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Abstract Background The midwife-led model of care is woman-centered and based on the premise that pregnancy and childbirth are normal life events, and the midwife plays a fundamental role in coordinating care for women and linking with other health care professionals as required. Worldwide, this model of care has made a great contribution to the reduction of maternal and child mortality. For example, the global under-5 mortality rate fell from 42 deaths per 1,000 live births in 2015 to 39 in 2018. The neonatal mortality rate fell from 31 deaths per 1,000 live births in 2000 to 18 deaths per 1,000 in 2018. Even if this model of care has a pivotal role in the reduction of maternal and newborn mortality, in recent years it has faced many challenges. Objective To explore facilitators and barriers to a midwife-led model of care at a public health institution in Dire Dawa, Eastern Ethiopia, in 2021. Methodology : A qualitative approach was conducted at Dire Dawa public health institution from March 1–April 30, 2022. Data was collected using a semi-structured, in-depth interview tool guide, focused group discussions, and key informant interviews. A convenience sampling method was implemented to select study participants, and the data were analyzed thematically using computer-assisted qualitative data analysis software Atlas.ti7. The thematic analysis with an inductive approach goes through six steps: familiarization, coding, generating themes, reviewing themes, defining and naming themes, and writing up. Result Two major themes were driven from facilitators of the midwife-led model of care (professional pride and good team spirit), and seven major themes were driven from barriers to the midwife-led model of care (lack of professional development, shortage of resources, unfair risk or hazard payment, limited organizational power of midwives, feeling of demoralization absence of recognition from superiors, lack of work-related security). Conclusion The midwifery-led model of care is facing considerable challenges, both pertaining to the management of the healthcare service locally and nationally. A multidisciplinary and collaborative effort is needed to solve those challenges.

Introduction One of the global strategic direction and policy priorities in 2021 through 2025 is preservice education of nurses. Even though, quality education is the foundation to produce competent health workers, ensuring the competence of the health professionals is as imperative as maximizing their number. This study aims to fill the literature gap among nursing students in public universities. Objectives The purpose of this study is to assess the prevalence of clinical practice competence and its associated factors among graduating BSc nursing students in public universities from July 15 to August 15, 2022. Methods An institutional-based cross-sectional study was carried out in randomly selected public universities in eastern Ethiopia. A total of 143 students were systematically selected to fill out the questionnaire through multistage sampling. Frequency, mean, and standard deviations of independent variables and proportion of clinical practice competence were analyzed using descriptive statistics. AOR with a p -value of

Summary: Background: Severe acute malnutrition (SAM) is caused by a significant imbalance between nutritional intake and individual needs. The uncomplicated form of SAM is managed at the outpatient therapeutic programme (OTP) in primary health care facilities with some medical protocols and ready-to-use-therapeutic food (RUTF). Evaluation of treatment outcomes of OTP centres is crucial for the effectiveness of the programme. Thus, this study aimed to assess the treatment outcomes and its associated factors among children aged 6–59 months attending the outpatient therapeutic programme in Zaria LGA, Kaduna, Nigeria. Methods: A total of 224 consented caregivers of children with SAM aged 6–59 months were recruited. Information on household sociodemographic characteristic, anthropometric measurements, clinical and medical history of the children with SAM was collected using pre-tested questionnaires administered by trained interviewers. Biochemical parameters were assessed using standard laboratory procedures. Results: Among the 229 admitted children with SAM, 48.10% were cured (their condition improved during the study period) from SAM, 1.70% died, 43.08% defaulted (not regularly attending the OTP centres during the programme) and 7.12% did not respond to treatment (still with SAM). The mean weight gain and length of stay in the programme were found to be 7.54% and 8.16% respectively. Distance to OTP site (X2 = 0.86, p-value = 0.001), presence of dermatosis (X2 = 0.449, p-value = 0.001), admission anaemia (X2 = 0.236, p-value=0.001), vaccination status (X2 = 0.839, p-value = 0.001), and adequacy of RUTF (X2 = 0.457, p-value = 0.001) were found to be associated with treatment outcome of SAM clinical management. Conclusion: The OTP centres in Zaria LGA were found to meet the international standards for death rate and length of stay only hence, the need for improvement in the OTP effectiveness to meet the acceptable range of Sphere standards. The presence of dermatosis, admission anaemia, inadequate RUTF and poor vaccination status are among the factors associated with treatment outcomes.

Objective The aim of this study was to investigate the prevalence of indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care (ANC) at public health facilities in Dire Dawa, Ethiopia.Design A facility-based cross-sectional study design.Setting The study was conducted in seven public health facilities (one referral hospital, three urban and three rural health centres) in Dire Dawa, Ethiopia, from October to November 2022.Participants 628 pregnant women of any gestational age who had been on ANC follow-up at selected public health facilities were included.Main outcome measures Prevalence of indigenous herbal medicine (users vs non-users) and associated factors.Results The study revealed that 47.8% (95% CI 43.8% to 51.6%) of pregnant women used herbal medicines. Lack of formal education (adjusted OR, AOR 5.47, 95% CI 2.40 to 12.46), primary level (AOR 4.74, 95% CI 2.15 to 10.44), housewives (AOR 4.15, 95% CI 1.83 to 9.37), number of ANC visits (AOR 2.58, 95% CI 1.27 to 5.25), insufficient knowledge (AOR 4.58, 95% CI 3.02 to 6.77) and favourable perception (AOR 2.54, 95% CI 1.71 to 3.77) were factors significantly associated with herbal medicine use. The most commonly used herbs were garden cress (Lepidium sativum) (32%), bitter leaf (Vernonia amygdalina) (25.2%), moringa (Moringa oleifera) (24.5%). Common indications were related to gastrointestinal problems, blood pressure and sugar.Conclusion The prevalence of herbal medicine use is high (one in two pregnant women) and significantly associated with education level, occupation, ANC visits, knowledge and perceptions. The study’s findings are helpful in advancing comprehension of herbal medicines using status, types and enforcing factors. It is essential that health facilities provide herbal counselling during ANC visits, and health regulatory bodies ought to raise awareness and implement interventions to lower the risks from over-the-counter herbal medicine use by pregnant women.

BackgroundThe short birth interval is a common public health issue that affects women's and children's health in sub-Saharan Africa. Despite a higher burden of short birth intervals reported in Ethiopia, there is limited evidence to indicate the primary risk factors, particularly in rural eastern Ethiopia. Therefore, this study assessed the determinants of the short birth interval among married multiparous women in Chinaksen district, Eastern Ethiopia.MethodsA community-based case-control study was conducted among randomly selected 210 cases and 210 controls from April 01 to June 30, 2019. The total sample size (219 cases and 219 controls) were calculated using Epi-Info software version 7.2. Data were entered using EpiData version 3.1 and analyzed using SPSS version 27, and multivariable logistic regression analyses conducted to identify the determinants of short birth intervals. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the strength of association and statistical significance declared at p-value

BackgroundCompassionate and respectful maternity care during childbirth has been identified as a potential strategy to prevent and reduce maternal mortality and morbidity. Despite its importance, there is a paucity of information on the level of disrespect and abuse meted out to mothers in eastern Ethiopia. This study assesses the level of disrespect and abuse suffered by women during childbirth, and the associated factors, in public health facilities in the rural East Hararghe Zone in eastern Ethiopia.MethodsA cross-sectional study was conducted among 530 women who gave birth in 20 public health facilities in the East Hararghe Zone during the period between 1 April and 30 April 2020. Data were collected using a validated questionnaire. Bivariable and multivariable binary logistic regression analyses were employed to identify the factors associated with disrespect and abuse during childbirth. Adjusted odds ratio (AOR) (95% CI) was used to report this association, and statistical significance was set at P

Objective This study aimed to determine the level of adherence to foot care recommendations and associated factors among people with diabetes on follow-up in public hospitals in Eastern Ethiopia.Setting An institutional-based cross-sectional study was conducted in public hospitals found in Eastern Ethiopia from 25 February to 25 March 2022.Participants A total of 419 patients with chronic diabetes who visited diabetic clinics in public hospitals in Eastern Ethiopia for follow-up were included.Main outcome measure The level of adherence to diabetic foot care recommendations and associated factors.Results The findings indicated that 44.3% (95% CI: 39.3, 49.0) of people with diabetes had inadequate adherence to diabetic foot care recommendations. Age between 28–37 (adjusted OR (AOR)=1.10; 95% CI: 1.27, 5.63) and 38–47 years (AOR=2.19; 95% CI: 2.74, 8.89), rural residence (AOR=1.71; 95% CI: 1.15, 2.57), absence of comorbidity (AOR=2.22; 95% CI:1.34, 5.14), obesity (AOR=1.43; 95% CI: 1.10, 5.05) and inadequate foot care knowledge (AOR=2.10; 95% CI: 1.52, 4.35) were factors significantly associated with inadequate adherence to diabetic foot care recommendations.Conclusion More than two-fifths of people with diabetes had inadequate adherence to diabetic foot care recommendations. Younger age, rural residence, absence of comorbidity, obesity and inadequate foot care knowledge were significantly associated with inadequate adherence to diabetic foot care recommendations. It is very essential to educate people with diabetes about the importance of foot care recommendations in preventing and delaying the risks of foot-related problems and complications.

BackgroundCultural practices are any experiences or beliefs that are socially shared views and behaviors practiced in a certain society at a certain time. Cultural malpractices are defined as socially shared views and traditionally accepted behaviors experienced in a certain society that harm maternal health. Worldwide, the period of pregnancy, labor, and delivery is embedded with different beliefs, customs, and rituals in different societies that contribute a lot to maternal death. They are responsible for the annual deaths of 303,000 mothers and 2.7 million newborns globally. In developing countries, it accounts for approximately 5%–15% of maternal deaths. In Ethiopia, approximately 18% of infant deaths occur due to cultural malpractice, and 52% of pregnant mothers give birth at home following cultural customs in Dire Dawa city. The objective of this study was to assess cultural malpractices during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa City in 2021.MethodsCommunity-based mixed study was conducted. A total of 624 study participants were selected through a systematic random sampling technique, and a purposive sampling method was used for qualitative data. The study was conducted in the randomly selected Kebeles of Dire Dawa City, Eastern Ethiopia, from November 1 to December 30, 2021. Data were entered into Epi Data version 4.1 and exported to SPSS version 24 for analysis. Bivariate and multivariate analyses were done, and the degree of association was measured by using the odds ratio with 95% CI and significance was declared at a p-value of 35), may help to reduce cultural malpractices.

Background: Broccoli and its active ingredient, sulforaphane were reported to possess tremendous pharmacological activities such as anticancer, antimicrobial, antidepressant, antihypertensive and antidiabetic to mention but few. Here in, the antidiabetic potential of broccoli and sulforaphane (clinical trials, in vivo and in vitro models) were critically reviewed and discussed. Methods: Relevant articles were sourced from the major scientific databases (Scopus, PubMed, and Google Scholar). Results: Collectively, the data revealed that broccoli and sulforaphane have the potential to reduce hyperglycemia, hyperlipidemia, insulin resistance and diabetes-induced oxidative stress. Such activities were linked to but not limited to the activation of Nrf2 and PI3K/Akt pathways, inhibitions of NF-κB, GSK3β, α-glucosidase and DPP-IV activities. Conclusion: With the current available clinical evidence, broccoli and sulforaphane are regarded as adjuncts in diabetes treatment but not classical antidiabetic drugs. Further detail clinical trials are warranted especially the phases II and III, where large number of diabetic patients will be recruited. In addition, improving bioavailability while improving efficacy and reducing toxicity are of paramount.

Background: In Ethiopia, the number of homeless girls and women is increasing, and the government has yet to devise a strategy to address the issue of teenage homelessness. They are influenced by numerous dimensions of health, including physical health, mental health, and social isolation. At all stages of homelessness, the stakeholders and homeless people must work together to address the issue. As a result, this study will be helpful to generate relevant data that may guide policymakers in designing solutions for this underserved group of people. Objectives: To explore coping mechanisms and suggestions to stakeholders among women experiencing homelessness in Dire Dawa city, eastern Ethiopia, 2021. Design: A community-based phenomenological qualitative study was conducted at Dire Dawa city. Methods: Data were collected from women experiencing homelessness and key informants through focus group discussion and in-depth interviews using a semi-structured tool. A total of 31 women experiencing homelessness (13 in-depth interviews and 3 focus group discussion with 6 participants in each) and 2 key informants participated in this study. Data were analyzed thematically using computer-assisted qualitative data analysis software Atlas.ti 7. The thematic analysis follows six steps: familiarization, coding, generating themes, reviewing themes, naming themes, and writing up. Results: Two major themes were driven: coping mechanisms and suggestions to stakeholders. There are three subthemes under the coping mechanism (begging, survival sex, and child prostitution) while there are a total of seven subthemes under suggestions to stakeholders (integration and collaboration, special attention to children, family education, shelter and job, schooling, sexual education, and addiction rehabilitation). Conclusion: Child prostitution and survival sex are a very common coping mechanism which is practiced by women experiencing homelessness. Changing society’s mindset and paying special attention to children is critical. Furthermore, the government and various stakeholders should work together to develop a rehabilitation program for street children who have been exposed to substance use.

Abstract Background Lemongrass (Cymbopogon citratus Stapf) tea is a widely consumed beverage for nourishment and the remedy of diabetes mellitus (DM) in Africa locally. The aim of the present study was to investigate the antidiabetic action of lemongrass tea (LGT) in a type 2 diabetes (T2D) model of rats. Methods The fructose-streptozotocin (STZ) animal model for T2D was used and the LGT was prepared by boiling for 10 min in water, allowed to cool and administered at 0.25 or 0.5% (ad libitum), for 4 weeks to the T2D rats. Results The LGT showed higher phytochemical contents compared to the cold-water extract. The diabetic untreated animals exhibited significantly (p

Background: Physcion is an active component of Rheum officinale Baill, a popular traditional Chinese medicine used locally to treat diabetes. Previous studies revealed that physcion possessed antidiabetic activity of physcion using various in vitro models and no information is available on the antidiabetic activity of physcion in animal model. Therefore, the present study aimed to investigate the antidiabetic effect of physcion in fructose-fed streptozotocin (STZ)-induced type 2 diabetes (T2D) rat model. In addition, acute toxicity of the physcion was evaluated in Wistar rats. Methods: Physcion was administered orally at 10, 20 30 mg/kg body weight (bw) for four (4) weeks to the treated animals. Acute exposure of physcion was used to notice any sign of toxicity in the treated animals. Results: Acute exposure of physcion showed no noticeable sign of toxicity in the treated animals. The diabetic untreated animals showed significant (P< 0.05) high fasting blood glucose (FBG), insulin resistance, dyslipidemia, inflammation and alterations in oxidative stress biomarkers. Oral administration of physcion (P< 0.05) improved the alterations induced by diabetes comparable to metformin treated group. Conclusion: This study therefore, confirms the antidiabetic activity of physcion in animal model and recommends for further clinical study to verify the antidiabetic effect in human subjects.

Objective: Reproductive rights violations are a serious public health concern worldwide, particularly in Sub-Saharan Africa, where more than 38.83% of victims live. Understanding the status of husbands’ knowledge and involvement helps to establish important programs and interventions. However, there are limited data related to husbands’ roles in women’s reproductive rights in the study setting. Therefore, this study aimed to assess husbands’ knowledge and involvement in women’s reproductive rights and their associated factors in Harar, eastern Ethiopia. Methods: A community-based cross-sectional study was conducted among 611 husbands in March 2020. A systematic random sampling technique was used to select the study participants. Data were collected using a structured and pretested interviewer-administered questionnaire. Data were entered using EpiData 3.1 and analyzed with SPSS Version 22. A multivariable logistic regression model was applied to examine the factors associated with the outcome variable using an adjusted odds ratio with a 95% confidence interval, and a p -value

The present study was designed to investigate the role of methoxylation on the anti-diabetic potential of ρ-hydroxybenzaldehyde (ρ-BN) and its derivatives vanillin (VN) and syringaldehyde (SN) in type 2 diabetes (T2D). Fructose-fed streptozotocin-induced T2D rat model was used and orally treated with 50 and 100 mg/kg body weight of ρ-BN, VN and SN for 28 days. From the results, the diabetic control (DBC) group showed significant (p < 0.05) elevation in insulin resistance, blood glucose, fructosamine, glycogen phosphorylase (GP) activity, lipid profiles, and a significant (p < 0.05) decrease in β-cell functions, insulin, liver glycogen contents, and glycogen synthase (GS) activity. The insulin receptor substrate-1 (IRS-1) and glucose transporter-4 (GLUT-4) mRNA expression in the hepatocyte and skeletal muscle were decreased in DBC group compared to the normal control (NC) group. Oral treatment of the compounds improved the above diabetes-induced alterations to near normal and were comparable to the metformin treated group. Variation in methoxylation of ρ-BN, VN, and SN displayed an inconsistent pattern on the measured indices of diabetes (insulin resistance, β-cell functions, blood glucose, insulin, fructosamine, GS, GP, lipid profiles, IRS-1 and GLUT-4). However, in the case of oral glucose tolerance ability, serum insulin and fructosamine levels, liver glycogen contents and cardiovascular risk indices, the methoxylation mediated positive effects. The phenolic aldehydes (ρ-BN, VN, and SN) possessed anti-T2D activity while methoxylation partly influenced the anti-diabetic effects of the phenolic aldehyde skeleton.

Context: The use of Aframomum melegueta K. Schum. (Zingiberaceae) fruit for treatment of diabetes has recently been established in Nigeria. However, compounds responsible for the antidiabetic action have not been identified. Objective: The present study carried out the bioassay-guided isolation of possible bioactive compounds responsible for the antidiabetic action of A. melegueta fruit. Materials and methods: The A. melegueta fruit was sequentially extracted using ethyl acetate (EtOAc), ethanol and water, and the most active extract (EtOAc) was subjected to column chromatography on a silica gel column using solvent gradient systems of hexane (HEX):EtOAc and EtOAc:MeOH and the isolation of compounds was guided by α-glycosidase and α-amylase inhibitory activities at various concentrations (30–240 μg/mL). Results: According to the results, 3 arylalkanes, 6-paradol (1), 6-shogaol (2) and 6-gingerol (3) and a pentacyclic triterpene, oleanolic acid (4) were isolated from A. melegueta fruit. All the compounds exhibited inhibitory effects against α-amylase and α-glucosidase. 6-Gingerol (3) and oleanolic acid (4) showed higher inhibitory activity against α-amylase (IC50: 6-gingerol: 81.78 ± 7.79 μM; oleanolic acid: 91.72 ± 1.63 μM) and α-glucosidase (IC50: 6-gingerol: 21.55 ± 0.45 μM; oleanolic acid: 17.35 ± 0.88 μM) compared to the standard drug, acarbose and other isolated compounds. The kinetics of the enzyme action of the compounds showed a noncompetitive mode of inhibition. Conclusion: The data of this study suggest that the 6-gingerol (3) and oleanolic acid (4) showed higher α-amylase and α-glucosidase inhibitory action and therefore could be responsible for the antidiabetic activity of A. melegueta fruit.

Spices possess tremendous therapeutic potential including hypoglycemic action, attributed to their bioactive ingredients. However, there is no study that critically reviewed the hypoglycemic potency, safety and the bioavailability of the spice-derived bioactive ingredients (SDBI). Therefore, the aim of the study was to comprehensively review all published studies regarding the hypoglycemic action of SDBI with the purpose to assess whether the ingredients are potential hypoglycemic agents or adjuvant. Factors considered were concentration/dosages used, the extent of blood glucose reduction, the IC50 values, and the safety concern of the SDBI. From the results, cinnamaldehyde, curcumin, diosgenin, thymoquinone (TQ), and trigonelline were showed the most promising effects and hold future potential as hypoglycemic agents. Conclusively, future studies should focus on improving the tissue and cellular bioavailability of the promising SDBI to achieve greater potency. Additionally, clinical trials and toxicity studies are with these SDBI are warranted.

Living organisms especially human beings get exposed to harmful substances such as heavy metals through the plants and animals we consume. Human sources of food like Oryza sativa and Clarias gariepinus get contaminated by the soil as a result of pesticides used by farmers. This study aimed to determine heavy metals levels and pesticide residue in soil, sediment, Oryza sativa, and Clarias gariepinus in three locations namely, Gadau, Jama’are, and Zabi (Giade LGA) in Bauchi State Nigeria. Samples of Soil, sediments, Oryza sativa, and Clarias gariepinus were collected at three different locations namely Gadau, Zabi, and Jamaare, to assess the level of some heavy metals and pesticide residues. The heavy metals present were detected in this order Zn>As>Pd>Cd>Cr>Ni in soil, sediment, Oryza sativa, and Clarias gariepinus respectively. The detected heavy metals were higher than the WHO/FAO recommended maximum tolerance values in three locations in this study. Among the active residues observed Abamectin and Dichlovos were more active compared to others with a 1- >5ppm range. The presence of these harmful substances in the environment is of serious concern to human health. This study recommends strict regulations on the use of pesticides for food crops and fish in the study area.

Abstract Urinary schistosomiasis, a water-based disease, is endemic to Nigeria. The infection is transmitted by trematodes known as Schistosoma haematobium. The goal of this study was to determine the occurrence of urinary schistosomiasis among primary school children in the Zaki Local Government Area, Bauchi State, Nigeria. A cross-sectional study involving 300 school pupils from three primary schools in Zaki was conducted between June and November of 2021. The urine samples were examined with the sedimentation technique to detect S. haematobium eggs. Data on socio-demographic characteristics and risk factors were obtained through a well-structured questionnaire. In SPSS version 24, the associations between the dependent and independent variables were evaluated with Chi-square, bivariate, and multiple logistic regression analyses. The strength of associations was determined with the odds ratio (OR) and 95% confidence interval. Urinary schistosomiasis was found in 29.7% of school-aged children in the three primary schools. Significantly higher prevalence was observed in the Almajiri (informal) school (59.6%) and one public primary school (31.5%), P = 0.001. Boys were four times more likely than girls to have schistosomiasis [AOR (95% CI): 4.38 (2.23–8.60)]. Children who played in shallow water had a higher risk of contracting schistosomiasis infection and were five times more likely to be infected [AOR (95% CI): 5.14 (1.97–13.37)]. Children who had blood in their urine (hematuria) were nearly nine times more likely to be infected [AOR (95% CI): 9.64 (4.79–20.66)]. The present study indicated that urinary schistosomiasis is endemic to the study area in the Zaki Local Government Area, with a moderate infection rate.