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Abstract Violence around pregnancy is critical in nature and major public health problem worldwide. Thus, the present study aims to determine the extent of perinatal partner violence and to identify its individual and community-level factors among postpartum women in Southern Ethiopia. A total of 1342 postpartum women nested in 38 ‘Kebles’ (clusters) were enumerated using multistage-clustered sampling techniques for multilevel analysis. Different parameters were computed for model comparison and model fitness. The overall prevalence of intimate partner violence before, during, and/or after pregnancy was estimated to be 39.9% [95% CI 36.9–44.5]. About 18% of women reported continuous abuse over the perinatal period. Postpartum women who live in rural areas [adjusted odds ratio (AOR) = 2.46; 95% CI 1.21–5.01], or in neighborhoods with high IPV favoring norms [AOR = 1.49; 95%CI 1.01–2.20], high female literacy [AOR = 2.84; 95%CI 1.62–5.01], high female autonomy [AOR = 2.06; 95%CI 1.36–3.12], or in neighborhoods with lower wealth status [AOR = 1.74; 95%CI 1.14–2.66] were more likely to encounter PIPV. The complex patterns of interplaying factors operating at different levels could put pregnant or postpartum women at higher risk of IPV victimization. Therefore, policies that prioritize the improvement of contextual factors, particularly norms toward IPV and women’s empowerment are likely to be the most effective interventions.

Background: The continuous intimate partner violence against postpartum women (perinatal partner violence) is an important indicator of severe violence. However, its prevalence estimates remain dissimilar and show a high variability for three mutually exclusive time periods for index birth: before, during, and after pregnancy. Therefore, this study aimed to determine pooled prevalence of continuous violence against postpartum women (VAPW) for the index child. Method: We performed a comprehensive search for PubMed, EMBASE, CINAHL, PsycINFO, POPLINE, Google, and Google Scholar databases. We included studies reporting the prevalence of VAPW for index child. The meta-analysis was conducted using STATA 14 software, and the forest plot was used to present the pooled estimate. Cochrane Q-statistics and І2 were used to assess heterogeneity. Funnel plots, Egger’s, and Begg’s tests were used to check publication bias. Result: This systematic review and meta-analysis included a total of sixteen studies with a total of 36,758 participants. The overall pooled prevalence of VAPW for the index child was 9.96% (95% CI: 8.30%, 11.59%). The pooled estimate of lifetime VAPW for index child was 29.27% (95% CI: 23.26%, 35.27%). The overall estimates of lifetime physical, sexual, and psychological VAPW were 11.35%, 6.3%, and 14.74% respectively. In Sub-group analysis, the summary estimate was higher for low-middle income countries, 35.07% (95%CI: 10.15%, 59.98%) and low-income countries, 17.40% (95% CI: 14.08%, 20.72%) than for high-income settings (3.27%, 95% CI: 2.18%, 4.37%). Conclusion: Approximately one out of every ten postpartum women experiences ongoing violence for the index child. When compared to postpartum women in high-income countries, a significant proportion of postpartum women in low- and middle-income countries experience continuous violence. This calls for a universal routine screening program in the continuum of care and working proactively on community-level intervention that prevent violence against women.

BackgroundEthiopia has achieved a remarkable improvement in the provision of family planning. The modern contraceptive prevalence rate has shown a fivefold increment in the last two decades, yet the family planning service in the country is still deficient and characterized by poor counseling quality.ObjectiveThe aim of the study is to assess the quality of family planning counseling provided and the associated factors at selected health centers in Akaki Kality sub-city, Addis Ababa, Ethiopia.MethodA cross-sectional study was conducted among 678 randomly selected women attending family planning services at health centers in Addis Ababa, Ethiopia. Multivariable logistic regression analysis was performed to identify factors associated with the quality of family planning counseling.ResultA total of 678 women participated in the study. About 29.1% [95% confidence interval (CI): 25.7%–32.6%] of the respondents were adequately counseled. Age groups 37–49 [adjusted odds ratio (AOR) = 2.7; 95% CI: 1.1–6.6], being in marital union (AOR = 2.8; 95% CI: 1.2–6.7), attaining secondary education (AOR = 1.9; 95% CI: 1.1–3.6) or higher education (AOR = 2.2; 95% CI: 1.2–4.3), and visit status (AOR = 1.6; 95% CI: 1.1–2.4) were significantly associated with good counseling.ConclusionLess than one in three women was counseled adequately. Health professionals should give due attention to younger women, single clients, and clients with their first presentation to the health facility. It also indicates that promoting education among Ethiopian women is crucial for a positive outcome of family planning counseling.

BackgroundAdopting contraception on time is a critical intervention for postpartum women, but violence exposure around pregnancy may interfere with postpartum contraceptive use behaviors. Hence, this study aimed to investigate the time duration of the first modern contraceptive adoption and its individual-and community-level predictors among postpartum women in the Wolaita zone, South Ethiopia.MethodsA community-based prospective follow-up study was conducted among 1,292 postpartum women nested in 38 “Kebles” (clusters) using multistage-clustered sampling techniques. A multilevel Weibull regression model was employed to investigate predictors of time-to-method initiation after childbirth using STATA Version 14. Kaplan-Meier curve and Wilcoxon log-rank test were used to estimate time-to-modern contraceptive use across different variables. All variables with p-values

IntroductionNumerous studies have explored an effect of cigarette smoking on tuberculosis treatment outcomes but with dissimilar conclusions.ObjectiveTo determine the effect of cigarette smoking on tuberculosis treatment outcomes.MethodsPubMed, Cochrane library and Google scholar databases were searched last on February 27, 2019. We applied the random-effects model for the analysis. Publication bias was assessed using funnel plot and Egger's regression. Furthermore, we performed Orwin's Fail-Safe N and cumulative meta-analysis to check for small studies' effect.ResultsOut of 22 studies we included in the qualitative synthesis, 12 studies reported p-values less than 0.05 where smoking significantly favored poor treatment outcomes. The remaining 10 studies reported p-values larger than 0.05 implying that smoking does not affect the treatment outcomes. Twenty studies met the criteria for inclusion in a meta-analysis. The meta-analysis found that smoking significantly increased the likelihood of poor tuberculosis treatment outcomes by 51% (OR = 1.51; 95% CI = 1.30 to 1.75 and I-square = 75.1%). In a sub-group analysis, the effect was higher for low- and middle-income countries (OR = 1.74; 95% CI = 1.31 to 2.30) and upper-middle-income economies (OR = 1.52; 95% CI = 1.16 to 1.98) than for high-income ones (OR = 1.34; 95% CI = 1.03 to 1.75) even though the differences in the effects among the strata were not statistically significant as demonstrated by overlapping of confidence intervals of the effects. Meta-regression analysis, adjusted for income economies, found the effect of smoking has not significantly improved over the years (p = 0.92) and thus implying neither of the covariates were source of the heterogeneity. Egger's regression test indicated that publication bias is unlikely (p = 0.403).ConclusionCigarette smoking is significantly linked with poor tuberculosis treatment outcomes.

Abstract Background Because of the unacceptably high maternal and perinatal morbidity and mortality, the government of Ethiopia has established health extension program with a community-based network involving health extension workers (HEWs) and a community level women organization which is known as “Women’s Health Development Army” (WHDA). Currently, the HEWs and WHDA network is the approach preferred by the government to register pregnant women and encourage them to link in the healthcare system. However, its association with skilled delivery service utilization is not well known. Methods A community-based cross-sectional study was conducted from January to February 2015. Within 380 clusters of WHDA, a total of 748 reproductive-age women who gave birth in 1 year preceding the study, were included using multistage sampling technique. The data were entered into EPI info version 7 statistical software and exported to STATA version 11 for analysis. Multilevel analysis technique was applied to check for an association of selected variables with a utilization of skilled delivery service. Results About 45% of women have received skilled delivery care. A significant heterogeneity was observed between “Women’s Health Development Teams (clusters)” for skilled delivery care service utilization which explains about 62% of the total variation. Individual-level predictors including urban residence [AOR (95% CI) 35.10 (4.62, 266.52)], previous exposure of complications [AOR (95% CI) 3.81 (1.60, 9.08)], at least four ANC visits [AOR (95% CI) 7.44 (1.48, 37.42)] and preference of skilled personnel [AOR (95% CI) 8.11 (2.61, 25.15)] were significantly associated with skilled delivery service use. Among cluster level variables, the distance of clusters within 2 km radius from the nearest health facility was significantly associated [AOR (95% CI) 6.03 (1.92, 18.93)] with skilled delivery service utilization. Conclusions In this study, significant variation among clusters of WHDA was observed. Both individual and cluster level variables were identified to predict skilled delivery service utilization. Encouraging women to have frequent ANC visits (− 4 and above), enhancing awareness creation towards the delivery care attendance, constructing more health facilities and roads in hard to reach areas and establishing telemedicine services are recommended.

aimed to explore postpartum women's lived experiences of perinatal intimate partner violence and its contributing factors in Wolaita Zone, Southern Ethiopia. Methods: A phenomenological study approach was used to explore postpartum women's lived experiences of perinatal partner violence from January to March 2020. A total of twenty-two postnatal women and five health extension workers (HEWs) were interviewed. Interviews were audio-recorded, transcribed verbatim in local languages, and then translated into English. Data were analyzed thematically, using deductive and inductive coding. The consolidated criteria for reporting qualitative research (CORE-Q) checklist was followed to report the findings. Results: Results indicated that postpartum women had experienced recurrent violence before, during, and after pregnancy from their husbands, with 16 out of 22 women being subjected to perinatal intimate partner violence. A majority of the participants delineated their exposure to perinatal physical violence next to perinatal psychological violence. Many of the interviewed women noted that violence during pregnancy was exacerbated and increased during postpartum. Moreover, the interviewees revealed that some partners were not only a serious threat to their wives, but also their infants during the postpartum period. Four of the participants stated that their newborns were hit and thrown by their father and became unconscious. Participants linked husbands' perinatal violence with suspicion about the newborn, male-child preference, partner infidelity and jealousy, contraceptives usage, alcohol consumptions, indifference to shortages on household necessities, improper parenting, and financial problems. Conclusion: This study highlights that postpartum women are experiencing continuous and severe forms of perinatal IPV in the study setting. Thus, community-level interventions that minimize perinatal partner violence against postnatal women and their infants are needed. [ABSTRACT FROM AUTHOR]

BACKGROUND: In Ethiopia, maternal health service utilization is very low, especially postnatal care (PNC). The percentage of mothers who receive care within two days of childbirth has shown little progress, from 2.4% in 2000 to 13% in 2014. However, it is very far below the expected level as compared to other sub-Saharan regions. Therefore, the aim of this study was to assess PNC services utilization and its associated factors among married women in Benchi-Maji Zone, Southwest Ethiopia. METHOD: A cross-sectional studywas conducted from June 15 to August 15, 2015. A total of 801 married women wassampled from randomly selected districts in the zone. Semi-structured questionnaire was used to collect, data and informed consent was obtained from participants. The collected data were entered into the computer using Epi-data version 3.0, and then exported to SPSS Windows version 20.0 for analysis. Logistic regression was used to identify important predictors of PNC utilization. RESULT: Out of 765 participants, 392(51.24%) of married women who attended PNC in this study. Out of them, more than two-third 305(77.8%) attended mainly to immunize their baby. The vast majority, 251(86.3%), of respondents mentioned lack of information as a main reason for not following PNC, and of them, the majority mentioned that they were appointed to come after 45 days for Family Planning(FP). In comparison with house wives, farmer women were less likely (AOR 0.3, 95% CI 0.2-0.7) to attend for PNC. Awareness of problems during postnatal period showedthe strongest association in which those who knew the problems were about nine times (AOR 8.7 95% CI 5.6-13.4) more likely to attend PNC. Similarly, married women who followedantenatal care (ANC) were more likely (AOR 2.2 95% CI 1.1-4.6) to attend PNC in comparison with those who did not attend ANC at all. CONCLUSION: Residence, ANC follow-up, maternal occupation, awareness about problems of postnatal period had effects on use of PNC. In light of this study, providing deep counselling about PNC at the timeof ANC visit and discharge after delivery is strongly recommended. Furthermore, targeting more of rural married women may increase PNC utilization. [ABSTRACT FROM AUTHOR]

Background: Because of the unacceptably high maternal and perinatal morbidity and mortality, the government of Ethiopia has established health extension program with a community-based network involving health extension workers (HEWs) and a community level women organization which is known as "Women's Health Development Army" (WHDA). Currently, the HEWs and WHDA network is the approach preferred by the government to register pregnant women and encourage them to link in the healthcare system. However, its association with skilled delivery service utilization is not well known. Methods: A community-based cross-sectional study was conducted from January to February 2015. Within 380 clusters of WHDA, a total of 748 reproductive-age women who gave birth in 1 year preceding the study, were included using multistage sampling technique. The data were entered into EPI info version 7 statistical software and exported to STATA version 11 for analysis. Multilevel analysis technique was applied to check for an association of selected variables with a utilization of skilled delivery service. Results: About 45% of women have received skilled delivery care. A significant heterogeneity was observed between "Women's Health Development Teams (clusters)" for skilled delivery care service utilization which explains about 62% of the total variation. Individual-level predictors including urban residence [AOR (95% CI) 35.10 (4.62, 266.52)], previous exposure of complications [AOR (95% CI) 3.81 (1.60, 9.08)], at least four ANC visits [AOR (95% CI) 7.44 (1.48, 37.42)] and preference of skilled personnel [AOR (95% CI) 8.11 (2.61, 25.15)] were significantly associated with skilled delivery service use. Among cluster level variables, the distance of clusters within 2 km radius from the nearest health facility was significantly associated [AOR (95% CI) 6.03 (1.92, 18.93)] with skilled delivery service utilization. Conclusions: In this study, significant variation among clusters of WHDA was observed. Both individual and cluster level variables were identified to predict skilled delivery service utilization. Encouraging women to have frequent ANC visits (− 4 and above), enhancing awareness creation towards the delivery care attendance, constructing more health facilities and roads in hard to reach areas and establishing telemedicine services are recommended. [ABSTRACT FROM AUTHOR]

Background: Adopting contraception on time is a critical intervention for postpartum women, but violence exposure around pregnancy may interfere with postpartum contraceptive use behaviors. Hence, this study aimed to investigate the time duration of the first modern contraceptive adoption and its individual-and community-level predictors among postpartum women in the Wolaita zone, South Ethiopia., Methods: A community-based prospective follow-up study was conducted among 1,292 postpartum women nested in 38 " Kebles" (clusters) using multistage-clustered sampling techniques. A multilevel Weibull regression model was employed to investigate predictors of time-to-method initiation after childbirth using STATA Version 14. Kaplan-Meier curve and Wilcoxon log-rank test were used to estimate time-to-modern contraceptive use across different variables. All variables with p -values <0.05 were considered for multivariate analysis. Adjusted time ratios (ATR) with 95 % CI were computed using Weibull accelerated failure time models., Results: Of the respondents, 62% (95% CI: 59.1-64.5) had started the first modern contraception within a year after childbirth. The restricted mean survival time-to-postpartum modern contraceptive use was 6.28 months. Being a rural dweller (aTR: 1.44; 95% CI: 1.06-1.99) and living in the middle household wealth quintiles (aTR: 1.10; 95% CI: 1.02-1.19) predicted longer time duration to adopt first modern contraception by 44 and 10%, respectively. The women from the community with a high early marriage (aTR: 1.14; 95% CI: 1.01-1.28) took longer time to initiate modern postpartum methods. Furthermore, women who had no history of perinatal abuse took less time than those who had a history of abuse to start postpartum contraception (aTR: 0.71; 95% CI: 0.66-0.78)., Conclusion: Rural residence, poor household wealth status, history of perinatal abuse, and a high rate of early marriage in the community are predicted to lengthen the time duration to start modern postpartum contraception. Thus, community-level women's empowerment, particularly among rural women and integration of intimate partner violence screening into family planning counseling throughout the continuum of care will likely to improve postpartum contraception timing., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Abota, Gashe and Deyessa.)