Providers' knowledge on postpartum intrauterine contraceptive device (PPIUCD) service provision in Amhara region public health facility, Ethiopia.

IntroductionPostpartum intrauterine contraceptive devices (PP-IUCD) are one type of post-partum family planning method, which can be provided to a post-partum woman starting from the placental delivery time (within 10 minutes), or within the first 48 hours of postpartum period. In most developing countries, delivery time is the primary opportunity for women to access post-partum family planning methods, especially for those living in remote areas. Hence, this study assesses providers' knowledge on postpartum intrauterine contraceptive device service provision.MethodsA facility-based cross-sectional study was conducted in Amhara region health center and hospitals. Health providers surveyed included obstetricians, gynecologists, general practitioners, emergency surgical officers, health officers, midwives and nurses from September 18, 2015 to December18, 2016. Simple random sampling was used to select 864 subjects. Data were collected by using a structured self-administered questionnaire and observing the facility. Multilevel analysis was done to see factors associated with outcome.ResultsA total of 197 health facilities and 864 providers are included in the final analysis. Of the total providers 524 (60.6%) were from a health center. The mean age (±SD) of participants was 27.8 years (±5.4). The number of providers with good knowledge accounted for 253 of those surveyed (29.3%). The proportion of good knowledge among trained PP-IUCD providers was 35.7% (those who scored above average), and 27.9% was untrained about PP-IUCD. A considerable heterogeneity was observed between health facilities for each indicator of provider's knowledge. Gender differences were observed as the mean knowledge score deference on PP-IUCD by 0.4 points (β = -0.41; -0.72, -0.10) when the participant was female. Having experience of regular counseling of pregnant women increases PP-IUCD knowledge score by 0.97. (β = 0.97; 95% CI: 0.48, 1.47). Where the health facility requested clients to purchase the IUCD themselves, the mean knowledge score decreased by 0.47 points compared with free of charge at the facility level (β = -0.47; 95%CI: -0.87, -0.07).ConclusionOur findings showed that providers' knowledge about postpartum IUCD was low in the Amhara region public health facility. The lowest knowledge score was noted among nurses, health Officers, midwives, and general practice professionals. Factors associated with providers' knowledge on PP-IUCD are the status of health facility, female sex, training on PP-IUCD, regular counseling of pregnant women, and unavailability of IUCD service

“Do Our Bodies Know Their Ways?” Villagization, Food Insecurity, and Ill-Being in Ethiopia’s Lower Omo Valley

This article investigates food security and well-being in the context of “development-forced displacement” in Ethiopia. In the lower Omo, a large hydroelectric dam and plantation schemes have forced people to cede communal lands to the state and business speculators, and indigenous communities have been targeted for resettlement in new consolidated villages. The authors carried out a food access survey in new villages and in communities not yet subjected to villagization and complemented this with ethnographic research carried out over a period of four years. The results of the two methodological approaches were inconsistent. The survey data suggest that household food access was poor in both places but better in villagization sites than in the other communities. The ethnographic research, however, suggests that village settlers were unable to feed themselves from the irrigated plots they were allotted and were therefore dependent on food aid. They spoke of indignity, bodily discomfort, and the severance of meaningful social relations. This article discusses the contrast between the information generated by the different research methods and asks how this tension relates to two major narratives about development: development as a process through which the state actualizes a national dream, and development as a process that creates affluence for some by impoverishing others