Continuum of maternity care among rural women in Ethiopia: does place and frequency of antenatal care visit matter?

IntroductionThe ministry of health (MOH) of Ethiopia recommends 4 or more focused antenatal care (ANC) visits at health centre (HC) or at a higher level of health facility (HF). In Ethiopia, few studies investigated time dimension of maternal health continuum of care but lack data regarding place dimension and its effect on continuum of care. The aim of this study is to estimate effect of place of ANC-1 visit and adherence to MOH's recommendations of MOH for ANC visits on continuum of care rural in Ethiopia.MethodsWe used data collected from 1431 eligible women included in the National Health Extension Program (HEP) assessment survey that covered 6324 households from 62 woredas in nine regions. The main outcome variable is continuum of care (CoC), which is the uptake of all recommended ANC visits, institutional delivery and postnatal care services. Following descriptive analysis, Propensity Score Matching was used to estimate the effect of place of ANC-1 visit on completion of CoC. Zero inflated Poisson regression was used to model the effect of adherence to MOH recommendation of ANC visits on intensity of maternal health continuum of care.ResultOnly 13.9% of eligible women completed the continuum of care, and place of first antenatal care (ANC) visit was not significantly associated with the completion of continuum of care (β = 0.04, 95% CI = -0.02, 0.09). Adherence of ANC visit to the MOH recommendation (at least 4 ANC visits at higher HFs than health posts (HPs)) increased the likelihood of higher intensity of continuum of care (aIRR = 1.29, 95% CI: 1.26, 1.33). Moreover, the intensity of continuum of care was positively associated with being in agrarian areas (aIRR = 1.17, 95% CI: 1.06, 1.29), exposed to HEP (IRR = 1.22, 95% CI: 1.16, 1.28), being informed about danger signs (aIRR = 1.14, 95% CI: 1.11, 1.18) and delivery of second youngest child at HF (IRR = 1.16, 95% CI: 1.13, 1.20). Increasing age of women was negatively associated with use of services (IRR = 0.90, 95% CI: 0.87, 0.94).ConclusionCompletion of maternal health continuum of care is very low in Ethiopia, however most of the women use at least one of the services. Completion of continuum of care was not affected by place of first ANC visit. Adherence to MOH recommendation of ANC visit increased the intensity of continuum of care. Intensity of continuum of care was positively associated with residing in agrarian areas, HEP exposure, danger sign told, delivery of second youngest child at health facility. To boost the uptake of all maternal health services, it is crucial to work on quality of health facilities, upgrading the infrastructures of HPs and promoting adherence to MOH recommendations of ANC visit

Tetraploid Wheat Landraces in the Mediterranean Basin: Taxonomy, Evolution and Genetic Diversity

The geographic distribution of genetic diversity and the population structure of tetraploid wheat landraces in the Mediterranean basin has received relatively little attention. This is complicated by the lack of consensus concerning the taxonomy of tetraploid wheats and by unresolved questions regarding the domestication and spread of naked wheats. These knowledge gaps hinder crop diversity conservation efforts and plant breeding programmes. We investigated genetic diversity and population structure in tetraploid wheats (wild emmer, emmer, rivet and durum) using nuclear and chloroplast simple sequence repeats, functional variations and insertion site-based polymorphisms. Emmer and wild emmer constitute a genetically distinct population from durum and rivet, the latter seeming to share a common gene pool. Our population structure and genetic diversity data suggest a dynamic history of introduction and extinction of genotypes in the Mediterranean fields

Measurements of neutrino oscillation parameters from the T2K experiment using 3.6×10213.6\times10^{21} protons on target

International audienceThe T2K experiment presents new measurements of neutrino oscillation parameters using $19.7(16.3)\times10^{20}$ protons on target (POT) in (anti-)neutrino mode at the far detector (FD). Compared to the previous analysis, an additional $4.7\times10^{20}$ POT neutrino data was collected at the FD. Significant improvements were made to the analysis methodology, with the near-detector analysis introducing new selections and using more than double the data. Additionally, this is the first T2K oscillation analysis to use NA61/SHINE data on a replica of the T2K target to tune the neutrino flux model, and the neutrino interaction model was improved to include new nuclear effects and calculations. Frequentist and Bayesian analyses are presented, including results on $\sin^2\theta_{13}$ and the impact of priors on the $\delta_\mathrm{CP}$ measurement. Both analyses prefer the normal mass ordering and upper octant of $\sin^2\theta_{23}$ with a nearly maximally CP-violating phase. Assuming the normal ordering and using the constraint on $\sin^2\theta_{13}$ from reactors, $\sin^2\theta_{23}=0.561^{+0.021}_{-0.032}$ using Feldman--Cousins corrected intervals, and $\Delta{}m^2_{32}=2.494_{-0.058}^{+0.041}\times10^{-3}~\mathrm{eV^2}$ using constant $\Delta\chi^{2}$ intervals. The CP-violating phase is constrained to $\delta_\mathrm{CP}=-1.97_{-0.70}^{+0.97}$ using Feldman--Cousins corrected intervals, and $\delta_\mathrm{CP}=0,\pi$ is excluded at more than 90% confidence level. A Jarlskog invariant of zero is excluded at more than $2\sigma$ credible level using a flat prior in $\delta_\mathrm{CP}$, and just below $2\sigma$ using a flat prior in $\sin\delta_\mathrm{CP}$. When the external constraint on $\sin^2\theta_{13}$ is removed, $\sin^2\theta_{13}=28.0^{+2.8}_{-6.5}\times10^{-3}$, in agreement with measurements from reactor experiments. These results are consistent with previous T2K analyses