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Background: Over the last 20 years, global healthcare has placed a major focus on improving the survival rates of mothers and children, recognizing the potential to prevent a significant number of deaths resulting from pregnancy and childbirth. Nevertheless, there remains an ongoing obstacle to the insufficient utilization of critical obstetric services to achieve optimal health outcomes for pregnant women. This study aimed to assess the magnitude and determinants of maternal healthcare use in the Jimma Zone, Ethiopia. Methods: Data were obtained from a household survey as part of the baseline assessment of a cluster randomized controlled trial. The study participants comprised 588 women in early pregnancy, specifically those with a gestational age of less than 20 weeks. Logistic regression analysis was employed to identify factors associated with the use of maternal health services. Adjusted odds ratios (AORs) were used to assess the strength of the associations, with significance level set at a p-value ≤ 0.05. Results: The overall prevalence of maternal health service utilization was 87.9% (CI: 85.1, 90.4) for antenatal care, 74.7% (CI: 73.2, 79.9) for health facility delivery, and 60.4% (CI: 56.4, 64.3) for postnatal care. Multivariable logistic analysis revealed that maternal health service use was significantly influenced by access to health facilities (AOR: 6.6; 95% CI: 2.39, 18.16), financial hardship (AOR: 3; 95% CI: 1.97, 4.61), perceived respectful care (AOR: 2.3; 95% CI: 1.07, 5.11), perceived privacy of service provisions (AOR: 2.4; 95% CI: 1.47, 4.06), and attitudes toward maternal service use (AOR: 2.2; 95% CI: 1.48, 3.24). Conclusions: The study revealed slightly higher rates of antenatal care, facility delivery, and postpartum care utilization. However, there was a low proportion of early antenatal care initiation, and high rates of antenatal care dropout. Mobile phone-based messaging intervention may enhance maternal health service use by addressing factors such as lack of access, economic challenges, disrespectful care, no privacy of procedures, and unfavorable attitudes. [ABSTRACT FROM AUTHOR]

Background: Growth monitoring and promotion (GMP) is a nutritional intervention designed to identify and address growth faltering before a child's nutritional status deteriorates into severe malnutrition. Despite GMP being recognized as a priority in Ethiopia's national nutrition program, there is no national aggregated figure to show the extent of GMP service utilization. Therefore, this systematic review and meta-analysis aimed to assess GMP service utilization and associated factors in Ethiopia. Methods: A systematic literature search was conducted using PubMed/MEDLINE, CINAHL, Hinari, EMBASE, Scopus, and grey literature sources like Google Scholar, WorldCat, and Institutional repository. The Joanna Briggs Institution (JBI) quality assessment tool was used to appraise the quality of the articles, and articles scoring > 50% were included in the analysis. The pooled prevalence and odds ratio of associated factors with 95%CI was computed using STATA version 16. A random-effect model was employed to estimate the effect size, and I-squared statistics and Egger's test were used to assess heterogeneity and identify potential publication bias, respectively. Subgroup analysis was conducted with publication year, sample size, and region to identify the source of heterogeneity. Results: Nine studies with 4,768 study participants were included in this meta-analysis. The overall pooled utilization of GMP service among children under two years of age in Ethiopia was 23.21% (95% CI: 16.02, 30.41, I2 = 97.27% & P = 0.0001). Mothers who received counselling on GMP service (OR = 3.16 (95%CI: 2.49-4.00), parents who use family health card (FHC) (OR = 3.29 (95%CI: 1.49–7.28), and mother who use postnatal care (OR = 3.93 (95%CI: 2.40–6.42), and Anti natal care (OR = 3.15 (95%CI: 1.29–7.69) were the factors associated with GMP service utilization among children under two years of age. Conclusions: The utilization of GMP services among children under the age of two in Ethiopia remains inadequate. Therefore, it is crucial to provide health education and counselling focusing on GMP to the mothers/caregivers of the child and encourage utilization of FHC. In addition, integrating GMP with other maternal health services should be promoted. [ABSTRACT FROM AUTHOR]

Background: Traditional uvulectomy is widely practiced in Africa especially in sub-Saharan countries including Ethiopia. Limited Studies conducted in different times and areas of the world have shown that the prevalence of uvulectomy and its associated factors are varied from country to country. There is limited evidence to determine the prevalence and reasons of malpractice in Ethiopia. Therefore, this study aimed to assess the prevalence of traditional uvulectomy, and its associated factors among parents who had children aged less than 6 months. Methods: A community-based cross-sectional mixed study design was conducted among 630 participants selected by a systematic sampling technique. Data were collected using a pretested interviewer-administered questionnaire. The collected data were entered into Epi-data, and analyzed by using STATA version 14software. Descriptive statistics were computed and presented using tables, figures and texts. Factors associated with the prevalence of uvulectomy were selected for multiple logistic regressions at the probability value (p-value) of less than 0.2 in the X2- analysis. Statistically significant associated factors were identified at the probability value (p-value) less than 0.05 and adjusted OR (AOR) with a 95% CI. A total of 10 individual depth interviewees and 5 key informants were included using purposive sampling techniques. For the qualitative study, and thematic content analysis was employed to analyze the data, which were transcribed, translated, coded, screened, thematized, analyzed, synthesized, and finally supplemented the quantitative finding. Results: The prevalence of traditional uvulectomy was 84.60% (CI: 81.77%n—87.42%). Being rural residence (adjusted OR = 2.08, CI = 1.06–4.12), mothers aged 30 to 34 years (adjusted OR = 2.9, CI = 1.28–6.60), having no antenatal care visit (adjusted OR = 3.91, CI = 1.33–11.47), having no bad obstetric history (adjusted OR = 2.11, CI = 1.12–3.98), having no postnatal care visit (adjusted OR = 3.88, CI = 1.36–11.12) and mothers' poor attitude (adjusted OR = 3.32, CI = 2.01–5.47) were statistically significant associated factors of traditional uvulectomy. Seeking traditional uvulectomy, lack of information and third-party pressure were the main themes of the qualitative study that support the findings of the quantitative study. Conclusion: The prevalence of traditional uvulectomy was high. Being rural residents, mothers aged 30 to 34 years, having no antenatal care visit, having no complications of obstetric history, having no postnatal care visit and mothers with poor attitude were statistically significant associated factors of traditional uvulectomy. Lack of information about uvulectomy and third-party pressure was the reason for seeking traditional uvulectomy. [ABSTRACT FROM AUTHOR]

Background: Poor attachment, suckling, and positioning contribute to ineffective breastfeeding techniques. Poor weight gain, stunting, and decreased immunity are caused by insufficient breast milk intake owing to ineffective breastfeeding techniques. Numerous primary studies conducted in Ethiopia have revealed negative effects of ineffective breastfeeding techniques. However, inconsistencies have been observed among these studies, and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and factors associated with ineffective breastfeeding techniques in Ethiopia. Methods: Using PRISMA standards, we systematically reviewed and meta-analyzed articles from PubMed, Cochrane Library, and Google Scholar to investigate the prevalence and associated factors of ineffective breastfeeding techniques. Q and I2 tests were used to assess heterogeneity across studies. To evaluate the national prevalence and effect size of the linked covariates, a weighted inverse variance random-effects model was used. Subgroup analysis was performed based on the region, sample size, and year of publication. Funnel plots and Egger's regression tests were used to examine publication bias. A sensitivity analysis was also performed to determine the impact of the studies. Results: The analysis included a total of eleven studies with 4,470 participants used in the analysis. The pooled prevalence of ineffective breastfeeding techniques in Ethiopia was 53.13% (45.49, 60.78) no formal education (AOR = 3.42; 95% CI:1.67–5.18; I2 = 72.2%; P = 0.0132), primipara (AOR = 2.72;95% CI:1.81–3.64; I2 = 46.7%; P = 0.131), postnatal care (PNC) (AOR = 1.84; 95% CI:1.35–2.32; I2 = 0%; P = 0.53), breastfeeding counseling (AOR = 1.93; 95% CI:1.23–2.63; I2 = 0%;P = 0.35), home delivery and having breast problem (AOR = 3.11; 95% CI:1.09–5.16; I2 = 0%;P = 0.877) and (AOR = 2.22; 95% CI:1.28–3.16; I2 = 0%;P = 0.80) respectively were significantly associated with ineffective breastfeeding techniques. Conclusion: The prevalence of ineffective breastfeeding techniques in Ethiopia remains high. Policymakers and program officials should focus on empowering women, increasing institutional delivery, and providing counseling on breastfeeding throughout the maternal continuum of care. These measures will improve breastfeeding techniques and lead to better health of both infants and women. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to describe the impact of COVID-19 on maternal and child health service utilization in the Eastern part of Ethiopia. Methods: Comparative analysis was used to examine 2 years of maternal and child health service utilization. Data were extracted from client registers. A traditional Expert Modeler and one-way Analysis of Variance were used to compare service utilization before and during the COVID-19 pandemic. Results: A total of 34,576 client records were reviewed, of which 17,100 (49.5%) and 17,476 (50.5%) had visited the MCH service before and during the COVID-19 pandemic, respectively. The total client visit has shown a 2% percentage point increase. However, postnatal care and child immunization services showed a decrease. Moreover, there was a significant difference between service visits before and during COVID-19 (f = 4.6, p < 0.04). Conclusion: Mothers and children have missed or unattended facility appointments due to protective impositions or fear of getting infected with COVID-19, which might suggest a higher proportion of MCH issues were not addressed during the pandemic. The health system should therefore improve its resilience and strengthen its access at the lowest health care inlets. [ABSTRACT FROM AUTHOR]

Background: Even if there is currently no research on food integration practices, there is an unreliable hole in the data for the first motives, especially 6 to 24 months, research at ages varies in different ways, always, but the child's development affects an important part of both the child and the parents. This gap limits our comprehensive knowledge of strategic choices and—their potential impact on children's overall health and well-being. Therefore, the aim of this study was factors shaping complementary feeding for 6 to 24-Month-Olds in Northeast Ethiopia. Methods: A community-based survey was conducted in northeastern Ethiopia from June to July 2022. A sample of 409 mothers with infants aged 6 to 24 months was selected using a simple random sampling method. A structured questionnaire was adopted and data were collected by an interviewer. Collected data were entered into Epi Data version 4.6 and subsequently converted to SPSS version 21 for further analysis. Variables with a P-value < = 0.25 in the bivariate analysis were included in the multivariable logistic regression model. Multivariable logistic regression analyses aimed at identifying independent associations between early initiation of supplement feeding and determinants-adjusted odds ratios with corresponding 95% confidence intervals were calculated to determine the strength of associations. P-values less than or equal to 0.05 were considered statistically significant. Results: A total of 409 mothers with their children were included in the analysis, revealing a prevalence of 38.1% for early initiation of complementary feeding among children aged 6–24 months. Factors associated with -early initiation included place of residence (Adjusted Odds Ratio (AOR) 3.63, 95% Confidence Interval (CI) 1.1–11.95), husband's educational status (AOR 16.83, 95% CI 1.98–24.8), maternal occupation (AOR 21.2, 95% CI 1.11–46.9), number of antenatal care (ANC) visits (AOR 25.94, 95% CI 22.7–85.67), initial breastfeeding time (AOR 4.98, 95% CI 1.22–14.9), and medical illness (AOR 2.81, 95% CI 1.12–3.6. Conclusion: Significant associations with Complementary Feeding were identified with the number of antenatal care (ANC) visits, postnatal care (PNC) check-ups, current residency, breastfeeding initiation time, maternal medical illness, and occupational status. To mitigate the early initiation of complementary feeding, it is recommended to enhance ANC/PNC services and educate mothers about the precise timing for introducing complementary foods to their infants. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effect of health education intervention (HEI) on maternal health service utilization (MHSU) in southern Ethiopia. Methods: From 10 January to 1 August 2023, a community-based, two-arm, parallel-group cluster randomized controlled trial (cRCT) was conducted among pregnant mothers in the Northern Zone of Sidama National Regional State, Ethiopia. We utilized multilevel mixed-effects modified Poisson regression with robust variance to control for the effects of clustering and potential confounders. The level of significance was adjusted for multiple comparisons. Results: The overall utilization of at least one antenatal care (ANC) visit was 90.2% in the treatment group and 59.5% in the comparator group (χ2 = 89.22, p < 0.001). Health facility delivery (HFD) utilization was considerably different between the treatment group (74.3%) and the comparator group (50.8%) (χ2 = 70.50, p < 0.001). HEI significantly increased ANC utilization (adjusted risk ratio [ARR]: 1.32; 99% CI: 1.12–1.56) and HFD utilization (ARR: 1.24; 99% CI: 1.06–1.46). The utilization of at least one postnatal care (PNC) service was 65.4% in the treatment group and 52.1% in the comparator group (χ2 = 19.51, p = 0.01). However, after controlling for the effects of confounders and clustering, the impact of HEI on PNC utilization was insignificant between the two groups (ARR: 1.15; 99% CI: 0.89–1.48). Conclusion: A community-based HEI significantly increased ANC and HFD utilization but did not increase PNC utilization. Expanding the HEI with certain modifications will have a superior effect on improving MHSU. Trial registration number: NCT05865873. [ABSTRACT FROM AUTHOR]

Background: The issue of Infant and Young Child Feeding practices was widespread; it was estimated that infants were not exclusively breastfed in the first six months of life. Complementary foods were frequently provided too soon or too late, and they were often nutritionally deficient. Even, there are nutrition-sensitive activities like irrigation schemes, evidence on infant and young child feeding practices between irrigated and non-irrigated areas is scarce or limited. Objective: To assess the prevalence of infant and young child feeding practices among 0–23 months of age children in irrigated and non-irrigated areas of Dangila District, North-west Ethiopia, 2020. Methods: A community based comparative cross-sectional study was conducted from Dec 1, 2020, to Jun 1, 2020. A stratified sampling technique was implemented to select 823 mothers with children age 0–23 months from irrigated (411) and non-irrigated (412) kebeles. Data were collected using structured questionnaires. Multivariable logistic regression was used to identify the associated factors of infant and young child feeding practice. Adjusted odds ratios with a 95% CI were used to determine the degree of association between the independent and outcome variables. A p-value < 0.05 was used as a cutoff point to declare statistically significant variables with the outcome variable. Results: Among 823 households visited, 802 respondents with a response rate of 97.8% in irrigated and 96.11% in non-irrigated areas gave complete responses. The overall prevalence of good IYCF practice was 62.5% (95% CI: 34.2, 41.3), and it shows a significant difference between irrigated (72.2%) and non-irrigated areas (52.8%). Moreover, the study identified that education primary and above (AOR = 1.889, 95% CI: 1.38, 2.648) knowledge above mean (AOR = 2.347, 95% CI: 1.555, 3.542), positive attitude (AOR = 1.716, 95% CI: 1.139, 2.587), PNC follow-up (AOR = 1.606, 95% CI: 1.154, 2.360), women's decision-making power (AOR = 1.840, 95% CI: 1.226, 2.763), and multiple delivery (AOR = 0.352, 95% CI: 0.213, 0.583) were significant factors for IYCF among 0–23 month-old children. Conclusion and recommendations: The infant and young child feeding practice among 0–23 month-old children was better in an irrigated area than in a non-irrigated area. Promoting irrigation practices, empowering women, and strengthening postnatal care are recommended interventions to increase infant, young, and child feeding practices in the study area. [ABSTRACT FROM AUTHOR]

Background: The early postnatal period is defined as the first 48 h to 7 days after delivery. The early postnatal visit is especially the most critical time for the survival of mothers and newborns, particularly through early detection and management of postpartum complications. Despite the benefits, most mothers and newborns do not receive early postnatal care services from healthcare providers during the critical first few days after delivery. Objectives: This study is aimed at assessing the prevalence of early postnatal care utilization and associated factors among mothers who gave birth within the last 6 weeks in Hosanna town, Southern Ethiopia, from April 20 to May 30, 2022. Method: A community-based cross-sectional study was conducted in Hadiya Zone, Hosanna town, Southern Ethiopia. A simple random sample technique was used to recruit 403 mothers who had given birth in the previous 6 weeks from a family folder. Data was collected through face-to-face interviews using a standardized questionnaire. Binary logistic regression was used to assess the association between outcomes and explanatory variables, and the strength of the association was interpreted using an odds ratio with a 95% confidence interval. In our study, p values of 0.05 were considered statistically significant. Results: The prevalence of early postnatal care utilization among mothers who gave birth within 1 week of the study area was 25.8% (95% CI: 21.7–30.0). No formal and primary educational level of husband (AOR = 0.05 , 95% CI: [0.02, 0.16]), antenatal care follow-up (AOR = 2.13 , 95% CI: [1.11, 4.1]), length of hospital stay before discharge (≥24 h) (A O R = 0.3 , 95% CI: [0.16, 0.55]), and information about early postnatal care utilization (AOR = 3.08 , 95% CI: [1.72, 5.52]) were factors significantly associated with early postnatal care utilization. Conclusion: In comparison to World Health Organization standards, the study's overall prevalence of early postnatal care utilization was low. Early postnatal care use was significantly associated with antenatal care follow-up, the husband's educational level, knowledge of early postnatal care use, and length of stay at the health institution following birth. As a result, the strength of health facilities is to improve service provision, information education, and communication. [ABSTRACT FROM AUTHOR]

Background: Globally, according to the World Health Organization (WHO) 2023 report, more than 14.3 million children in low- and middle-income countries, primarily in Africa and South-East Asia, are not receiving any vaccinations. Ethiopia is one of the top ten countries contributing to the global number of zero-dose children. Objective: To estimate the prevalence of zero-dose children and associated factors in underserved populations of Ethiopia. Methods: A cross-sectional vaccine coverage survey was conducted in June 2022. The study participants were mothers of children aged 12–35 months. Data were collected using the CommCare application system and later analysed using Stata version 17. Vaccination coverage was estimated using a weighted analysis approach. A generalized estimating equation model was fitted to determine the predictors of zero-dose children. An adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p-value of 0.05 or less was considered statistically significant. Results: The overall prevalence of zero-dose children in the study settings was 33.7% (95% CI: 34.9%, 75.7%). Developing and pastoralist regions, internally displaced peoples, newly formed regions, and conflict-affected areas had the highest prevalence of zero-dose children. Wealth index (poorest [AOR = 2.78; 95% CI: 1.70, 4.53], poorer [AOR = 1.96; 95% CI: 1.02, 3.77]), single marital status [AOR = 2.4; 95% CI: 1.7, 3.3], and maternal age (15–24 years) [AOR = 1.2; 95% CI: 1.1, 1.3] were identified as key determinant factors of zero-dose children in the study settings. Additional factors included fewer than four Antenatal care visits (ANC) [AOR = 1.3; 95% CI: 1.2, 1.4], not receiving Postnatal Care (PNC) services [AOR = 2.1; 95% CI: 1.5, 3.0], unavailability of health facilities within the village [AOR = 3.7; 95% CI: 2.6, 5.4], women-headed household [AOR = 1.3; 95% CI:1.02, 1.7], low gender empowerment [AOR = 1.6; 95% CI: 1.3, 2.1], and medium gender empowerment [AOR = 1.7; 95% CI: 1.2, 2.5]. Conclusion: In the study settings, the prevalence of zero-dose children is very high. Poor economic status, disempowerment of women, being unmarried, young maternal age, and underutilizing antenatal or post-natal services are the important predictors. Therefore, it is recommended to target tailored integrated and context-specific service delivery approach. Moreover, extend immunization sessions opening hours during the evening/weekend in the city administrations to meet parents' needs. [ABSTRACT FROM AUTHOR]

Introduction: Postnatal care is care that is provided to mothers and newborn baby after delivery. The care given after childbirth is the most critical time because most maternal and neonatal mortality occurs during this period. Utilization of this service is low in Ethiopia, and no evidence exists to describe the status of early postnatal care service utilization among women in the study area. Objective: This study aimed to assess the utilization of early postnatal care services and associated factors among mothers who gave birth in the last 12 months in the South Gondar Zone District, Amhara Region, Ethiopia, in 2021. Method: This study was conducted in South Gondar Zone Districts from October 1 to 30, 2021. A total of 761 participants were included in this study using a simple random sampling method. The study participants were mothers who gave birth in the last 12 months. The data were collected via interview-guided semistructured questionnaires. The collected data were coded and entered into EPI Info version 7.2 and exported into SPSS version 23 for analysis. Both binary and multivariate logistic regression analyses were applied to identify factors affecting the outcome variables. The results of the final model are presented as the adjusted odds ratio (AOR) and 95% confidence interval (CI). A P value less than 0.05 was considered to indicate statistical significance. Results: In this study, 761 mothers participated, for a response rate of 100%. The overall prevalence of early utilization of postnatal care services was 20.6%. Mothers who live in urban areas were five times more likely to have early visits than those living in rural areas with adjusted odds ratio [AOR (95% CI) = 5.2 (3.19, 8.54)], a mothers who had a history of more than four parity had more likely to visit than the others at [AOR (95% CI) = 2.25 (1.18, 4.29)], mothers who had a history of pregnancy had two times more likely to visit than the other [AOR (95% CI) = 2.06 (1.05, 4.05)], and mothers who had delivered by instrumental vaginal delivery or cesarean section delivery and those mothers who had mass media exposure were two and five times more likely to visit, respectively [AOR (95% CI) = 2.62 (1.40, 4.91)] and [AOR (95% CI) = 5.18 (2.55, 10.52)]. Conclusion and recommendation: Compared with those of other studies, the overall prevalence of early utilization of postnatal care services was low. Improving mothers' knowledge of early postnatal care visits is very important for enhancing quality of life and minimizing neonatal and maternal morbidity and mortality. [ABSTRACT FROM AUTHOR]

Background: Promoting a favorable experience of postpartum care has become increasingly emphasized over recent years. Despite the fact that maternal health care services have improved over the years, postnatal care service utilization is generally low and the health-related quality of life of postpartum women remains overlooked. Furthermore, the health-related quality of life of postpartum women is not well studied. Therefore, this study aimed to assess the health-related quality of life of postpartum women and associated factors in Dendi district, West Shoa Zone, Oromia, Region, Ethiopia. Methods: A community-based cross-sectional study was conducted among 429 participants. A multistage stratified sampling procedure was used to select the sampling unit and simple random sampling technique was employed to select the study participants from 23 August 2022 to 16 November 2022. A pre-tested standard structured questionnaire was used to collect the data. Data were entered using Epi-Data 3.1 and then exported to Statistical package for social science version 26. Binary logistic regression analysis was computed at p-value < 0.25 were considered candidates for multivariable logistic regression. Adjusted Odds Ratios (AOR) with 95% confidence interval and statistical significance was declared at a p-value < 0.05. Results: The study revealed that 73.7% (95% CI: 69.4–77.7) had a low level of health-related quality-of-life with a mean of 44.02 (SD ± 10.4). Urban residing [AOR = 0.27, 95% CI: (0.10–0.74)], no education [AOR = 3.44, 95% CI (1.35–8.74)], received at least four antenatal contact [AOR = 0.56, 95% CI (0.33–0.95)], received at least one postnatal care [AOR = 0.30, 95% CI (0.14–0.62)], poor social support [AOR = 2.23, 95% CI: (1.025–4.893)], having postpartum depression [AOR = 2.99, 95% CI: (1.52–5.56)], cesarean delivery [AOR = 3.18, 95% CI: (1.09–9.26)], and lowest household assets [AOR = 5.68, 95% CI: (2.74–11.76)] were significant associations with low health-related quality of life of postpartum women. Conclusions: The health-related quality of life among postpartum women was very low. Postpartum women with low socio-economic status and inadequate maternal health service utilization had a low health-related quality of life. Promoting women's education and postnatal care services is needed to improve the health-related quality of life of postpartum women. [ABSTRACT FROM AUTHOR]

Background: Home delivery is a nonclinical childbirth practice that takes place in one's home with or without traditional birth attendants and postnatal care is the care given to the mother and her newborn baby; according to world health organization (WHO), the postnatal phase, begins one hour after birth and lasts six weeks (42 days). This paper aimed to study the spatial pattern and determinant factors of low utilization of delivery care (DC) services and postnatal check-up (PNC) after live births in Ethiopia. Methods: This study used the 2016 Ethiopian Demographic and Health Survey data as a source. A total weighted samples of 11023 women-children pairs were included. The bivariate binary logistic regression analyses with spatial effect were modeled using SAS version 9.4 and ArcGIS version 10.8 was used for mapping. Results: The spatial distribution of low utilization of delivery care service and postnatal check-up were significantly clustered in Ethiopia (Moran's I statistic 0.378, P-value < 0.001 and 0.177, P-value < 0.001 respectively). Among 11023 children-women pair, the prevalence of home delivery and no postnatal check-up within two months following birth were 72.6% and 91.4% respectively. The Liben, Borena, Guji, Bale, Dolo and Zone 2 were predicted to have high prevalence of home delivery and part of Afder, Shabelle, Korahe, Dolo and Zone 2 were high risk areas of no postnatal checkup. Conclusion and recommendations: Lack of occupation, region, large family size, higher birth order, low utilization of antenatal care visit, unable to access mass media, big problem of health facility distance and the spatial variable were found to be jointly significant predictors of low utilization of DC and PNC in Ethiopia. Whereas older age, being reside in rural area and low wealth status affects delivery care service utilization. We suggest health providers, policy makers and stakeholders consider those variables with priority given to Liben, Borena, Guji, Bale, Dolo, Zone 2, Afder, Shabelle and Korahe, where home delivery and no PNC were predicted relatively high. We also recommend researchers to conduct further studies using latest survey data set. [ABSTRACT FROM AUTHOR]

Despite the efforts made in Ethiopia to decrease maternal mortality by increasing postnatal care and other maternal health care services, neither significant reduction in maternal mortality nor an increase in postnatal care utilization. The objective of this study was to develop an action plan to improve postnatal care services in the Ethiopian context. Sequential mixedmethods research, was conducted over three phases. In the first phase of the study, background information on postnatal care services in Ethiopia was assessed and described. During the second phase of the study, an action plan for postnatal care improvement was developed, and the third phase concentrated on the validation of the developed action plan. For phase 1 one of the study 422 respondents were randomly selected and participated in the study from November 1 to 30, 2020. A self-administered structured questionnaire was used for quantitative data collection. The collected data were checked for completeness, cleaned, coded, and then entered into Statistical Package for Social Sciences (SPSS) software program version 21. For the thrird phase of the study a delphi technique was used to validate the developed action plan. For all phases of the study, the open-ended questions were open-coded and thematically analyzed. A validated action plan for the improvements of postnatal care was developed using the inputs from respondents during Phase 1, available literature as well as the threeround Delphi technique. The findings revealed that the developed action plan is applicable in the Ethiopian context and is crucial for improvement of postnatal care. The study revealed that the developed and validated action plan will improve postnatal care in Ethiopia. Follow-up studies to assess the limitations of the action plan can be conducted to adapt and improve the action plan. Further studies on possible challenges associated with the implementation can enhance the success of the implementation of the action plan. [ABSTRACT FROM AUTHOR]

Background: Maternal health service utilization decreases maternal morbidity and mortality. However, the existing evidence is inadequate to design effective intervention strategies in Ethiopia. Objectives: This study aimed to examine the utilization of maternal health service and identify its determinants among women of reproductive age in southern Ethiopia. Design: A community-based cross-sectional study was conducted from October 21 to November 11, 2022 on a sample of 1140 women selected randomly from the Northern Zone of the Sidama region. Methods: Data were collected using the Open Data Kit mobile application and exported to Stata version 15 for analysis. We used a multilevel mixed-effects modified Poisson regression with robust standard error to identify determinants of maternal health service utilization. Results: Utilization of antenatal care, health facility delivery, and postnatal care was 52.0% (95% confidence interval: 49.0%, 55.0%), 48.5% (95% confidence interval: 45.6%, 51.4%), and 26.0% (95% confidence interval: 23.0%, 29.0%), respectively. Antenatal care use was associated with receiving model family training (adjusted prevalence ratio: 1.19; 95% confidence interval: 1.06, 1.35), knowledge of antenatal care (adjusted prevalence ratio: 1.54; 95% confidence interval: 1.31, 1.81), perceived quality of antenatal care (adjusted prevalence ratio: 1.02; 95% confidence interval: 1.01, 1.03), and having birth preparedness plan (adjusted prevalence ratio: 1.13; 95% confidence interval: 1.02, 1.25). The identified determinants of health facility delivery use were middle wealth rank (adjusted prevalence ratio: 1.35; 95% confidence interval: 1.03, 1.77), perceived quality of health facility delivery (adjusted prevalence ratio: 1.02; 95% confidence interval: 1.01, 1.03), antenatal care (adjusted prevalence ratio: 1.76; 95% confidence interval: 1.36, 2.26), and high community-level women literacy (adjusted prevalence ratio: 1.55; 95% confidence interval: 1.10, 2.19). Postnatal care use was associated with facing health problems during postpartum period (adjusted prevalence ratio: 1.79; 95% confidence interval: 1.18, 2.72), urban residence (adjusted prevalence ratio: 3.52; 95% confidence interval: 2.15, 5.78), knowledge of postnatal care (adjusted prevalence ratio: 1.11; 95% confidence interval: 1.04, 1.19), and low community-level poverty (adjusted prevalence ratio: 0.43; 95% confidence interval: 0.25, 0.73). Conclusion: Maternal health service use was low in the study area and was influenced by individual- and community-level determinants. Any intervention strategies must consider multi-sectorial collaboration to address determinants at different levels. The programs should focus on the provision of model family training, the needs of women who have a poor perception, and knowledge of maternal health service at the individual level. [ABSTRACT FROM AUTHOR]

Early newborn care provided in the first 2 days of life is critical in reducing neonatal morbidity and mortality. This care can be used to monitor and evaluate the content and quality of neonatal postnatal care. This study aimed to identify determinants and geographic distributions of early newborn care uptake in Ethiopia. We used data from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). We conducted a multilevel binary logistic regression model and geographic analysis to identify the determinants of receiving early newborn care. A total of 2105 children were included in the study. Of the included children, 39.6% (95% confidence interval (CI) 38%, 42%) received at least two components of early newborn care services in the first 2 days after birth. Greater odds of receiving early newborn care were experienced by infants to mothers with secondary or above education (adjusted odds ratio (AOR) = 1.72; 95% CI 1.44, 2.18), from households with highest wealth quantiles (AOR = 1.47; 95% CI 1.16, 1.79), with at least one antenatal care contact (AOR = 2.73; 95% CI 1.79, 4.16), with birth at health facility (AOR = 25.63; 95% CI 17.02, 38.60), and those births through cesarean section (AOR = 2.64; 95% CI 1.48, 4.71). Substantial geographic variation was observed in the uptake of early newborn care in Ethiopia. Several individual- and community-level factors were associated with newborn postnatal care. Policymakers should prioritise these areas and the enhancement of postnatal healthcare provisions for mothers with low socioeconomic status. [ABSTRACT FROM AUTHOR]

Background: The postpartum period is critical for both the mother's and newborn child's health and survival. Rising morbidity and mortality are usually the consequence of absence of adequate, suitable, or timely care during that time period. There is lack of information on the adequacy of postnatal care in Ethiopia and this study was aimed to investigate adequacy of postnatal care and its determinants in the study area. Methods: In this study, we used a cross-sectional dataset from the 2019 Ethiopia Mini Demographic and Health Survey. A multistage stratified clustered design applied and survey weights were used to take into account the complicated sample design. A multilevel mixed effects logistic regression was fitted on 3772 women who were nested within 305 clusters. The fixed effect models were fitted and expressed as adjusted odds ratios with 95% confidence intervals, while intra-class correlation coefficients, median odds ratio, and proportional change in variance explained measures of variation. As model fitness criteria, the deviance information criterion and the Akaike information criterion were used. Results: This study found that only 563(16.14%, 95% CI: 16.05–16.24) women had adequate post natal care. Age of between 25–35 years old (AOR = 1.55, 95%CI = 1.04–2.31), secondary level of education (AOR = 2.23, 95%CI = 1.43–3.45), Having parity of between two and four had (AOR = 0.62, 95%CI = 0.42 0.93), having ANC follow up four and above (AOR = 1.74, 95%CI = 1.31–2.33), being residents of Oromia region (AOR = 0.10, 95CI = 0.02- 0.43) were strong predictors of adequate postnatal care. Conclusion: The study found that prevalence of adequate PNC in Ethiopia was significantly low. To increase postnatal care adequacy, it was recommended to reinforce existing policies and strategies such as increasing number of antenatal care follow up, and scheduling mothers based on the national postnatal care follow-up protocol. [ABSTRACT FROM AUTHOR]

Background: Inappropriate complementary feeding is one of the leading causes of malnutrition among children 6–23 months old and delays children's growth milestone. The determinants of inappropriate complementary feeding practice have diverse natures, so that many of the previous studies fail to generate adequate evidence on it. This study aim to address the determinants of in appropriate complementary feedings at community level. Methods: A community-based unmatched case-control study design was carried out among children 6–23 months of age in Dessie City from April 13, 2021 to May 13, 2021. Nine kebeles were selected by simple random sampling method. One month prior to the data collection time survey was conducted and 482 samples were taken from the preliminary survey data; 241 cases and 241 controls by computer generated random numbers. Interviewer administered questionnaire was used to investigate potential determinants of inappropriate complementary feeding practice. Binary logistics regression was used to identify independent determinants. Results: Part working situation of mother [AOR = 0.21 CI: 0.08, 0.52] was negatively associated with inappropriate complementary feeding. Having no post-natal care visit [AOR = 4.062 CI:2.35,7.02], poor wealth status [AOR = 2.7 CI:1.09,6.68], food in-security [AOR = 4.49 CI:1.94,10.37], home delivery [AOR = 4.33 CI:1.43,13.15], having poor knowledge on infant and young child feeding [AOR = 5.94 CI:2.8,12.6], having no health education on complementary feeding [AOR = 2.54 CI:1.28,5.06] and father's job [AOR = 2.2 CI:1.17,4.1] were found to be positively associated with inappropriate complementary feeding. Conclusion: Mothers' work situation, fathers' job, wealth index, food security, mothers' knowledge on infant feeding, post-natal care, health education on infant feeding and place of delivery were independent determinants for inappropriate complementary feeding. Thus, interventions shall effectively address those factors to alleviate the problem. [ABSTRACT FROM AUTHOR]

Neonatal health is a significant global public health concern, and the first two days of life are crucial for newborn survival. Most studies on newborn postnatal care have focused on crude coverage measures, which limit the evaluation of care quality. However, evidence suggests a shift towards emphasising effective coverage, which incorporates the quality of care when measuring intervention coverage. This research aimed to assess the effective coverage of newborn postnatal care in Ethiopia while also examining its inequalities and spatial distribution. The study used secondary data from the 2016 Ethiopian Demographic and Health Survey, which was a cross-sectional community-based study. A total weighted sample of 4169 women was used for analyses. We calculated crude coverage, which is the proportion who received a postnatal check within 48 hours of birth and quality-adjusted coverage (effective coverage), which is the proportion who received a postnatal check within 48 hours of birth and reported receipt of 6 or more contents of care provided by health care providers. Concentration index and concentration curves were used to estimate the socioeconomic-related inequalities in quality-adjusted newborn postnatal care. The spatial statistic was analysed by using Arc-GIS. The crude coverage of newborn postnatal care was found to be 13.2%, while the effective coverage was 9%. High-quality postnatal care was disproportionately concentrated among the rich. A spatial variation was found in quality-adjusted coverage of newborn postnatal care across regions. The findings suggest that there is a significant gap in the coverage and quality of postnatal care for newborns across regions in Ethiopia. The low rates of coverage and effective coverage, combined with the concentration of high-quality care among the rich and the spatial variation across regions, highlight the need for targeted interventions and policies to address the inequalities in access to high-quality postnatal care for newborns. [ABSTRACT FROM AUTHOR]

Background: Access to basic health services, notably child health services, is severely hampered by the armed conflict in Tigray, North Ethiopia. Little is known regarding the impacts of the armed conflict during the war in Tigray on access to child health services. The current study investigates the impact of the armed conflict on the utilization of child health services in Tigray. Methods: 4,381 caregivers from randomly recruited households (HHs) with at least one child younger than 1 year old participated in a community-based cross-sectional survey. We collected data on childhood immunizations and illness-related treatment seeking from August 4 to 20, 2021. We describe data using frequency and percentage and carry out an internal comparison among the study participants using chi-square tests. Results: 4,381 children under the age of one included in the study. In total, 39% of infants received no basic vaccines, 61.3% of the children under the age of one received at least one vaccine, and 20% received all the vaccinations recommended for their age. About 61% of children were affected by at least one childhood ailments where majority of them were from rural areas. Mothers who did not seek postnatal care (PNC) were responsible for more than 75% of reported childhood illnesses. Conclusions: A sizable portion of children were unvaccinated and had at least one childhood sickness while the war was in progress. Particularly, people who live in rural areas reported a higher percentage of children's illnesses but a lower use of child health services. To lower childhood morbidity and mortality in the besieged area, such as Tigray, local to global actors need to get coordinated and warrying parties should stop weaponization of vaccination healthcare services. [ABSTRACT FROM AUTHOR]

Background: Persistent inequalities in coverage of maternal health services in sub-Saharan Africa (SSA), a region home to two-thirds of global maternal deaths in 2017, poses a challenge for countries to achieve the Sustainable Development Goal (SDG) targets. This study assesses wealth-based inequalities in coverage of maternal continuum of care in 16 SSA countries with the objective of informing targeted policies to ensure maternal health equity in the region. Methods: We conducted a secondary analysis of Demographic and Health Survey (DHS) data from 16 SSA countries (Angola, Benin, Burundi, Cameroon, Ethiopia, Gambia, Guinea, Liberia, Malawi, Mali, Nigeria, Sierra Leone, South Africa, Tanzania, Uganda, and Zambia). A total of 133,709 women aged 15-49 years who reported a live birth in the five years preceding the survey were included. We defined and measured completion of maternal continuum of care as having had at least one antenatal care (ANC) visit, birth in a health facility, and postnatal care (PNC) by a skilled provider within two days of birth. We used concentration index analysis to measure wealth-based inequality in maternal continuum of care and conducted decomposition analysis to estimate the contributions of sociodemographic and obstetric factors to the observed inequality. Results: The percentage of women who had 1) at least one ANC visit was lowest in Ethiopia (62.3%) and highest in Burundi (99.2%), 2) birth in a health facility was less than 50% in Ethiopia and Nigeria, and 3) PNC within two days was less than 50% in eight countries (Angola, Burundi, Ethiopia, Gambia, Guinea, Malawi, Nigeria, and Tanzania). Completion of maternal continuum of care was highest in South Africa (81.4%) and below 50% in nine of the 16 countries (Angola, Burundi, Ethiopia, Guinea, Malawi, Mali, Nigeria, Tanzania, and Uganda), the lowest being in Ethiopia (12.5%). There was pro-rich wealth-based inequality in maternal continuum of care in all 16 countries, the lowest in South Africa and Liberia (concentration index = 0.04) and the highest in Nigeria (concentration index = 0.34). Our decomposition analysis showed that in 15 of the 16 countries, wealth index was the largest contributor to inequality in primary maternal continuum of care. In Malawi, geographical region was the largest contributor. Conclusions: Addressing the coverage gap in maternal continuum of care in SSA using multidimensional and people-centred approaches remains a key strategy needed to realise the SDG3. The pro-rich wealth-based inequalities observed show that bespoke pro-poor or population-wide approaches are needed. [ABSTRACT FROM AUTHOR]

Background: Immunization has been promoted as a global strategy aimed at improving child survival. The World Health Organization strives to make immunization services available to everyone, everywhere to save over 50 million lives by 2030. Monitoring the change and identifying the factors contributing to the change in immunization coverage over time and across the nations is imperative for continuing global success in increasing immunization coverage. In this study, we examined the changes and factors that contributed to the change in full immunization coverage over time in Ethiopia (2000 to 2019). Methods: We analyzed data on children aged 12–23 months, extracted from the 2000 and 2019 Ethiopian Demographic and Health Survey (EDHS) datasets. A total of 3,072 weighted samples (2,076 in 2000 and 966 in 2019) were included in the analysis. A multivariate decomposition analysis technique was used to determine change and identify factors that contributed to the change over time. Statistical significance was defined at a 95% confidence interval with a p-value of less than 0.05. Results: There was a 29.56% (95% CI: 24.84, 34.28) change in full immunization coverage between the two surveys. It increased from 14.62% (95% CI: 12.43, 17.11) in 2000 to 44.18% (95% CI: 37.19, 51.41) in 2019. The decomposition analysis showed that about 75% of explained change was attributed to the differences in the composition of explanatory variables (the endowment effect). Particularly, women aged 35–49 years (-2.11%), those who attended four or more antenatal care visits (17.06%), individual who had postnatal care visits (16.90%), households with two or more under-five children (2.50%), and those with a history of child mortality (17.80%) were significantly attributed to the change. The rest, 25% of the explained change was attributed to the difference in the effects of explanatory variables (coefficient). The change in the coefficient for women who had experienced child death (-20.40%) was statistically significant to the change in full immunization coverage over time. Conclusion: The finding of this study revealed that there was a statistically significant change in full immunization coverage over time. The majority of the change was attributed to the differences in the composition of explanatory variables such as antenatal care and postnatal care visits, age of the mother, and number of living children in the household. Therefore, strengthening maternal health services utilization may enhance immunization coverage in Ethiopia. Furthermore, the difference in coefficient of mothers with a history of child death had a substantial counteracting effect on the change, emphasizing the importance of raising awareness and delivering vaccine education to them and the larger community. [ABSTRACT FROM AUTHOR]

Background: Postpartum contraceptives during the first year after delivery is a key service for women to prevent unintended pregnancy and reduce the risk of maternal and child mortality by ensuring safe birth intervals. This process evaluation aimed to assess the availability, compliance, and accommodation of Post-Partum Contraceptives (PPC) and the experience of women's contraception in the first 12 months postpartum in Ayder Comprehensive Specialized Hospital (ACSH). Methods: A case study evaluation design with a mixed method was employed from February 16/2020 to Mar 30, 2020. Direct observations, 12-month document reviews, and key informant interviews were conducted. The quantitative data were entered into Epi-Data version 3.1 and exported to SPSS version 21 for analysis. In the multivariate logistic regression analysis, variables with < 0.05 p-values and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were used to declare the association. The qualitative data were transcribed, translated, coded, and analyzed using thematic analysis. The overall process of program implementation was measured based on pre-determined judgmental criteria. Result: From the total of charts reviewed 302 only 188 (62.3%) postpartum mothers used any method within 12 months of the postpartum period out of which only 27.1% mothers used of long-acting reversible contraceptive (LARC). The overall evaluation of postpartum contraceptives was 84.1% (V/good). Notable gaps observed in this study were poor provision of information in relation to methods given, poor technical performance in following the aseptic procedure, poor utilization of postpartum family planning guidelines and clinical checklists for counseling, and poor use of information education materials compared to the national standards. Residence, number of stillbirths or neonatal loss, counseling status of family planning during ANC visits, and maternal counseling status of family planning during postnatal care visits were factors associated with PPC. Conclusion: The overall postpartum contraceptive service delivery in ACSH was V/good compared to the national family planning guideline standards. With the notable gaps identified, specific recommendations were suggested to different responsible bodies. [ABSTRACT FROM AUTHOR]

Background: Since bottle feeding has an impact on the effectiveness of breastfeeding and appropriate supplemental feeding, the World health organization recommends being avoided for infant and early child feeding. Thus, this study aimed to assess the level of the bottle-feeding practice and its associated factors among mothers of 0–24 month's children in Asella town, Oromia region, Ethiopia. Methods: Community-based cross-sectional study design was conducted from March 8-April 8, 2022, among a sample of 692 mothers of children aged 0–24 months. A multi-stage sampling technique was used to select the study subjects. Data were collected using a pretested and structured questionnaire by face-to-face interview technique questionnaire. The outcome variable bottle-feeding practice (BFP) was assessed using WHO and UNICEF UK healthy baby initiative BF assessment tools. Binary logistic regression analysis was used to identify the association between explanatory and outcome variables. Adjusted Odds ratio (AOR) with a 95% confidence interval was used to measure the strength of the association and a p-value < 0.05 was used to declare statistical significance. Results: A total of 692 mothers with mean age and standard deviation (SD) of 31.86 (± 4.87) participated in the study. The prevalence of bottle-feeding practice was 246(35.5% with 95% CI: (31.8, 39.5). Mothers who were government-employed (AOR: 1.64, 95% CI: 1.02, 2.64), mothers who delivered at home (AOR: 3.74, 95% CI: 2.58–5.42), mothers who did not attend postnatal care (AOR: 3.76, 95% CI: 2.60,5.44) and mother who had negative attitude (AOR: 1.94, 95%CI: 1.34,2.8) were significantly associated with bottle feeding practices. Conclusion: The BFP were higher in the study area when compared with national reports of practices. The occupational status of the mothers, place of delivery, attending postnatal care, and attitude of the mothers were factors that increased bottle-feeding practice in the study area. Strengthening dietary behavioral modification for mothers who have children 0–24 months of the child to practice appropriate feeding is recommended. [ABSTRACT FROM AUTHOR]

Background: Vitamin A deficiency is one of the major public health problems in low and middle-income countries including Ethiopia. Despite this fact, little attention was given to routine vitamin A supplementation in hard-to-reach rural areas and districts. Therefore, this study aimed to assess vitamin A supplementation coverage and its associated factors among children aged 6–59 months in West Azernet Berbere woreda, southern Ethiopia, 2021. Methods: A community-based cross-sectional study was conducted from April to May 2021. A total sample size of 471 study participants was involved in the study area. A simple random sampling technique was used to recruit the study subject. A pretested structured interviewer-administered questionnaire was used. Bivariable and multivariable logistic regression analyses were done to identify variables having a significant association with vitamin A supplementation. The variables having a p-value ≤ 0.05 with 95% CI were used to declare an association between factors and a dependent variable. Results: In this study, a total of 471 respondents were successfully interviewed with a response rate of 97.3%. The coverage of vitamin A supplementation was found to be 58.0%. Family monthly income [AOR = 2.565, 95% CI(1.631,4.032)], having PNC visit [AOR = 1.801, 95% CI (1.158, 2.801)], husbands disapproval about vitamin A supplementation [AOR = 0.324, 95% CI (0.129, 0.813)], information about vitamin A supplementation [AOR = 2.932, 95% CI (1.893, 4,542)] and ANC follow-up [AOR = 1.882, 95% CI (1.084, 3.266)] were factors significantly associated to vitamin A supplementation. Conclusion: Vitamin A supplementation was found to be low and it is strongly associated with family monthly income, postnatal care, husband's disapproval of vitamin A supplementation, antenatal care follow-up, and information about vitamin A supplementation. Based on our findings, it is recommended to improve the monthly income of the household by actively engaging in various income-generating activities, enhance health information dissemination among mothers, particularly those who are underprivileged by using different strategies like local health campaigns, and mass media, advocacy of antenatal, and postnatal follow-up and promote the involvement of males/husband in childhood immunization service. [ABSTRACT FROM AUTHOR]

Introduction: nearly three-quarters of infants younger than six months were not exclusively breastfed globally. Despite some research indicating what factors influence early exclusive breastfeeding interruption in Ethiopia's stable population, there is little evidence indicating what factors influence exclusive breastfeeding interruption in vulnerable populations such as refugee camps. Therefore, this study aimed to determine the factors that contributed to the early termination of exclusive breastfeeding in Ethiopian refugee camps in the Dollo Ado district. Methods: a case-control study was conducted at the Dollo Ado refugee camps from April 05th to 25th, 2017. The eligible 112 cases and 224 controls were identified using the 24-hour recall method. The information was gathered using an interviewer-administered questionnaire that was pretested and organized. Logistic regression analysis was computed to assess the effect of independent variables. Results: the determinants for early interruption of exclusive breastfeeding were not counseled about infant feeding during antenatal care follow-up (adjusted odds ratio (AOR =5.87, 95% CI [2.61-13.1]), not counseled about infant feeding during postnatal care service use (AOR= 4.33, 95% CI [2.71-10.8), breastfeeding problem (AOR= 5.62, 95% CI [4.55-15.2]) and late initiation of breastfeeding (AOR= 4.79, 95% CI [28-10.1]). Conclusion: in this study, early termination of exclusive breastfeeding was caused by breastfeeding problems and late commencement of breastfeeding, as well as not receiving infant feeding advice during antenatal care or postnatal care. The results of this study highlight the significance of concentrating on newborn and young child feeding counseling during prenatal and postnatal care services in order to promote exclusive breastfeeding. In addition, health providers should educate parents on the significance of starting exclusive breastfeeding on time and obtaining help right away if there is a problem, such as breast soreness or the infant refusing to eat due to oral trash, to avoid early exclusive breastfeeding interruption. [ABSTRACT FROM AUTHOR]

Background: The use of maternal health care services tends to rise with women's empowerment. However, disparities in the use of maternal health care services in Ethiopia that are founded on women's empowerment are not sufficiently addressed. In light of women's empowerment equity stratifier, this study seeks to assess inequalities in the uptake of maternal health care services (early antenatal care, four or more antenatal care and postnatal care services). Methods: Drawing on data from the four rounds of Ethiopia Demographic and Health Surveys (EDHSs) conducted between 2000 and 2016, we conducted analysis of inequalities in utilization of maternal health care services using women's empowerment as equity stratifier. We utilized concentration index and concentration curve for assessing the inequalities. We used clorenz and conindex Stata modules to compute the index and curve. Decomposition of the Erreygers normalized concentration index was done to explain the inequalities in terms of other variables' percent contributions. Complex aspect of the EDHSs data was considered during analysis to produce findings consistent with the data generating process. All analyses were done using Stata v16. Results: Utilization of maternal health care services was inequitably distributed between empowered and poorly empowered women, with women in the highly empowered category taking more of the services. For instance, the Erreygers index for quality ANC are 0.240 (95% CI 0.207, 0.273); 0.20 (95% CI 0.169, 0.231) and 0.122 (95% CI 0.087, 0.157), respectively, for the attitude towards violence, social independence and decision-making domains of women's empowerment. Inequalities in the distribution of other variables like wealth, education, place of residence and women's empowerment itself underpin the inequalities in the utilization of the services across the women's empowerment groups. Conclusions: Equity in maternal health care services can be improved through redistributive policies that attempt to fairly distribute the socioeconomic determinants of health such as wealth and education between highly and poorly empowered women. [ABSTRACT FROM AUTHOR]

Background: A minimum of one ultrasound scan is recommended for all pregnant women before the 24th week of gestation. In Ethiopia, there is a shortage of skilled manpower to provide these services. Currently, trained mid-level providers are providing the services at the primary healthcare level. The aims of this study were to compare antenatal care 1 (ANC1), antenatal care 4 (ANC4), skilled birth attendance (SBA), and postnatal care (PNC) service utilization before and after institutionalizing Vscan limited obstetric ultrasounds at semi-urban health centers in Ethiopia. Methods: A pre and post intervention observational study was conducted to investigate maternal and neonatal health service utilization rates before and after institutionalizing Vscan limited obstetric ultrasound services, between July 2016 and June 2020. The data were extracted from 1st August– 31st December 2020. Results: The observed monthly increase on the mean rank of first ANC visits after the introduction of Vscan limited obstetric ultrasound services showed a statistically significant difference at KW-ANOVA H (3) = 17.09, P = 0.001. The mean rank of fourth ANC utilization showed a statistically significant difference at KW- ANOVA H (3) = 16.24, P = 0.001. The observed mean rank in skilled birth attendance (SBA) showed a statistically significant positive difference using KW-ANOVA H (3) = 23.6, P<0.001. The mean rank of increased utilization in postnatal care showed a statistically significant difference using KW-ANOVA H (3) = 17.79, P<0.001. Conclusion: The introduction of limited obstetric ultrasound services by trained mid-level providers at the primary healthcare level was found to have improved the utilization of ANC, SBA, and postnatal care (PNC) services. It is recommended that the institutionalization of limited obstetric ultrasound services be scaled up and a further comparative study between facilities with and without ultrasound services be conducted to confirm causality and assess effects on maternal and perinatal outcomes. [ABSTRACT FROM AUTHOR]

Background: There are foods considered as taboo across different communities in the world and in Ethiopia in particular. Although food taboos exist across all ages or physiologic states, they are predominant among pregnant women and children. Identifying such foods among pregnant women is crucial in providing focused interventions and prevents their negative consequences. Therefore, the aim of this review was to review the available evidence on food taboos and their perceived reasons among pregnant women in Ethiopia to provide comprehensive and precise evidence for decision making. Methods: Electronic search of the literature was made from Pub-Med, Google Scholar, Google Scopus, and Medline databases using search terms set based on the PICO/PS (Population, Intervention/exposure, Comparison, and Outcome) and PS (Population and Situation) search table. The search was made from December 05, 2020 – December, 29, 2021, and updated on January, 2022. All quantitative and qualitative studies published in English were included in the review. The systematic review protocol was registered at INPLASY (Registration number: INPLASY202310078). The outcome of interest was food taboo for pregnant women and its perceived reasons. The results of the review was narrated. Results: After identifying eighty two articles, thirteen were found eligible for the review. Vegetables, fruits, and fatty foods like meat, and dairy products were considered as taboo for pregnant women in different parts of Ethiopia. The reasons stated for the food taboo vary from fear of having a big baby, obstructed labour, and abortion to evil eye and physical and aesthetic deformities in the newborn. Conclusions: Though not uniform across the country, there are foods considered as taboo for pregnant women in Ethiopia due to several perceived reasons, misconceptions, and societal influences. This could increase the risk of malnutrition and could have short and long term consequences on both the mother and her growing foetus. Therefore, context specific nutritional counseling with emphasis during ante-natal care and post-natal service is important. [ABSTRACT FROM AUTHOR]

Background: Despite efforts to make maternal health care services available in rural Ethiopia, utilisation status remains low. Therefore, this study aimed to assess maternal health care services' status and determinants in rural Ethiopia. Methods: The study used quasi-experimental pre- and post-comparison baseline data. A pretested, semi-structured, interviewer-administered questionnaire was used to collect data. A multilevel, mixed-effects logistic regression was used to identify individual and communal level factors associated with utilisation of antenatal care (ANC), skilled birth attendance (SBA), and postnatal care (PNC). The adjusted odds ratio (AOR) and corresponding 95% confidence intervals (CI) were estimated with a p-value of less than 0.05, indicating statistical significance. Results: Seven hundred and twenty-seven pregnant women participated, with a response rate of 99.3%. Four hundred and sixty-one (63.4%) of the women visited ANC services, while 46.5% (CI: 42–50%) of births were attended by SBA, and 33.4% (CI: 30–36%) had received PNC. Women who reported that their pregnancy was planned (aOR = 3.9; 95% CI: 1.8–8.3) and were aware of pregnancy danger signs (aOR = 6.8; 95% CI: 3.8–12) had a higher likelihood of attending ANC services. Among the cluster-level factors, women who lived in lowlands (aOR = 4.1; 95% CI: 1.1–14) and had easy access to transportation (aOR = 1.9; 95% CI: 1.1–3.7) had higher odds of visiting ANC services. Moreover, women who were employed (aOR = 3.1; 95% CI: 1.3–7.3) and attended ANC (aOR = 3.3; 95% CI: 1.8–5.9) were more likely to have SBA at delivery. The likelihood of being attended by SBA during delivery was positively correlated with shorter travel distances (aOR = 2.9; 95% CI: 1.4–5.8) and ease of access to transportation (aOR = 10; 95% CI: 3.6–29) to the closest healthcare facilities. Being a midland resident (aOR = 4.7; 95% CI: 1.7–13) and having SBA during delivery (aOR = 2.1; 95% CI: 1.2–3.50) increased the likelihood of attending PNC service. Conclusions: Overall, maternal health service utilisation is low in the study area compared with the recommended standards. Women's educational status, awareness of danger signs, and pregnancy planning from individual-level factors and being a lowland resident, short travel distance to health facilities from the cluster-level factors play a crucial role in utilising maternal health care services. Working on women's empowerment, promotion of contraceptive methods to avoid unintended pregnancy, and improving access to health care services, particularly in highland areas, are recommended to improve maternal health service utilisation. [ABSTRACT FROM AUTHOR]

Background: Colostrum avoidance is failure to feed first breast milk to a newborn baby for the first 2 to 3 days after delivery. The problem of avoiding colostrum is prevalent in Ethiopia. But it is not adequately addressed yet. Therefore, the purpose of this study was to assess prevalence of colostrum avoidance practices and associated factors among mothers of infants aged less than six months; and to explore barriers for colostrum feeding in ChenchaZuria District. Methods: A community-based cross-sectional study supplemented with a qualitative study was conducted in August 2020. The quantitative data were collected from 674 mothers selected by systematic sampling using a structured questionnaire. Both bi-variable and multi-variable binary logistic regression analysis was used to identify factors associated with the colostrum avoidance practices. The statistical significance was declared at a p-value < 0.05. The qualitative data were collected using in-depth interviews from breastfeeding mothers and thematic analysis was done manually. Result: The prevalence of the colostrum avoidance practice was 15.3% (95% CI: 11.4%- 18.2%). Late initiation of breastfeeding (AOR 4.15 95% CI 2.51–6.84), giving pre-lacteal feeding (AOR 3.16 95% CI 1.93–5.15), not using of postnatal care (PNC) service (AOR 1.79 95% CI 1.05–3.04), and having poor maternal knowledge regarding colostrum. (AOR 1.88 95% CI 1.14–3.08) were factors significantly associated with the colostrum avoidance practices. And in the qualitative part, cultural beliefs and misconceptions, community influence, and complementary feeding practices were found to be facilitators for the colostrum avoidance. Conclusion: About one in seven mothers practiced colostrum avoidance. Factors that contributed to the colostrum avoidance practices were breastfeeding initiation, pre-lacteal feeding, PNC utilization, and maternal knowledge regarding colostrum. Thus, efforts to prevent colostrum avoidance practices should focus on strengthening and promoting PNC services utilization, timely initiation of breastfeeding, and improving awareness creation activities on the importance of colostrum feeding and risks of pre-lacteal feeding. [ABSTRACT FROM AUTHOR]

Background: Male partner involvement during the postpartum period is an effective strategy to improve maternal and newborn health outcomes. However, since reproductive health has been viewed as only a woman's issue, it remains a major challenge in developing countries, including Ethiopia. The current study aimed to assess male partner involvement in postnatal care service utilization and associated factors in the Motta district of North West Ethiopia in 2020. Methods: A community-based cross-sectional study was conducted from March 16 to 30, 2020, among male partners whose wives gave birth in the last twelve months in Motta district. A systematic random sampling technique was used to obtain 612 study participants. Data entry was carried out by using Epi Data version 3.1 and exported to Statistical Package of Social Science version 23 for analysis. A binary and multiple logistic regression method were employed to estimate the crude and adjusted odds ratios with a confidence interval of 95% and a P value of less than 0.05 were considered statistically significant. Results: The findings from this study highlight that the overall male partner involvement in postnatal care service utilization was 20.8% at 95%CI (17.6%, 24.1%). The regression results indicated that male partners residing in urban areas, attending primary and secondary education, having good knowledge of postnatal care services, having good knowledge of danger signs and complications during the postnatal period, having a favorable attitude toward male partner involvement in postnatal care, and a short distance to health care facilities were shown to be significantly and positively associated with male partner involvement in postnatal care services. Conclusion: The magnitude of male partner involvement in postnatal care service utilization was low as compared to other studies. Community-based awareness creation through health education and expanding educational and health care service institutions are essential to increase the involvement of male partners in postnatal care services. [ABSTRACT FROM AUTHOR]

Objective: High‐quality postnatal care is vital for improving maternal health. This study examined the relationship between household socioeconomic status and both coverage and quality of postnatal care in Ethiopia. Method: Cross‐sectional household survey data were collected in October–November 2013 from 12 zones in 4 regions of Ethiopia. Women reporting a live birth in the 3–24 months prior to the survey were interviewed about the care they received before, during and after delivery and their demographic characteristics. Using mixed effect logistic and linear regression, the associations between household socioeconomic status and receiving postnatal care, location of postnatal care (health facility vs. non‐health facility), cadre of person providing care and the number of seven key services (including physical checks and advice) provided at a postnatal visit, were estimated. Results: A total of 16% (358/2189) of women interviewed reported receiving at least one postnatal care visit within 6 weeks of delivery. Receiving a postnatal care visit was strongly associated with socioeconomic status with women from the highest socioeconomic group having twice the odds of receiving postnatal care compared to women in the poorest quintile (OR [95% CI]: 1.98 [1.29, 3.05]). For each increasing socioeconomic status quintile there was a mean increase of 0.24 postnatal care services provided (95% CI: 0.06–0.43, p = 0.009) among women who did not give birth in a facility. There was no evidence that number of postnatal care services was associated with socioeconomic status for women who gave birth in a facility. There was no evidence that socioeconomic status was associated with the provider or location of postnatal care visits. Conclusion: Postnatal care in Ethiopia shows evidence of socio‐economic inequity in both coverage and quality. This demonstrates the need to focus on quality improvement as well as coverage, particularly among the poorest women who did not deliver in a facility. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the impact of intrapartum and post‐partum complications and newborn care practices on early initiation of breastfeeding (EIBF). Data for the study came from a prospective cohort study in Ethiopia that recruited and followed pregnant and post‐partum women from 2019 to 2021. Resident enumerators conducted interviews at enrolment in 2019 and follow‐ups at 6 weeks, 6 months and 1 year post‐partum. The present analysis is based on data from the baseline survey and 6 weeks follow‐up. Multivariable logistic regression was used to estimate the effects of newborn care practices and intrapartum and post‐ partum complications on EIBF (the proportion of newborns who initiated breastfeeding within the first hour of birth). Overall, 2660 mother–infant pairs were included in this analysis. After adjustment, EIBF was less likely among women who experienced intrapartum haemorrhage (adjusted odds ratio [AOR]: 0.76, 95% confidence interval [CI]: 0.59–0.97), malpresentation (AOR: 0.46, 95% CI: 0.30–0.72) and convulsions (AOR: 0.48, 95% CI: 0.34–0.66) during childbirth. Mother–newborn skin‐to‐skin contact increased the likelihood of EIBF (AOR: 1.47, 95% CI: 1.11–1.94). Women who experienced post‐partum haemorrhage (AOR: 0.63, 95% CI: 0.47–0.84), retained placenta for more than 30 min (AOR: 0.36, 95% CI: 0.24–0.52) and convulsions after delivery (AOR: 0.57, 95% CI: 0.41–0.79) were less likely to initiate breastfeeding early. Also, women who had a caesarean birth (AOR: 0.28, 95% CI: 0.18–0.41), delivered outside of a healthcare facility (AOR: 0.70, 95% CI: 0.50–0.99) or had twin birth (AOR: 0.43, 95% CI: 0.22–0.85) were less likely to initiate breastfeeding early. Skin‐to‐skin contact should be encouraged whenever possible, and women with obstetric complications should be encouraged and supported to initiate breastfeeding early. Key messages: Malpresentation, intrapartum haemorrhage, and convulsions during childbirth were associated with a lower likelihood of breastfeeding initiation within the first hour of birth.Retained placenta for more than 30 min, post‐partum haemorrhage, and convulsions after childbirth were associated with a lower likelihood of breastfeeding initiation within the first hour of birth.Out‐of‐facility delivery, multiple births and caesarean delivery were associated with a lower likelihood of breastfeeding initiation within the first hour of birth.Women who practised skin‐to‐skin contact after birth were more likely to initiate breastfeeding within the first hour of birth than those who did not practise skin‐to‐skin contact. [ABSTRACT FROM AUTHOR]

Despite the significant benefit of postpartum modern contraceptives to avert the problems related to short interpregnancy intervals and unintended pregnancy, still the uptake remains low in Ethiopia. The aim of the study was to assess the magnitude of family planning use during the puerperium period and the factors associated with it in the Benchi Sheko zone of Southwest Ethiopia. From 10th March to 10th May/2021, 385 mothers were enrolled in a community-based cross-sectional study. Participants were nominated using simple random sampling. To collect the data, an interviewer-administered questionnaire was used. To identify the factors associated with the utilization of postpartum contraceptives, bivariate and multivariable logistic regression analyses were used. The statistical significance level was determined at p -value <.05. The overall utilization of postpartum modern family planning utilization was 50.4% (95% CI: 45.3, 55.3). Maternal education (AOR = 2.26, 95% CI; 1.03–4.95), informed on family planning (AOR = 0.34, 95% CI; 0.13–0.91), counseled on contraceptives during Antenatal Care (ANC) (AOR = 1.82, 95% CI: 1.05–3.17), previous family planning utilization (AOR = 0.45, 95% CI: 0.28–0.73), counseled on contraceptives at the time of PNC (AOR = 1.70, 95% CI: 1.07–2.71), and resumption of sexual intercourse after delivery (AOR = 4.17, 95% CI: 1.57–11.08) were the major factors hindering the utilization of modern contraceptives. the overall magnitude of modern contraceptive utilization during the puerperium period was low. Having counseling, information, and previous experience in family planning, and time to sexual intercourse resumption were clinical predictors of family planning utilization. A concerted effort to incorporate contraceptive services into maternal, neonatal, and child health (MNCH) service units should strengthen much, and counseling gives due emphasis. [ABSTRACT FROM AUTHOR]

There is evidence that women in Ethiopia often face disrespect and abuse in health care facilities during childbirth. Disrespect and abuse (D&A) violate women's right to dignified, respectful health care and decrease their trust in health care facilities. There is a need for more insight into women's perspectives on D&A during childbirth in different contexts. Therefore, this study aimed to explore women's perspectives on D&A during childbirth in a teaching hospital in South-West Ethiopia. A qualitative study was conducted from November 2017 to February 2018 using in-depth interviews and focus group discussions. Postnatal women were purposively chosen and scheduled for interviews six weeks postpartum. Data saturation occurred once 32 women were interviewed, and four focus group discussions were conducted. A thematic analysis method was used to analyse the data using MAXQDA qualitative analysis software. Three main themes emerged from the data: disrespect and abuse, its contributors, and perceived consequences. The subthemes of D&A include neglected care, non-consented care, physical abuse, lack of privacy, loss of autonomy, objectification, lack of companionship, and verbal abuse. The subthemes of contributors include health care provider-related, health care system-related, and women-related contributors. The subthemes of perceived consequences include the fear of using health care facilities. Women in Ethiopia experienced D&A. Health system factors, such as the teaching environment and scarcity of supplies, contribute the most to the identified D&A. Therefore, providers, administrators, training institutions, and researchers must collaborate to address these health system factors to reduce disrespect and abuse during childbirth in teaching hospitals. [ABSTRACT FROM AUTHOR]

Background: Postnatal care (PNC) is critical for both the mother and the infant to treat delivery complications and provide the mother with important information on caring for herself and her baby. However, only 17% of women and 13% of newborns in Ethiopia received a postnatal checkup within the first two days of birth. This figure is significantly lower than the least developed countries. This study aimed to assess the coverage and associated factors of PNC service utilization in South Gondar Zone, Northwest Ethiopia. Method: A community-based cross-sectional study was conducted from September 2020 to May 2021. The data were gathered using an interviewer-administered structured questionnaire. A total of 434 women who gave birth within 2 years of the study were included in the analysis. Bivariable and multivariable logistic regression model was used to identify factors associated with PNC service utilization. Result: The prevalence of women who used PNC services was 36.4%. The study showed that antenatal care visit, husbands who have a secondary education, women with a secondary education, daily laborer women, husbands working for the government or non-profit sector, delivered in a health institution, nearby hospitals, travel by car to the nearest health facility were positively associated with PNC utilization. While, not having a cell phone, rural women and not having road access to a health facility, have not been receiving counseling were negatively associated with PNC utilization. Conclusion: The coverage of PNC service utilization in the study area was extremely low. Therefore, government and health care departments should pay special attention to uneducated women, women in rural areas, and women who are unemployed, are not exposed to mass media, and do not have access to transportation to improve PNC service utilization. Furthermore, programs educating mothers on the benefits of antenatal checkups and safer places of childbirth should be considered to increase PNC service utilization. [ABSTRACT FROM AUTHOR]

In Ethiopia, only 58% of the mothers practice exclusively breast feeding, which is far from recommended; therefore, identifying factors associated with exclusive breast feeding helps to fill this gap. Community-based mixed cross-sectional study was conducted on 532 mothers. Binary logistic regression was performed and Variables with p value ≤ 0.05 in multivariable analysis declared as statistically significant variables. For the qualitative part focused group discussion was performed, and a thematic framework analysis was done. Finally the results were presented with narration. Prevalence of exclusive breastfeeding was 52%. Husband education (AOR = 2.9; 95% CI 1.6, 5), colostrum feeding (AOR = 2.3; 95% CI 1.3, 3.9), antenatal care (AOR = 2.1; 95% CI 1.1, 4.3.), place of delivery (AOR = 2.1, 95% CI 1.2, 3.6), residence (AOR = 0.3; 95% CI 0.2, 0.6), counseling during postnatal care (AOR = 2; 95% CI 1.2, 3.3) were associated with exclusive breastfeeding. As most discussant explained reason for not exclusive breastfeeding were due to different perceptions such as breast milk not sufficient, giving water decrease infantile colic and fear of food refusal. Prevalence of breastfeeding is low. Husband education, residence, colostrum feeding, antenatal care, institutional delivery, counseling during antenatal and postnatal care were significantly associated variables. [ABSTRACT FROM AUTHOR]

BACKGROUND: Postnatal care is given to mothers and newborn babies within 42 days of delivery. It is a period of high maternal and newborn mortality and is also the most neglected in terms of maternal health services in many parts of the world. This study aimed to assess postnatal care and associated factors among mothers who gave birth in the year preceding the survey of the Ayssaeta district. METHODS: A community-based cross-sectional study was conducted among 406 mothers who gave birth in the year preceding the survey from August 02-30, 2020. Bivariable and multivariable logistic regression analyses were done to identify factors associated with postnatal care utilization. RESULTS: Slightly greater than four out of ten mothers have visited postnatal care units at least once. Living in urban areas, giving birth in a health facility, having complications during labor and after, and getting advice during antenatal care visits were associated with higher odds of postnatal care utilization. CONCLUSION: Less than half of the mothers received postnatal care following the delivery of their last child. Living in an urban, place of delivery, experiencing labor and postpartum complications, and receiving postnatal care advice during antenatal care have affected the utilization of postnatal care. Promoting skilled delivery and antenatal care with a focus on rural areas can help mothers learn about postnatal care and increase the number of mothers who use it [ABSTRACT FROM AUTHOR]

Background and Aims: Health services during pregnancy, childbirth, and the postnatal period play a pivotal role in the survival of both the mother and the baby. We, therefore, analyzed maternal health service utilization and the related drivers among women of childbearing age in Ethiopia. Methods: We used secondary data from the 2019 Ethiopian mini Demographic and Health Survey. The survey was conducted in 11 regions, and 2 city administrations, in Ethiopia from March 21 to June 28, 2019. Maternal health service utilization was measured in terms of three dimensions including antenatal care (ANC), skilled delivery service, and postnatal care (PNC). Bi‐variable and multivariable logistic regression was used. We then fitted three separate models. Data were analyzed using SPSS version 25; all analysis was adjusted for cluster and sample weight. Results: A total of 2923, 3924, and 1899 women were included for ANC, delivery, and PNC utilization, respectively. The majority of 1802 (61.7%) women had a "good" antenatal care utilization, and it was explained by the level of maternal education, marital status, and wealth index. Nearly half, of 1899 (48.1%) of the women gave birth in a health facility, and it was associated with age, educational status, wealth index, the timing of first antenatal care, and the number of antenatal care contact. Finally, one third (33.7%) of them had adequate PNC utilization and it was associated with households having a television, the timing of first antenatal care, and the number of antenatal care contacts. Conclusion: Despite the due emphasis on maternal health services by the Ethiopian government, the uptake of services is not optimal. Women empowerment and timely and adequate ANC contacts will prepare women for better uptake of services. [ABSTRACT FROM AUTHOR]

Background: Essential nutrition action(ENA) is a framework for managing advocacy, establishing a foundation, and implementing a comprehensive package of preventive nutritional activities. Essential Nutrition Actions study studies provide current information on each nutrition action, allowing health systems to focus more on nutrition, which is critical in tackling the "double burden" of malnutrition: underweight and overweight. Hence, this study aimed at assessing the level of ENA practice and its predictors among mothers of children aged 6 to 24 months in southern Ethiopia. Methods: A community-based cross-sectional study was conducted from May 1 to 30, 2021 among randomly selected 633 mothers of children aged 6–24 months. A multi-stage sampling technique was used to access study participants. Data were collected by using a pretested, structured interviewer-administered questionnaire. To identify predictors of ENA practice, bivariable and multivariable logistic regression were used. The strength of the association was measured using an adjusted odds ratio with 95 percent confidence intervals. The statistical significance was declared at a p-value less than 0.05. Results: A total of 624 participants took part in the study, with a response rate of 98.6%. The uptake of key ENA messages among mothers was measured using 27 items, and it was found to be 47.4% (95% CI: 43.8, 51.4). Complementary feeding was the commonest ENA message practiced by 66.7% of respondents, while prevention of iodine deficiency disorder was practiced by only 33.7% of respondents. Variables namely, mother's education level of college and above [AOR: 3.90, 95% CI: 1.79, 8.51], institutional delivery [AOR: 2.75, 95% CI: 1.17,6.49], having PNC service [AOR: 2.95, 95% CI: 1.91, 4.57], being knowledgeable on ENA message [AOR: 2.37, 95% CI: 1.81, 3.26] and being a model household [AOR: 3.83,95% CI: 2.58, 5.69] were positively associated with a good uptake of key ENA messages. On the other hand, primiparity [AOR: 0.32, 95% CI: 0.21,0.56] was identified as a negative predictor. Conclusion: The overall practice of key Essential nutrition action messages in the study area was low as compared to studies. Stakeholders must step up their efforts to improve and hasten the utilization of maternal and child health services, especially institutional delivery and Postnatal care by focusing on uneducated women to promote compliance to key ENA messages. Furthermore, health workers need to focus on awareness-raising and model household creation. [ABSTRACT FROM AUTHOR]

Background: The continuity of care throughout pregnancy, birth, and after delivery is an effective strategy to avert maternal and newborn deaths. A low proportion of mothers have achieved the continuum of maternal care in Ethiopia. This study aimed to assess the rate and factors associated with the completion of a continuum of maternal healthcare services in Hadiya Zone, Southern Ethiopia. Methods: A community-based, cross-sectional study was conducted over two months (from September to October 2021) in 18 kebeles of the Hadiya zone, southern Ethiopia. Multistage cluster sampling was carried out to select the required study subjects, and data were collected using a structured, interviewer-administered questionnaire. A multilevel binary logistic regression model was used to examine the effects of individual and community-level factors on key elements of the care continuum. The measure of fixed effects was expressed as an odds ratio with a 95% confidence interval (CI). Results: In this study, only 11.3% of women completed all components of the care continuum, which included four or more antenatal visits, skilled birth attendance, and postnatal care. The factors that are significantly associated with the completion of maternal care include higher maternal education [AOR = 4.1; 95%CI: 1.3–12.6], urban residence [AOR = 1.8; 95%CI: 1.1–3.0], time of first antenatal care follow-up [AOR = 2.7; 95% CI: 1.6–4.6], knowledgeability regarding postnatal danger signs [AOR = 1.9, 95% CI: 1.1–3.3], being in the highest wealth quintile [AOR = 2.8; 95%CI: 1.2–6.6] and primipara [AOR = 3.6; 95%CI: 1.4–9.4]. Conclusion: The rate of continuum of maternal healthcare services utilization was low in the study area. The findings indicated that higher maternal education, urban residence, time of first antenatal care follow-up, knowledgeability regarding postnatal danger signs, being in the highest wealth quintile and primipara were the factors associated with the completion of the continuum of maternal care. As a result of this study's findings, program planners and ministry of health and non-governmental organizations working on maternal health should prioritize continued and strengthened health education in order to increase the completion level of the continuum of maternal healthcare services. [ABSTRACT FROM AUTHOR]

Background. Appropriate complementary feeding practices prevent malnutrition among children. The proportion and determinant factors of appropriate complementary feeding practices identified by different studies were inconsistent in Ethiopia. Therefore, this systematic review and meta-analysis aimed to assess the pooled proportion and determinants of appropriate complementary feeding practices among mothers. Methods. Databases (PubMed, HINARI, Google Scholar, Cochrane Library, and Web of Science) and university repositories were used to search for important articles. A critical appraisal of the studies was conducted. Data analysis was conducted using STATA version 11. Cochran (Q test) and I2 test were used to test the heterogeneity of the studies. Publication bias was checked using the funnel plot for asymmetry and Egger's regression test. Results. Seventeen primary studies with a total sample size of 9166 mothers were involved in this study. The pooled proportion of appropriate complementary feeding practices among mothers who had infants and young children aged between 6 and 24 months was 21.77 (with a 95% CI: 14.07–29.48). Mothers' educational status of secondary school and above (OR = 3.36 with a 95% CI: 3.03–3.69), having repeated antenatal care visits (OR = 4.77 with a 95% CI: 3.49–6.05), child's age between 12 and 24 months (OR = 3.7 with a 95% CI: 2.75–4.65), having repeated postnatal care visits (OR = 3.17 with a 95% CI: 1.96–4.38), health education (OR = 4.88 with a 95% CI: 3.86–5.9), knowledge of mothers (OR = 4.85 with a 95% CI: 3.77–5.93), maternal age between 18 and 35 years (AOR = 2.67 with a 95% CI: 1.64–3.72), institutional delivery (OR = 2.23 with a 95% CI: 1.79–2.68), and higher household wealth (OR = 2.65 with a 95% CI: 1.46–3.84) were found to be statistically significant associated factors of appropriate complementary feeding practices among mothers. Conclusions. The pooled proportion of appropriate complementary feeding practices was low in Ethiopia. Knowledge of mothers and maternal health service uptake such as antenatal care, postnatal care, and institutional delivery increase appropriate complementary feeding practices. More focus is required for mothers who have children aged less than 12 months, mothers aged above 35 years and less than 18 years, lower mothers' educational status, and lower household wealth. Therefore, integrated interventions are still required to improve appropriate complementary feeding practices. [ABSTRACT FROM AUTHOR]

Objectives: This study assessed the non-utilization of PNC services, identified factors associated with PNC non-utilization, and explored barriers to PNC utilization in the rural community. Method: A community-based mixed-cross-sectional study was conducted from 20 March to 20 April 2020 among 521 women who gave birth in the last 12 months prior to this survey. A multistage sampling and face-to-face interview techniques were used for the quantitative data collection, and a purposive sampling technique was used to select the study participants. In-depth interviews were used for the qualitative data collection. The quantitative data were entered into EpiData version 3.1 and then exported to SPSS version 25 for analysis. A binary logistic regression analysis was used to test the association between the independent and outcome variables. A p -value of <0.2 was used as the cutoff value to include variables in the multivariate analysis. Finally, a p -value of <0.05 was used to declare an independent association. The qualitative data were manually sorted, cleaned up, and labeled as themes. Every major theme was identified and enumerated, and the meaning units were cited together with the relevant participant's socio-demographic details. Result: The non-utilization of postnatal care was found to be 75.4% in the area. Normal delivery, fewer than four antenatal care visits, inaccessibility to transportation, and poor knowledge of postnatal care were all identified as factors enhancing non-utilization of postnatal care. However, being informed about postnatal care positively influences postnatal care utilization. Poor awareness, information gaps, cultural and religious beliefs, service inaccessibility, and the unfriendly approach of healthcare workers were all explored as barriers in the qualitative study. Conclusions: The non-utilization of PNC services in this study was higher than the majority, but not all, of the previous comparable local and worldwide findings. Mode of delivery, hearing postnatal care information, the number of antenatal visits, transportation availability, and knowledge of postnatal care services were factors affecting the non-utilization of postnatal care. The clients' poor awareness, information gaps, cultural and religious beliefs, service inaccessibility, and healthcare staff's inauspicious approach were barriers explored. Therefore, counseling and transportation access need to be reinforced in the setting. [ABSTRACT FROM AUTHOR]

Introduction: Neonatal mortality remains a persisting public health challenge in Ethiopia. Timely intervention to neonatal morbidity and early neonatal care visit could reduce the burden of mortality. Studies related to home based postnatal care is limited in Ethiopia. Therefore, this study aimed to assess home based postnatal care visits and determinants in Ethiopia. Methods: A secondary data analysis using 2016 EDHS data was conducted among 7590 women who had live births two years preceding the survey. A multilevel mixed-effect logistic regression analysis model was used and those variables with a P-value ≤ of 0.05 in multivariable analysis were considered as predictors. Results: Home based postpartum care by health care providers was 6.3% and 67.9% of women gave birth at home. Women perceived that distance is not big problem [AOR = 1.37; 95% CI: 1.06, 1.68], richer wealth index [AOR = 1.69; 95% CI: 1.15, 2.48], attending antenatal care visit [AOR = 2.17; 95% CI:1.57, 2.99], giving birth in health institution [AOR = 2.07; 95% CI:1.53, 2.80], giving birth by cesarean section [AOR = 3.41; 95% CI: 2.33, 4.99], and having awareness about neonatal danger sign [AOR = 3.68; 95% CI: 2.90,4.70] were factors associated with home based postpartum care. Conclusion: Home based care by health care providers was low. Therefore, measures should be taken in increasing the number of nearby health care facility, strengthen the continuum of care on antenatal care follow-up, institutional delivery and improve mother's knowledge about neonatal danger sign. [ABSTRACT FROM AUTHOR]

Worldwide, the magnitudes of neonatal mortality are estimated to be about 3 million due to insufficient care. The burden of neonatal mortality is high in Ethiopia as compared to high and middle-income countries. The study aimed to assess the neonatal care practice and associated factors among mothers of infants 0–6 months old in Northern Shewa, Ethiopia. A community-based cross-sectional study design was undertaken on a mother living in the North Shewa zone from September 2019 to June 2020. Neonatal care practice was assessed by World Health Organization (WHO) minimum neonatal care package indicators. Over the study period, a total of 245 (62.0%) mothers had a good neonatal care practice. Being urban areas [AOR 5.508, 95% CI 2.170, 13.984], having ANC follow-up [AOR 3.042, 95% CI 1.031, 12.642], lack of adequate information [AOR 0.123, 95% CI 0.054, 0.282] and post-natal care (PNC) [AOR 5.779, 95% CI 2.315, 14.425] were predictors of good neonatal care practice. In our study, there was moderate neonatal care practice among mothers. Therefore, all elements of neonatal care packages should be studied at large. [ABSTRACT FROM AUTHOR]

Background: Complementary foods are defined as any solid or liquid foods other than breast milk offered to children. Timely initiation of complementary foods during infancy is necessary for growth and development. The first two years of life are important period for rapid physical, cognitive and social development that requires optimal nutrition. Currently, there is no study done in this rural community about timely initiation of complementary feeding. Objective: The main aim of this study was to assess the prevalence of timely initiation of complementary feeding among mothers having children aged 6–24 months in Farta district, rural Ethiopia. Methods: A community-based cross-sectional study was employed from December 2020 to February 2021 among 570 mothers by using multi-stage sampling techniques. Data were collected using a structured interviewer-administered questionnaire and entered into Epi Data 4.6 then transferred to Statistical Package for Social Science version 25 for analysis. Bivariate and multivariable logistic regression analysis with a 95% confidence interval carried out to determine the association between explanatory and the outcome variables. A P-value of < 0.05 was considered statistically significant. Results: The prevalence of timely initiation of complementary feeding among mothers having children aged 6–24 months was 51.9%. Institutionaldelivery [(AOR = 2.10, 95% CI: (1.31–3.32)],Keeping livestock [(AOR = 2.21, 95% CI: (1.35, 3.65)], Postnatal follow up [(AOR = 0.60, 95% CI:(0.36, 0.77)],merchants [(AOR = 4.58; 95% CI:1.99, 10.55)], and daily labourer [(AOR = 2.88, 95% CI:(1.50–5.51)] were statistically associated with timely initiation of complementary feeding. Conclusion: This finding revealed that the prevalence of timely initiation of complementary feeding is still low. Factors affecting timely initiations of complementary feeding were home delivery, unable to attend postnatal care follow-up, being housewife and farmers. All health professionals including health extension workers should give special attention to advising and counseling for mothers and their husbands about timely initiation of complementary feeding. [ABSTRACT FROM AUTHOR]

Background: Kangaroo mother care is a key procedure in reducing neonatal mortality and morbidity associated with preterm birth. In Ethiopia, neonatal death remains a serious problem, and this study aims to determine the prevalence of the knowledge, attitudes and practice of kangaroo mother care among Ethiopia women. Methods: PubMed, Web of Science, Google Scholar, EMBASE and the Ethiopian University online library were searched. Data were extracted using Microsoft Excel and analysed using STATA statistical software (v. 11). Publication bias was checked by forest plot, Begg's rank test and Egger's regression test. To look for heterogeneity, I2 were computed and an overall estimated analysis carried out. Subgroup analysis was done by region, study setting, publication, gestational age, birth weight and component of kangaroo care. The Joanna Briggs Institute risk of bias assessment tool was used. We carried out a leave one out sensitivity analysis. Results: Out of 273 articles retrieved, 16 studies met the eligibility criteria and are thus included in this study. Those 16 studies had a total of 12,345 respondents who reported kangaroo mother practice, with five (comprising 1,232 participants combined) reporting that both knowledge and attitude were used to determine the overall estimation. The pooled estimates of good knowledge, positive attitude and poor practice of kangaroo mother care were found to be 64.62% (95% CI: 47.15%–82.09%; I2 = 97.8%), 61.55% (49.73%–73.38%; I2 = 94.8%) and 45.7% (95% CI: 37.23%–54.09%; I2 = 98.5%), respectively. This study is limited to postnatal women and does not take account their domestic partners or health providers. Conclusion: The findings revealed significant gaps in the knowledge, attitudes and practice of kangaroo mother care in Ethiopia when compared with other developing countries. Therefore, kangaroo mother care training to women, along with further studies on domestic partners and health providers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Postnatal care is a key strategy to reduce maternal mortality. An early postnatal visit is a critical time for the survival of mothers and newborns. Despite the benefits, most mothers do not receive postnatal care services. Thus, this study was aimed to assess early postnatal care utilization among rural women and identify its associated factors. METHODS: Community-based cross-sectional study was conducted in the Horo Guduru Wollega zone from May 10 to 27/2019. A total of 695 randomly selected women participated in the study. A simple random sampling method was employed using the women's registration logbook. Multivariate logistic regression was used to control for possible confounders. A significance level of less than 0.05 was used in the final model to judge statistical significance. RESULTS: The magnitude of early postnatal care utilization was 21.8%. Multiple logistic regression analysis revealed that decision-making power, awareness about postnatal care, knowing at least one danger sign, place of delivery (AOR = 8.01), and model household (AOR = 5.65) were statistically significant. CONCLUSION: This study showed that the utilization of early postnatal care among rural women was found to be low. Decision-making, awareness about the danger signs, place of delivery, and graduating as a model household were the factors associated with postnatal care. Therefore, recommended that health facilities should work on increasing community awareness about the danger signs that can occur after birth or during the postnatal period and increase institutional deliveries. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite a global decline in under-five deaths, the neonatal mortality rate remains slow in developing countries and birth asphyxia remains the third cause of neonatal deaths. Globally, neonatal deaths accounts for 45% of under-five deaths, birth asphyxia causes 23-40% of neonatal deaths in Ethiopia. There is limited data on risk factors of asphyxia in Ethiopia, particularly in the study area. Therefore, this study aimed to identify the risk factors of birth asphyxia among newborns. METHODS: This research followed a hospital-based unmatched case-control study design at Debre Markos comprehensive specialized referral hospital, Northwest Ethiopia, among 372 newborns (124 cases and 248 controls). Data were collected by interviewing index mothers and chart review using a pre-tested questionnaire. Then it was entered in Epi-data version 3.1 and transferred to STATA version 14.0 for analysis. Bivariate and multiple variable logistic regression were carried out to the possible risk factors. Finally, statistical significance was declared using adjusted odds ratio with 95% CI and p-value <0.05. RESULTS: Prolonged labor >12, meconium-stained amniotic fluid, assisted vaginal delivery, gestational age < 37 weeks, noncephalic presentation, comorbidity, birthweight<2500grams were found to be significant factors of birth asphyxia. CONCLUSION: In this study, Prolonged labor >12 hours, meconium-stained amniotic fluid, assisted vaginal delivery, gestational age < 37 weeks, non-cephalic presentation comorbidity, fetal distress, birthweight<2500grams were found to be risk factors of birth asphyxia were risk factors of birth asphyxia. Therefore, to reduce neonatal mortality associated with birth asphyxia, attention should be given to holistic pregnancy, labor and delivery care, and post-natal care. Moreover, interventions aimed at reducing birth asphyxia should target the identified factors. [ABSTRACT FROM AUTHOR]