Unmet need for modern contraceptives and associated factors among women in the extended postpartum period in Dessie town, Ethiopia

Abstract Background The contraceptive use of women in the extended postpartum period is usually different from other times in a woman’s life cycle due to the additional roles and presence of emotional changes. However, there is lack of evidence regarding women contraceptive need during this period and the extent they met their need. Therefore, the objective of this study was to assess unmet need for modern contraceptives and associated factors among women during the extended postpartum period in Dessie Town, North east Ethiopia in December 2014. Methods A community-based cross-sectional study was conducted among women who gave birth one year before the study period. Systematic random sampling technique was employed to recruit a total of 383 study participants. For data collection, a structured and pretested standard questionnaire was used. Descriptive statistics were done to characterize the study population using different variables. Bivariate and multiple logistic regression models were fitted to control confounding factors. Odds ratios with 95% confidence intervals were computed to identify factors associated with unmet need. Results This study revealed that 44% of the extended post-partum women had unmet need of modern contraceptives of which 57% unmet need for spacing and 43% for limiting. Education of women (being illiterate) (AOR (adjusted odds ratio) =3.37, 95% CI (confidence interval) 1.22–7.57), antenatal care service (no) (AOR = 2.41, 95% CI 1.11–5.79), Post-natal care service (no) (AOR = 3.63, CI 2.13–6.19) and knowledge of lactational amenorrhea method (AOR = 7.84 95% CI 4.10–15.02) were the factors positively associated with unmet need modern contraceptives in the extended postpartum period. Conclusion The unmet need for modern contraception is high in the study area. There is need to improve the quality of maternal health service, girls education, information on postpartum risk of pregnancy on the recommended postpartum contraceptives to enable mothers make informed choices of contraceptives

Determinants of unmet need for family planning among currently married reproductive age women at Dewa Chefa District of Oromia special zone, Amhara region, Ethiopia, 2021; a case-control study

Abstract Background Unmet need for family planning is a proportion of women among reproductive age group who want to stop or delay childbearing but are not using any method of contraception. One in ten married women face unmet need for family planning world-wide whereas, one in five women in Africa. Thus, by understanding factors associated with unmet need specific to the study area; the study contributes to planning and intervention of programs, gives additional finding for controversies in earlier studies, and also helps as a baseline for other researchers conducting studies on similar topics. Methods A community-based unmatched case-control study was conducted from March 29-April 25, 2021 G.C on 462 currently married reproductive age women (154 cases and 308 controls) in Dewa Chefa District. Currently married reproductive-age women who were fecund, and wanted to limit or delay childbearing but were not using any contraceptive methods were taken as cases and currently married reproductive-age women who were using family planning or did not want to use were taken as controls. A structured and pre-tested questionnaire was used to collect data. Collected data were entered into Epi-data 3.1 and exported to SPSS 23 for analysis. Binary Logistic regression was conducted and variables with p-value < 0.05 were taken as statistically significant. Results A total of 462 women participated in this study, with 100% response rate. The mean age of the respondents was 27.92 years (with SD of ± 6.3) Age of woman 35–49 [AOR = 6.6 (1.1–39)], having poor knowledge on family planning [AOR = 1.9 (1.1–3.1)], using family planning decided by husband [AOR = 3.8 (2.1–6.9)], using family planning decided together [AOR = 2.3 (1.07–5.1)] and have no support and disapproval of husband for family planning use [AOR = 2.1 (1.08-4)] were factors significantly associated with unmet need. Conclusion and recommendations Age of the woman, main decider of family planning use, knowledge about family planning and support and approval of spouse for family planning use were found to have significant association with unmet need for family planning. Thus, family planning providers, District health office, and other concerned bodies should strengthen female empowerment and male involvement in the program with strong couple counseling to reduce unmet need

Short birth spacing and its association with maternal educational status, contraceptive use, and duration of breastfeeding in Ethiopia. A systematic review and meta-analysis.

BackgroundClosely spaced birth increases the risk of adverse maternal and child health outcomes. In Ethiopia, the prevalence of short birth spacing was highly variable across studies. Besides, contraceptive use, educational status, and duration of breastfeeding were frequently mentioned factors affecting short birth spacing. Therefore, this meta-analysis aimed to estimate the pooled prevalence of short birth spacing and its association with contraceptive use, educational status, and duration of breastfeeding among reproductive-age women in Ethiopia.MethodsInternational databases: Google Scholar, PubMed, CINAHL, Cochrane library, HINARI, and Global Health were searched systematically to identify articles reporting the prevalence of short birth spacing and its association with contraceptive use, educational status, and duration of breastfeeding among reproductive-age women in Ethiopia. The data were analyzed by STATA/SE version-14 statistical software. The random-effect model was used to estimate the pooled prevalence of short birth spacing and the log odds ratio was used to determine the association. Moreover, egger's test and I-squared statistics were used to assess publication bias and heterogeneity respectively.ResultsAfter reviewing 511 research articles, a total of nine articles with 5,682 study participants were included in this meta-analysis. The pooled prevalence of short birth spacing in Ethiopia was 46.9% [95% CI: (34.7, 59.1)]. Significant heterogeneity was observed between studies (I2 = 98.4, p ConclusionsAlthough a minimum inter-pregnancy interval of two years was recommended by the World Health Organization (WHO), significant numbers of women still practiced short birth spacing in Ethiopia. Duration of breastfeeding and non-use of contraceptives were factors significantly associated with short birth spacing. So, efforts should be made to improve breastfeeding practice and contraceptive utilization among women in Ethiopia

Predictors of sexual violence among female students in higher education institutions in Ethiopia: A systematic review and meta-analysis.

BackgroundSexual violence is a profound social and public health problem in Ethiopia. Female students in institutions of higher education are highly vulnerable to sexual violence. Different studies conducted on sexual violence at higher education institutions lack consistency and inclusiveness. Thus, this systematic review and meta-analysis were conducted to estimate the lifetime and twelve-month prevalence, and predictors of sexual violence among female students in institutions of higher education in Ethiopia.MethodsThis study used a systematic review and meta-analysis of studies conducted from January 1, 2000, to June 1, 2020, in Ethiopia. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases including PubMed, Cochrane Library, Hinari, Google Scholar, CINAHL, and Global Health were searched using relevant search terms. Meta-analysis was performed using STATA 14 software. The I2 statistics and Egger's test were used to assess heterogeneity and publication bias, respectively. Forest plots were used to present the prevalence and odds ratio (OR) with a 95% confidence interval (CI).ResultsThis systematic review and meta-analysis included 10 studies, 5790 study participants. The pooled lifetime and twelve-month prevalence of sexual violence among female students in Ethiopia was 49.4% (95%CI: 37.87, 60.96) and 36.02% (95%CI: 26.42, 45.62) respectively. Rural residence (OR = 2.13;95%CI: 1.33, 3.42), alcohol drinking (OR = 2.03; 95%CI: 1.44, 2.87), and ever had a boyfriend (OR = 2.07; 95%CI: 1.32, 3.62) were factors associated with sexual violence.ConclusionsThe lifetime prevalence of sexual violence among female students in institutions of higher education in Ethiopia was high. Place of residence, alcohol drinking, and ever had a boyfriend were statistically significant factors of sexual violence. Life skill training and law enforcement are needed to control alcohol consumption. Additionally, more focused interventions should be done in rural settings.RegistrationThis systematic review has been registered in the International Prospective Registry of Systematic Review (PROSPERO) with a specific registration number CRD42020155894

Trend and determinants of anemia change among pregnant and/or lactating women in Ethiopia: A multivariate decomposition analysis.

BackgroundEven though anemia was highly targeted in different global strategies, many pregnant and/or lactating women and children were suffering from it and its complications. Besides this, prior trend analysis has not been conducted among pregnant and/or lactating women in Ethiopia. Therefore, this study aimed to assess the trend and determinants of anemia change among pregnant and/or lactating women in Ethiopia.MethodsThe study utilized two consecutive Ethiopia Demographic and Health Survey (EDHS) datasets. A total of 6,106 and 5,641 pregnant and/or lactating women in 2011 and 2016 survey respectively were included in the analysis. The data were analyzed by using Stata version 14.0. Logit based decomposition analysis was done to identify contributing factors for anemia change and statistical significance was determined by using P-value.ResultsThe trend of anemia was increased from 19% in 2011 to 29% in 2016 EDHS. The analysis revealed that, 8% of the overall change in anemia was because of the change in women's composition. Changes in the composition of pregnant and/or lactating women according to region, economic status and tobacco and/or cigarette use were the major sources of the change. Greater than 90% of the increase in anemia was due to differences in the coefficient. Mostly, the change in behaviors of the Amhara population, those who had a history of terminated pregnancy and use tobacco and/or cigarette were the sources of the change.ConclusionsAnemia among pregnant and/or lactating women was increased against government interventions over the last half-decade in Ethiopia. Programmatic interventions targeting Somali and Dire Dawa regions are still needed to decrease anemia

Gross motor developmental delay and associated factors among under-five children attending public health facilities of Dessie city, Ethiopia

Abstract Background Child psychomotor development and factors affecting it today is the subject of interest of many studies, in particular by the experts involved in the protection and improvement of children’s health. There is limited evidence on developmental delay among under-five children in low-income countries like Ethiopia. The aim of this study was to assess gross motor developmental delay and associated factors among under-five children attending public health facilities of Dessie city, Ethiopia. Methods Facility based cross sectional study design was used among under-five children attending under-five OPD in public health facilities of Dessie town from July 1, 2020 to August 15, 2021. A total of, 417 under-five children were systematically selected based on their average number of clients in a month. A pretested structured questionnaire was used for data collection, and data was entered into Epi-data 3.1 version and it was exported to STATA version 14 for analysis. Binary logistic regression analysis was used to identify factors associated with the outcome variable. Odds ratio with 95% confidence interval was used to show the strength and direction of association respectively and P-value less than 0.05 is used to declare statistical significance. Results The overall proportion of gross motor developmental delay among under-five children attending health facilities of Dessie city, Ethiopia was 16.31%, 95% CI: (13.05, 20.19). Increased age of the child [AOR = 0.97, 95% CI: (0.96, 0.99)], increased gestational age during pregnancy [AOR = 0.47, 95% CI: (0.37, 0.65)], being male [AOR = 5.26, 95% CI: (1.76, 15.67)], having history of alcohol intake during pregnancy [AOR = 7.40, 95% CI: (2.36, 23.25)], taking iron during pregnancy [AOR = 0.04, 95% CI: (0.01, 0.15)], facing fetal and/or maternal complication [AOR = 4.98, 95% CI: (1.20, 20.62)], having instrumental delivery [AOR = 9.78, 95% CI: (2.48, 38.60)] were significantly associated with gross motor developmental delay. Conclusions The gross motor developmental delay among under-five children was higher as compared to other literatures. This study indicated that, age and sex of the child, iron and alcohol intake during pregnancy, gestational age, mode of delivery and any complication to her and or her neonate were independent variables which showed statistical significant association. The physicians should advise mothers to take iron-folic acid supplement properly and to avoid intake of alcohol during pregnancy. In addition, they should focus on those mothers who faced any complication to her and/or her neonate and better to discourage instrumental delivery unless there are no other options

Time to initiation of antenatal care and its predictors among pregnant women in Ethiopia: Cox-gamma shared frailty model.

BackgroundTimely initiating antenatal care (ANC) is crucial in the countries that have high maternal morbidity and mortality. However, in developing countries including Ethiopia, pregnant mother's time to initiate antenatal care was not well-studied. Therefore, this study aimed to assess time to first ANC and its predictors among pregnant women in Ethiopia.MethodsA community-based cross-sectional study was conducted among 7,543 pregnant women in Ethiopia using the Ethiopian Demographic Health Survey (EDHS), 2016 data. A two-stage stratified cluster sampling was employed. The Kaplan-Meier (KM) method was used to estimate time to first antenatal care visit. Cox-gamma shared frailty model was applied to determine predictors. Adjusted Hazard Ratio (AHR) with 95% confidence interval was reported as the effect size. Model adequacy was assessed by using the Cox-Snell residual plot. Statistical significance was considered at p value ResultsThe median time to first ANC was 5 months with IQR (3,-). The independent predictors of time to first ANC visit were primary education [AHR: 1.24 (95%CI, 1.13-1.35)], secondary education [AHR: 1.28(95% CI, 1.11-1.47)], higher education [AHR: 1.43 (1.19-1.72)] as compared to women with no formal education. Having media exposure [AHR: 1.13 (95% CI, 1.03-1.24)], early initiation of ANC increases by 25% [AHR: 1.25 (95% CI, 1.12-1.40)] in poorer, 32% [AHR: 1.32 (95% CI, 1.17-1.49)] in middle, 37% [AHR: 1.37 (95% CI, 1.20-1.56)] in richer and 41% [AHR: 1.41 (95%CI, 1.1.19-1.67)] in richest households as compared to poorest household wealth index. Living in city administration, media exposure and community women literacy were also enabler factors, while, long distance from health facility and nomadic region residency were hindering factors of early ANC visit.ConclusionsThe current study revealed that women's time to first antenatal care visit was by far late in Ethiopia as compared to the world health organization recommendation (WHO). The predictors of time to first ANC visit were education status of women, having media exposure, level of household wealth index, community women literacy ad distance to health facility. It is vital that maternal and child health policies and strategies better to be directed at women development and also designing and applying interventions that intended to increase timely initiation ANC among pregnant-women. Researchers also recommended conducting studies using a stronger design like a cohort to establish temporality and reduce biases

The effect of maternal age on still birth in Africa: A systematic review and meta‐analysis

Abstract Background and Aims Stillbirth is a public health as well as a development problem in low and middle‐income countries. The studies that found out maternal age as a factor for the risk of stillbirth reported different findings. This systematic review and meta‐analysis is believed to fill the inconclusiveness of these findings. Hence, the aim of this systematic review and meta‐analysis is to estimate the pooled effect of advanced maternal age on stillbirth in Africa. Methods PubMed & HINARY databases and Google Scholar search engine were searched to access the primary studies. The extracted data using Microsoft excel was exported to Stata 15 software for analysis. The presence of heterogeneity was checked using Cochran's Q statistic and the I2 test. Publication bias was examined by using funnel plot and Egger's test. The pooled effect measure with DerSimonian and Laird method of random‐effect model was reported using odds ratio (OR) with respective 95% confidence interval. Results Totally, 14 articles are included for the systematic review and meta‐analysis. The stillbirth reported by the studies ranges from 15 to 146.7 per 1000 births. The overall OR of advanced maternal age (≥35 years) on stillbirth is 1.42 (1.18, 1.71) when compared with the age group of 20–35 years. The cumulative effect of getting pregnant at advanced age on stillbirth was slightly increasing from year to year. Conclusion Advanced maternal age is a risk factor for stillbirth. Health Information Communication on the risk of getting pregnant at the advanced ages on stillbirth should be well addressed to all women of reproductive age group

Induced abortion among female students in higher education institutions in Ethiopia: A systematic review and meta-analysis.

BackgroundFemale students in institutions of higher education are at higher risk of abortion and its consequences. There is no nationally representative data on induced abortion among students in higher education institutions in Ethiopia. Hence, this study aimed to estimate the pooled prevalence of induced abortion among female students in institutions of higher education in Ethiopia.MethodsThis study used a systematic review and meta-analysis of studies conducted from January 1, 2010, to June 30, 2022, in Ethiopia. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. PubMed, Cochrane Library, Hinari, Google Scholar, CINAHL, and Global Health electronic databases were searched. The analysis was performed using STATA 14 software. Heterogeneity and publication bias were assessed using I2 statistics and Egger's test, respectively. Duval and Tweedie's 'trim and fill' method was also performed to adjust the pooled estimate. Forest plots were used to present the pooled prevalence with a 95% confidence interval (CI) of meta-analysis using the random effect model.ResultsThis systematic review and meta-analysis included a total of 10 studies and 4656 study participants. The pooled prevalence of induced abortion among female students in institutions of higher education in Ethiopia was 5.06% (95%CI: 2.16, 7.96). The rate of induced abortion was 51 per 1000 women.ConclusionsThe pooled prevalence of induced abortion among female students in institutions of higher education in Ethiopia was high. Thus, concerned bodies should design and implement an effective strategy to realize friendly and non-judgmental family planning and comprehensive abortion care service to curb the problem