Quality of family planning counseling among women attending prenatal care at a hospital in Addis Ababa, Ethiopia

ObjectiveTo assess the quality of family planning counseling among women attending a prenatal clinic in Addis Ababa, Ethiopia.MethodsIn a descriptive cross‐sectional study conducted between February and April, 2015, at the prenatal care clinic of Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, pregnant women in their third trimester were interviewed about their experience of family planning counseling. Data were collected via a questionnaire. Logistic regression was used to assess predictors of satisfaction with the counseling service.ResultsDuring the study period, 400 women were interviewed. Only 139 women (34.8%) were counseled about family planning. Among those counseled, 126 (90.6%) decided to use a contraceptive method after delivery and 46 (36.7%) decided to use an injectable contraceptive. Women were more likely to report high satisfaction when their provider asked about their partner’s attitude toward contraceptive methods (adjusted odds ratio 6.6; P<0.001), and when asked about their concerns and worries regarding family planning methods (adjusted odds ratio 5.1; P<0.001).ConclusionVery few women were counseled about contraception during prenatal care. Asking about a partner’s attitude toward contraceptives and discussing women’s fears or worries about contraceptives should be considered during family planning counseling to improve satisfaction and quality of care.Despite a hospital policy of universal counseling, only 35% of women attending prenatal care were counseled about family planning methods.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136375/1/ijgo12110.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136375/2/ijgo12110_am.pd

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Factors associated with success of vaginal birth after one caesarean section (VBAC) at three teaching hospitals in Addis Ababa, Ethiopia: a case control study

Abstract Background Vaginal delivery after previous one cesarean section for a non recurring indication has been described by several authors as safe and having a success rate of 60–80%. Hence many centers are offering VBAC for candidates leaving the century old dictum of once cesarean always cesarean. But predicting success of VBAC after trial of labor (TOL) is still a difficult task due to the lack of a validated prediction tool. Studies on predictors of success are few and most of them conducted in developed countries and difficult to generalize. Therefore assessing factors associated with successful VBAC is very important to for counseling mothers while offering VBAC. The aim of this study was to assess factors associated with successful VBAC in three teaching Hospitals in Addis Ababa Ethiopia. Methods A case control study was conducted to compare the factors associated with successful VBAC in teaching hospitals in Addis Ababa in one year period. The cases were those successfully delivered vaginally and the controls were those with failed VBAC and delivered by caesarean section. The sample size of the cases was 101vaginal deliveries and the controls were 103 failed VBAC patients which made the case to control ratio of 1:1. Result In this study independent factors determining successful VBAC were, history of successful VBAC in the past, rupture of membrane at admission, and cervical dilatation of more than 3cm at admission. Presence of meconium, malposition and history of stillbirth were associated with failed VBAC. Factors like maternal age, past caesarean indications, inter delivery interval, and birth weight were not found to be significant determinants of success. The most common reason for repeat cesarean section for after trial of labor was labour dysfunction because of absence of a policy for augmentation on a scarred uterus in these hospitals. Conclusion It is possible to prepare a decision tool on the success of VBAC by taking important past and present obstetric and reproductive performance history as predictor.</p

Factors affecting long-term and permanent contraceptive uptake among post-partum mothers at a hospital in Addis Ababa, Ethiopia: a cross-sectional study

Background: Family planning is important in reducing the total fertility rate and subsequent reduction in maternal and infant morbidity and mortality. Postnatal care represents a window of opportunity for education and communication to newly delivered mothers so that they may make appropriate choices on use of family planning. We assessed the barriers to uptake of long-term and permanent family planning methods among immediate post-partum mothers at Saint Paul's Hospital Millennium Medical College in Addis Ababa, Ethiopia. Methods: We did an institution-based cross-sectional study from Jan 1 to June 30, 2017. The 6 months of study were used as strata, with equal allocation and systematic sampling used to select participants in each month. Post-partum mothers were interviewed using pretested semi-structured questionnaires. Data entry and analysis were done using SPSS version 17. Bivariate and multivariate logistic regression were done and adjusted odds ratios (aOR), 95% CIs, and p values set at 0·05 were used to determine statistical significance of the associations. χ2 tests were used for statistical analysis of results. Findings: 422 post-partum women were interviewed, 192 (45%) of whom started long-term or permanent contraception before discharge. 268 (63%) of women had received counselling on family planning and 241 (57%) got information about contraception from the health facility. Contraceptive counselling (aOR 2·138, 95% CI 0·004–0·331, p=0·003), getting information from the health facility (15·155, 1·848–124·257, p=0·011), and partner support (1·367, 0·175–0·771, p=0·008) were associated with uptake of long-term and permanent contraception. Reasons reported for non-use were fear of side-effects (84 [40%]), opposition from husband (52 [25%]), desire to have more children, lack of awareness, and use of other methods such as lactation amenorrhoea. Interpretation: One-to-one counselling with partner involvement would ensure that mothers receive complete information from health facilities, and hence could reduce myths and misperceptions and improve uptake of long-term and permanent methods of contraception. Funding: Saint Paul's Hospital Millennium Medical College

Myomectomy Overview

This overview of myoma and myomectomy module was prepared for residents in obstetrics and gynaecology at St. Paul Hospital Millennium Medical College in Addis Ababa, Ethiopia.http://deepblue.lib.umich.edu/bitstream/2027.42/133159/1/medical_african_health_oer_network-myocmectomy_overview-August13.zi

Women’s satisfaction with intrapartum care in St Paul’s Hospital Millennium Medical College Addis Ababa Ethiopia: a cross sectional study

Abstract Background Satisfaction during intrapartum care is the most influential attribute on maternal health service return behaviors and utilization. Measuring satisfaction of women with intrapartum care helps to address the problems and improves the quality of delivery services. The aim of this study is to assess women’s level of satisfaction during intrapartum care. Method A hospital based, analytic, cross sectional study was conducted at St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa Ethiopia, from May to June 2015. Data collectors administered a structured and pretested questionnaire to collect data and then analyzed it using SPSS version 20.0 software. Binary logistic regression was used to identify factors associated with women’s intrapartum care satisfaction. Result A total of 394 women of mean age 25.98 years with a standard deviation of ±4.72were included in the study. Only 19% of the women were satisfied with the intrapartum care they received. The variables which were significantly associated with satisfaction of intrapartum care were; opportunity to talk Adjusted Odds Ratio (AOR) (95% CI) 2.44 (1.12, 5.29); Pain Management AOR (95% CI) 3.37 (1.83, 6.21); Short Length of Time Taken for Admission After Seen by Health Professionals AOR (95% CI)0 .97 (0.93, 0.99), and Short Length of Stay in the Hospital AOR (95% CI) 0.91 (0.87, 0.96). Conclusions The women’s overall satisfaction with intrapartum care was low. Multiple factors influence their satisfaction. Health professionals, policy makers and health administrators should give emphasis to factors that contribute to low satisfaction of women with intrapartum care. They should also strengthen their efforts to deliver quality and easily accessible maternal health service to improve women’s overall satisfaction with the maternal health service

Additional file 1: of Women’s satisfaction with intrapartum care in St Paul’s Hospital Millennium Medical College Addis Ababa Ethiopia: a cross sectional study

Questionnaire. (DOCX 17 kb

MAPPING LOCAL PATTERNS OF CHILDHOOD OVERWEIGHT AND WASTING IN LOW- AND MIDDLE-INCOME COUNTRIES BETWEEN 2000 AND 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic