Kersa, in Eastern Ethiopia. This very high mortality setting (>100 deaths/1000 live-births in Kersa) had limited previous surveillance capacity, weak infrastructure and political instability. Here we describe site development, from conception in 2015 to the end of the first year of recruitment. METHODS: We formed a collaboration between Haramaya University and the London School of Hygiene & Tropical Medicine and engaged community, national and international partners to support a new CHAMPS programme. We developed laboratory infrastructure and recruited and trained staff. We established project specific procedures to implement CHAMPS network protocols including; death notifications, clinical and demographic data collection, post-mortem minimally invasive tissue sampling, microbiology and pathology testing, and verbal autopsy. We convened an expert local panel to determine cause-of-death. In partnership with the Ethiopian Public Health Institute we developed strategies to improve child and maternal health. RESULTS: Despite considerable challenge, with financial support, personal commitment and effective partnership, we successfully initiated CHAMPS. One year into recruitment (February 2020), we had received 1173 unique death notifications, investigated 59/99 MITS-eligible cases within the demographic surveillance site, and assigned an underlying and immediate cause of death to 53 children. CONCLUSIONS: The most valuable data for global health policy are from high mortality settings, but initiating CHAMPS has required considerable resource. To further leverage this investment, we need strong local research capacity and to broaden the scientific remit. To support this, we have set up a new collaboration, the “Hararghe Health Research Partnership”