Introduction: All across the world, youths struggle with a variety of health issues. Adolescents everywhere are entering puberty earlier and engaging in more premarital sex. There was limited evidence about the current adolescent sexual reproductive health (RH) service utilization status and its associated factors in the study area, especially after the occurrence of COVID-19 and the war between the Ethiopian federal government and Tigray regional forces. Objective: The study is aimed at assessing the magnitude of sexual RH service utilization and associated factors among Bahir Dar City high school students, Amhara region, Ethiopia, in 2022. Methods: An institution-based cross-sectional study design was conducted among Bahir Dar City high school students from December 18, 2022, to January 12, 2022. A multistage sampling technique was applied to select study participants. A total of 629 respondents participated in the study. The data were collected using a pretested, structured, self-administered questionnaire. The data were entered into EpiData Version 3.1 and then exported to SPSS Version 25 for analysis. Bivariable and multivariable logistic regression was used for analysis. Results: The magnitude of adolescent sexual RH service utilization was found to be 30.4%. School RH club participation (AOR = 5.93, CI: 3.29-10.71), having ever had sexual exposure (AOR = 6.03, CI: 3.31-10.98), history of sexual RH problems (AOR = 3.26, CI: 1.41-7.51), being perceived as at risk of sexual RH problems (AOR = 6, CI: 3.26-11.04), hearing information about adolescent sexual RH (AOR = 5.19, CI: 3-8.97), and knowing the place to use RH service (AOR = 2.37, CI: 1.47-3.82) were associated with utilization of adolescent sexual RH service. Conclusions: The magnitude of adolescent sexual RH service utilization was found to be 30.4%. School RH club participation, having ever had sexual exposure, a history of sexual RH problems, being perceived as at risk of sexual RH problems, hearing information about sexual RH, and knowing the place where to get RH services were associated with the utilization of sexual RH services.
Background: Refugees and conflict‐affected areas are often unreached by national strategies and programs. As a result, high unmet needs are more likely because of their social interruption with their traditional information sources, support, protection, and lack of income which limits refugees’ ability to make a free choice that would allow them to plan and space the number of children they desire. Information on the unmet needs of internally displaced persons (IDPs) women is scarce. This study is aimed at assessing the magnitude of the unmet need for modern contraceptive methods and associated factors among IDPs currently married reproductive‐age women.Methods: A community‐based cross‐sectional study was conducted among 393 internally displaced women currently married reproductive‐age women using a simple random sampling method using a structured, pretested, and interview‐administered questionnaire. A logistic regression model was used to identify associated factors. Statistically significant variables at p value < 0.25 in the bivariate analysis were entered into multivariable analysis, and statistical significance was declared at p value ≤ 0.05.Results: About 160 (40.7%) (95% CI: 35.94%–45.67%) of women had an unmet need for modern contraceptive methods, 139 (35.4%) for spacing, and 21 (5.3%) for limiting. Less than 18 years of age at first marriage, lack of access to modern contraception, lack of discussion with healthcare providers, and travel time of 30 min or more to obtain family planning were found to be risk factors for unmet contraceptive needs. The risk of unmet need for modern contraceptives was high among women who were married at age of less than 18 years of age in comparison with women who were married at 18 and above (AOR = 1.559; 95%CI = 1.019–2.385). Unmet needs were higher among participants who had no adequate availability of modern contraceptive methods than those who had adequate availability of modern contraceptive methods (AOR = 1.738; 95%CI = 1.125–2.684). Similarly, the odds of unmet needs were 1.673 times higher among participants who did not discuss FP with healthcare providers than those who discussed FP with healthcare providers (AOR = 1.673; 95%CI = 1.085–2.581). Moreover, the odds of unmet needs were 1.551 times higher among participants who traveled 30 min and above to access family planning services as compared to those respondents who traveled below 30 min (AOR = 1.551; 95%CI = 1.002–2.401).Conclusion and Recommendations: The magnitude of the unmet need for modern contraceptive methods was higher than both the Ethiopian national and Oromia regional state total unmet need for the general population. Governmental and nongovernmental organizations should increase their efforts to reduce this high magnitude of unmet needs by emphasizing those factors that have a great contribution to unmet needs.
Introduction: Teenage pregnancy is a global public health challenge, and it is a major contributor to the high maternal and neonatal morbidity and mortality rates reported in sub-Saharan Africa and Uganda. However, there is a paucity of data regarding pregnancy outcomes and their associated factors among teenagers in Uganda. The purpose of this study was to determine the prevalence and factors associated with pregnancy outcomes among teenagers who delivered at a National Referral Hospital in Kampala, Uganda. Materials and Methods: This cross-sectional study was conducted among teenage mothers who delivered at a National Referral Hospital in Kampala, Uganda. Consecutive participant recruitment was done for those who fulfilled the eligibility criteria. The outcomes of interest included adverse maternal outcome with obstructed labor being used as a proxy and adverse fetal outcomes with birth asphyxia used as a proxy. Logistic regression analysis was used to determine the association between independent and dependent variables with a 5% level of statistical significance (α = 0.05). Results: Teenage pregnancy was associated with adverse maternal outcomes which included obstructed labor (18%) and preterm labor (5.5%). There were no maternal deaths during the study period. Adverse fetal outcomes observed in this study population included low birth weight (83%), birth asphyxia (18%), and stillbirth (4%). The only factor associated with adverse maternal outcome was gestational age where teenage mothers had 4 times likelihood of delivering before 37 weeks. Relatedly, teenage mothers had an 81% chance of having a preterm birth. Conclusion: Teenage pregnancy was generally not associated with adverse maternal or fetal outcomes except for preterm birth. The reasons for adverse pregnancy outcomes may reflect a combination of gynecological and biological immaturity, as well as adverse socioeconomic pressures.
Background. Myomectomy can be associated with life-threatening conditions such as bleeding. Excessive bleeding usually necessitates blood transfusion. Interventions to reduce bleeding during myomectomy will help reduce the need for blood transfusion with its associated complications. Tranexamic acid has been used to reduce bleeding in other surgical procedures, and its usage during myomectomy merits evaluation. Objective. To assess the efficacy of tranexamic acid in reducing myomectomy-associated blood loss. Materials and Methods. This is a prospective double-blinded randomized trial conducted on women who had abdominal myomectomy. Patients were randomized into two groups. The study group received perioperative intravenous tranexamic acid (TXA) while the control group received a placebo. Intraoperative blood loss was calculated by measuring the volume in the suction apparatus and weighing the surgical swabs. In addition, blood collected postoperatively from the wound drains and drapes were measured. Haemoglobin concentrations were determined preoperatively and on second postoperative day for all cases. Any adverse effect was noted in both groups. The data was processed using Epi Info software (7.2.1, CDC, Atlanta, Georgia). The relationships between categorical data were analyzed using X2 and Student’s t-test to determine relationships between continuous variables, with a P value of 0.05 considered statistically significant, and correlation coefficients were calculated using Pearson’s formula, and probability of 0.05 was set for statistical significance. Results. Symptomatic uterine myomas constituted 17.3% of all gynaecological admissions and 21.3% of gynaecological operations at Federal Teaching Hospital Abakaliki. The mean intraoperative blood loss among patients that had perioperative tranexamic acid infusion was 413.6±165.6 ml, while that of patients with placebo infusion was 713.6±236.3 ml. Perioperative tranexamic acid infusion therefore reduced mean intraoperative blood loss by 300 ml, and this was statistically significant (SMD=−0.212, 95% CI: −403.932 to −196.067, P<0.0001). Perioperative tranexamic acid reduced mean total blood loss by a value of 532.3 ml, and this is statistically significant (SMD=30.622, 95% CI: 393.308 to 670.624, P<0.0001). Tranexamic acid also improved postoperative haemoglobin concentration by 1.8 g/dl compared with placebo, and this is statistically significant (SMD=−0.122, 95% CI: 1.182 to 2.473, P<0.0001). Tranexamic acid infusion decreased hospital stay by about 2 days, and this difference was statistically significant (SMD=−3.929, 95% CI: -3.018 to –0.983, P=0.0003). There was no adverse drug reaction in the course of the study. Conclusion. The use of tranexamic acid during myomectomy reduced intraoperative and postoperative blood loss. It is also associated with decreased hospital stay. This trial is registered with NCT04560465.
Background:Client satisfaction is an important and commonly used indicator for measuring the quality of health care as it affects clinical outcomes, patient retention, and medical malpractice claims. To limit unintended pregnancies and avoid repeated abortions promoting comprehensive abortion care services is crucial. In Ethiopia problems related to abortion were neglected and access to quality abortion care was very limited. Similarly, information related to comprehensive abortion service, particularly clients' satisfaction, and associated factors are limited in the study area that the study will be going to fill. Methods:A facility-based cross-sectional study design was employed on 255 women who come for abortion service in public health facilities of Mojo town were included consecutively. The data was coded and entered into Epi info version 7 software and exported to SPSS version 20 for analysis. Bivariable and multivariable logistic regression models were applied to identify the associated factors. Model fitness and multicollinearity were checked by using the Hosmer-Lemeshow goodness of fit test and the Variance Inflation Factor (VIF). Adjusted Odds Ratios and their 95% Confidence were reported. Results:A total of 255 study subjects were included in this study with a 100% response rate. The study depicted that 56.5% (95% CI: 51.3, 61.7) of the clients were satisfied with comprehensive abortion care. Having college and above educational level (AOR: 0.27; 95% CI: (0.14, 0.95)), Employee occupation (AOR: 1.86; 95% CI: (1.41, 2.93)), medical abortion as a type of uterine evacuation (AOR: 3.93; 95% CI: (1.75, 8.83)) and natural method of family planning users (AOR: 0.36; 95% CI: (0.08, 0.60)) were factors associated with women's satisfaction. Conclusion:The overall satisfaction toward comprehensive abortion care was considerably lower. Waiting time, cleanness of rooms, lack of laboratory service, and availability of service providers are mentioned factors for client dissatisfaction.
Background:Early prenatal syphilis testing and treatment are essential preventative measures for maternal syphilis and associated adverse pregnancy outcomes of pregnancy; however, data shows that two-thirds of all cases are missed among women who visit prenatal care center at least once but are not tested for syphilis. This study determined the prevalence and factors associated with syphilis infection among mothers with missed opportunities for antenatal syphilis testing in rural western Uganda delivered at Fort Portal Regional Referral Hospital (FRRH).Methods:A cross-sectional study was done during the period from April 2022 to June 2022. A total of 124 participants had been recruited consecutively from postnatal ward of FRRH. Pretested questionnaires were used to obtain information on data required for analysis. Venous blood sampling (2 ml taken from the forearm using anticoagulant free vacutainer) was done for all mothers who missed opportunity for prenatal syphilis testing using both RPR and TPHA. Descriptive statistics followed by binary logistic regression analysis was done using SPSS version 22.0.Results:The prevalence of syphilis infection was 27 (21.8%). After adjusted analysis, having more than one sexual partners in the past one year was associated with higher odds of syphilis infection (aOR = 24.922, 95% CI: 4.462-139.201, p < 0.001), and staying with the partner was found to be associated with lower odds of syphilis infection (aOR = 0.213, 95% CI: 0.040-1.142, p = 0.050).Conclusions:The study identified high prevalence of syphilis infection among mothers with missed opportunities for antenatal syphilis testing, and this was positively associated with having more than one sexual partners in the past one year and negatively associated with not staying with partner.
Introduction:The placenta, or afterbirth, plays a vital role in supplying nutrients and oxygen via the umbilical cord. Western medicine sees the placenta as a medical waste and discards it after delivery. Meanwhile, indigenous groups observe rituals or ceremonies prior to their disposal since it bears sacred importance.Aim:The aim of the literature review is to review the current literature on indigenous methods of disposing placenta.Methods:Through the EBSCOhost search engine, the authors had access to the following databases: CINAHL; MEDLINE; E-Journals; Health Sources: Nursing/Academic Edition; Scopus; and African Journals Online. A manual search of the grey literature through Google Scholar and Google Search engines, as well as citation searching using reference lists, was also used. The following keyword searches came up: placental disposal, placental waste, placental release, indigenous placental disposal, traditional placental disposal, cultural placenta, and placental rituals. The authors followed the inclusion criteria of qualitative, quantitative, or mixed research articles or reports from experts and different organisations published between 2013 and 2022 in English. Findings. The following three themes with subthemes emerged in the context of this review paper: (1) placental consumption (increases milk production, prevents postpartum depression, and prevents postpartum bleeding); (2) placental burial (burial site determines the child's fate, protection of the child, and fertility); and 3). artifacts (memorabilia).Conclusion:Indigenous placental disposal methods have a significant value to Indigenous women globally. The rituals performed have a special meaning attached to them. It is important for Western medicine to respect and support indigenous placental disposal methods and ensure safe handling from the healthcare facilities to their homes.
Background. Tragically, rape victims keep their ailments a secret from the police and their family members or significant others out of concern for societal stigma. The prevalence and severity of rape are highest among minorities, including girls and children who live as refugees. The current study assessed the prevalence of rape and its predictors among female students attending elementary schools in the Kule refugee camp, Gambella, southwest Ethiopia. Methods. An institution-based cross-sectional study was conducted from May 15 to 25, 2022, using an interviewer-administered structured questionnaire. A total of 211 participants were selected using a simple random sampling technique. The collected data were entered into EpiData and then exported to SPSS version 23 for analysis. The descriptive statistics were presented using frequencies, means, and standard deviations. A binary logistic regression model was used to test the association between the outcome and explanatory variables. The multivariable analysis included variables with p values of less than 0.25. Finally, statistical significance was declared at a p value of less than 0.05. Results. A total of 210 participants were involved in this study, which has a 99.5% response rate. Of these, 73 (34.8%) were subjected to rape. Shockingly, the majority (79.5%) of those who experienced rape reported that their perpetrator did not use a condom. Smoking (AOR: 4.3; 95% CI: 1.61, 10.93), drinking alcohol (AOR: 3.2; 95% CI: 1.43, 7.03), and having a boyfriend (AOR: 2.81; 95% CI: 21, 4.05) were found to be factors associated with rape. Conclusion. This study found a high prevalence of rape in the study area. The study also identified that participants’ behaviors, such as having a boyfriend, smoking, and drinking alcohol, predispose them to rape. Therefore, we recommend that the camp’s administrative bodies and humanitarian service organizations strengthen the preventive measures against rape crime, including the reinforcement of solid laws against perpetrators.
Background. Premarital sexual practice becomes a common phenomenon among youths in Ethiopia. It is usually associated with unwanted pregnancies, abortions, and sexually transmitted diseases including HIV/AIDS. Objective. This study is aimed at assessing the magnitude and determinants of premarital sexual practice among Ethiopian youths. Methods. A community-based cross-sectional study was conducted in all regions of Ethiopia from January 18 to June 27, 2016. A total of 7389 youths with the age range from 19 to 24 were included in the present study. Bivariable and multivariable binary logistic regression analyses were employed to identify factors associated with premarital sex. A 95% CI and p value < 0.05 were used to declare statistical significance. Result. The prevalence of premarital sexual practice was 10.8% (95% CI, 10%–11.5%). Being in the age group of 20-24 ( AOR = 3.6 , 95% CI (2.8, 4.6)), male sex ( AOR = 1.7 , 95% CI (1.3, 2.2)), employed ( AOR = 1.4 , 95% CI (1.03, 1.8)), from pastoral region ( AOR = 1.4 , 95% CI (1.3,2.4)), having mobile phone ( AOR = 1.7 , 95% CI, (1.3, 2.3)), ever use of internet ( AOR = 1.8 , 95% CI (1.3, 2.5)), ever drinking alcohol ( AOR = 2.4 , 95% CI (1.7, 2.5)), ever chewed khat ( AOR = 2.4 , 95% CI (1.6, 3.5), and ever tested for HIV ( AOR = 1.3 , 95% CI (1.1,1.6)) were statistically significant factors associated with premarital sex. Conclusion. For every 10 youths, at least one of them had sexual intercourse before they got married. Being in the age group of 20-24, male sex, employed, from a pastoral region, having a mobile phone, ever use of the internet, alcohol drinking, khat chewing, and ever tested for HIV were important factors affecting premarital sex. Thus, national sexual education and reproductive health behavior change interventions should give due attention to those groups. Furthermore, adequate education should be given about premarital sexual intercourse when youths come for HIV tests.
Despite the high rates of adolescent pregnancies, the utilization of modern contraceptives is still low among adolescents in Uganda which highlights a missed opportunity for the prevention of unwanted pregnancies among adolescents. We explored the perception of parents and guardians regarding the use of modern contraceptives by adolescents and the roles parents and guardians play in the use of modern contraceptives by the adolescents. A descriptive qualitative study was conducted in one of the suburbs of Arua city in the West Nile subregion in Uganda. Fifteen (15) in-depth interviews were conducted with parents and or guardians to explore their perceptions and roles regarding the use of modern contraceptives by adolescents. Thematic analysis was used in qualitative data analysis. Parents did not support adolescents' use of modern contraceptives. Lack of parental support was related to perceptions that modern contraceptives promote sexual promiscuity, fear that it causes infertility and that it is incompatible with cultural, religious, and moral norms. Parents and guardians opted to emphasize the importance of abstinence, conformity with cultural and religious norms, and the need to focus on completing school instead of encouraging the use of modern contraceptives. Few parents and guardians supported the use of modern contraceptives, specifically condoms, to prevent unwanted pregnancy by the adolescents and parents/guardians, sexually transmitted infections, and early school dropouts. Parents and guardians expressed feelings of inadequacy related to discussions on contraception use with their adolescent children and therefore avoided talking about it. Our study reveals a lack of parental support regarding the use of modern contraceptives among adolescents. Public health interventions which promote intergenerational, socioculturally, and religiously appropriate communication should be instituted in the communities in order to promote sustainable adoption of modern contraceptive use among adolescents.
Purpose There are very limited evidences showing the status of adolescent-parent communication in rural areas of Ethiopia as most of the studies focus in urban areas and were school-based. Therefore, this study intends to determine the adolescent-parent communication on sexual and reproductive health matters and its determinants among rural adolescents in Jimma Zone, Southwest Ethiopia. Methods Community-based cross-sectional study design was employed using the multistage sampling technique. Structured questionnaire was used to collect the data. The data was cleaned and entered into Epi data version 3.1 and exported to SPSS version 23 for descriptive and regression analysis. Results From 833 adolescents participated in the study, only 364 (43.7%) of them had ever discussed sexual and reproductive health matters of which males represent 196 (53.8%) followed by females 168 (46.2%). Among these, only 35 (9.6%) had discussed with their mother, and 24 (6.6%) had discussed with their father. The proportion of adolescents who communicated with their parents on sexual and reproductive health issues was 364 (43.7%). Multivariable logistic regression analysis indicated that never getting information on SRH issues (AOR = 0.5, 95% CI, 0.4-0.8) and particularly on sexually transmitted infections (AOR = 0.5, 95% CI, 0.4-0.7) and unknowing the period in which there is a possibility to be pregnant for a girl (AOR = 0.2, 95% CI, 0.04-0.9) were found to be independent factors affecting adolescent-parental communication negatively. Conclusion This study's result implies that the majority of the adolescents in the rural area were not communicating with their parents about sexual and reproductive health issues. However, most of them knew about different sexual and reproductive health services and where they could be found. Therefore, the provision of detailed information on the importance of communication with their parents on such a sensitive issue is suggested. Further research is needed to identify the barrier from the parents' side.
Background:An obstetric fistula is an abnormal opening between the vagina, rectum, and/or bladder. Obstetric fistula has a devastating impact on women's physical, social, and psychological health. Despite the numerous health consequences in developing countries, including Ethiopia, there have been few studies on the determinants of time to recovery from obstetric fistula. Therefore, this study is aimed at addressing the gap.Methods:A retrospective cohort study was employed to include 328 randomly selected records of women admitted for obstetric fistula treatment at Mekelle Hamlin Fistula Center from January 2015 to 2020. Data collected from the medical records was coded and entered into SPSS software version 20 and exported to STATA 10 and R statistical software for data cleaning and data analysis. The Kaplan-Meier and log-rank tests were computed to explore the data. The log-logistic inverse Gaussian shared frailty model was employed using a 95% CI, and variables with a p value < 0.05 were declared as determinants of recovery time.Results:Of 328 fistula patients, 293 (89.33%) were physically cured. The Kaplan-Meier result showed that the overall mean and median survival time of time to recovery from obstetric fistula patients at Mekelle Hamlin Fistula Center is 42 and 33 days, respectively. In a log-logistic inverse Gaussian shared frailty model analysis, extensive fistula size (AHR : 1.282; 95% CI = 1.175-1.388), secondary and above education level (AHR : 0.830; 95% CI = 0.693-0.967), rural residence (AHR : 1.357; 95% CI = 1.236-1.479), and physiotherapy use (AHR : 0.801, 95% CI = 0662-0.940, 95% CI = 1.175-1.388) were statistically significant predictors of recovery from obstetrics fistula.Conclusion:Rural place of residence, home delivery, and large and extensive size of the fistula prolong the timing of healing from the obstetric fistula. However, having tall height, physiotherapy treatment, secondary and above-educated women, and RVF type of fistula has a short time of healing for obstetric fistula in Mekelle Hamlin Fistula Center. Therefore, we recommend that health professionals promote institutional delivery and physiotherapy, shorten the duration of catheterization, and manage urine incontinence. In addition, we recommend that the regional health bureau promotes female education and pregnancy after 18 years. The survival probability of patients with obstetric fistulas is better predicted by the log-logistic inverse Gaussian shared frailty model. Therefore, it would be good for future researchers to take this model into account.
Background. Postpartum family planning is an effective strategy for reducing maternal and childhood morbidity and mortality by preventing unintended pregnancy and short interpregnancy intervals. Despite the paramount advantages of long-acting reversible contraceptives (LARC), their uptake remains low in Ethiopia. Therefore, the aim of this study was to assess the uptake of immediate postpartum LARC methods and its associated factors among women who gave birth in Hawassa University Comprehensive Specialized Hospital, Hawassa city, Southern Ethiopia. Methods. An institution-based cross-sectional study was conducted among 418 eligible mothers who were in the immediate postpartum period. Data were collected using a pretested structured questionnaire before their discharge from the hospital and analyzed by using SPSS version 20. The statistical significance was declared at P value less than 0.05. Results. The uptake LARCs among immediate postpartum mothers was 25.4%. The most commonly reported reasons for not using LARC were preference to start contraception after six weeks of delivery (43.3%) and the need to use other methods of contraception (26%). Having unplanned birth (AOR: 1.97; 95% CI: 1.04-3.71) and receiving family planning counselling on LARCs during the postpartum period (AOR: 21.1; 95% CI: 6.49-68.66) were factors significantly associated with immediate postpartum LARC use. Conclusion. Low utilization of immediate postpartum LARC uptake was found in the current study setting. There was increased utilization of immediate postpartum LARC among mothers who received family planning counselling during the postpartum period. Therefore, strengthening family planning counselling during the immediate postpartum period is crucial to enhance postpartum LARC use.
Background:Pregnancy risk perception affects a pregnant woman's decision about health care services such as prenatal care, place of birth, choices about medical interventions, adherence to medical procedures, and recommendations. Therefore, the study is aimed at assessing pregnancy risk perception and associated factors among pregnant women attending antenatal care at health centers in Jabi Tehnan District. Methods:An institutional-based cross-sectional study was conducted among 424 mothers attending ANC at health centers in the Jabi Tehnan District from April 1 to 30, 2021. Data was collected through a face-to-face interview using a structured questionnaire which was developed according to the health belief model. The logistic regression model was used using an adjusted odds ratio with 95% CI and pvalue < 0.05 to declare significance and associations. Result:Four hundred twenty four (424) pregnant women were interviewed of which nearly half of the respondents 48% (43.2%, 52.7%) had good pregnancy risk perception. Women who had a history of obstetric complications (AOR: 95% CI = 3.44 : 1.73, 6.83), those who knew at least one pregnancy danger sign (AOR: 95% CI = 5.22, 2.46, 11.07), pregnant women who had a bad obstetric history (AOR: 95% CI = 2.23 : 1.13, 4.41), and knowing women who died due to pregnancy-related complications (AOR: 95% CI = 2.85 : 1.45, 5.60) were more likely to have good perception towards pregnancy risk compared to their counterparts. Conclusion:Obstetric complications, awareness of pregnancy danger signs, bad obstetric history, and known women who died due to pregnancy-related complications were found to be significantly associated with pregnancy risk perception.
Background:The World Health Organization recommends the use of effective contraception for the prevention of unintended pregnancy and unsafe abortion. The main aim of postabortion contraceptive services is to prevent recurrent pregnancy and ultimately mitigate the associated maternal mortality.Objective:To assess postabortion contraceptive utilization (PACU) and postabortion contraceptive preferences (PACP) and the associated factors among women receiving abortion care services in Ambo town, Oromia Region, Western Ethiopia.Methods:A cross-sectional study was conducted at the health facilities in Ambo town from 22 July to 24 September 2021. The data was collected using a structured questionnaire. Bivariate and multivariable logistic regression was done to determine the factors associated with postabortion contraceptive utilization and preferences.Results:Out of 388 participants who were included in the final analysis, 262 (67.5%) had utilized postabortion contraceptives of which 173 (66%) received contraceptive methods of their primary preference. The multivariate logistic regression showed that cohabiting couples showed lower utilization (AOR = 0.15; 95% CI: 0.06-0.21; p value = 0.004) than married ones and planning to have an additional child within 1-3 years (AOR = 7.41; 95% CI: 2.18-11.41; p value = 0.005) or after 3-5 years (AOR = 6.67: 95% CI: 5.12-10.18; p value = 0.033) was identified to be significantly associated with postabortion contraceptive utilization. Having a secondary education level (AOR = 3.06; 95% CI: 1.54-6.07; p value = 0.001) and having experience of domestic violence (AOR = 2.19; 95% CI: 1.27-3.81; p value = 0.005) were significantly associated with unsatisfied postabortion contraceptive preference. Conclusions and Recommendations. About two-thirds of the women who were given abortion services received postabortion contraceptives whereas almost two-thirds of them received a contraceptive method of their primary preference. Marital status, duration before additional child planned, and being counseled on contraceptive determined postabortion contraceptive utilization. Having a secondary education level and having experienced domestic violence were significantly associated with unsatisfied PACP.
Background The primary objective of this research was to investigate how socioeconomic and demographic factors influence the usage of contraceptives by women in 18 developing countries. Methods The study used the latest DHS data from 18 developing countries in order to acquire a broad perspective of contraceptive methods. We applied meta-analysis techniques for 18 developing countries to find out the summary results. Results The overall summary effect showed that the variable respondent education (OR = 1.39; 95% CI: 1.17 to 1.65), husband education (OR = 1.60; 95% CI: 1.32 to 1.93), type of place of residence (OR = 0.88; 95% CI 0.78 to 0.98), current working status (OR = 1.47; 95% CI 1.30 to 1.66), age of the respondent (OR = 3.41; 95% CI 2.35 to 4.93), breastfeeding status (OR = 1.34; 95% CI 1.11 to 1.62), and desire for more children (OR = 0.53; 95% CI 0.43 to 0.65) were the significant factors for contraceptive utilization in developing countries. Conclusions According to the findings of this descriptive study, the respondent's age, level of education, and work status were shown to be the most significant factors that influence the usage of contraceptives in developing countries. It is necessary to take reasonable steps in order to increase the rate of utilizing methods of contraception among women of reproductive age who are uneducated, living in rural areas, and unemployed.
Background Adequate antenatal care is essential for the health of the mother and the development of the fetus. The World Health Organization recommends at least four antenatal care (ANC) visits during pregnancy. In Ethiopia, only 32% of women of childbearing age attend four or more ANC visits. This figure is significantly lower than the average for least developed countries. This study is aimed at calculating the magnitude and identifying the factors associated with optimal antenatal care utilization in the South Gondar Zone, Northwest Ethiopia. Methods A community-based cross-sectional study was conducted in the South Gondar Zone of Northwest Ethiopia from September 2020 to May 2021. A total of 434 participants were selected using multistage cluster sampling. Data were gathered through face-to-face interviews using a structured questionnaire. A multivariate binary logistic regression model was used to determine the factors associated with the optimal use of antenatal care. Result The magnitude of optimal antenatal care utilization was 59% (95% CI; 54.20, 63.65). The study showed that mothers who completed their secondary school (AOR = 8.205; 95% CI: 3.406, 19.767), women who completed their tertiary school (AOR = 6.406; 95% CI: 2.229, 18.416), women whose husbands' level of education is secondary school (AOR = 5.967; 95% CI: 2.753, 12.936), those with a planned pregnancy (AOR = 1.912; 95% CI: 1.117, 3.271), those with a wanted pregnancy (AOR = 2.341; 95% CI: 1.366, 4.009), women whose husbands work in the government or nongovernment sector (AOR = 3.736; 95% CI: 2.093, 6.669), those not being exposed to the media (AOR = 0.520; 95% CI: 0.345, 0.783), and rural women (AOR = 0.267; 95% CI: 0.164, 0.435) were significantly associated with optimal ANC utilization. Conclusion The findings suggest that more emphasis should be placed on education-based programs for women and their husbands that highlight the benefits of a planned pregnancy, desired pregnancy, and maternal health care. Meanwhile, the government and other concerned bodies should focus on expanding road accessibility, health institutions, and ambulance distribution to improve optimal ANC utilization in the area.
Background. Implanon is a long-acting contraceptive method that is extremely effective in preventing pregnancy with a clinical failure rate of less than 1%. Despite these, the rate of Implanon discontinuation is a common problem in various societies and exposes women to unwanted conception and its consequences. Objective. The current study sought to find and consolidate relevant literature on Implanon discontinuation and associated factors in Ethiopia. Methods. Medline, PubMed, Cochrane Library, EMBASE, and Google Scholar databases were systematically searched for studies published in English before December 2021. The included studies were critically appraised using the JBI instrument for observational studies. STATA version 16 was used for analysis. The presence of statistical heterogeneity was checked using Cochran’s Q test, and its level was quantified using I 2 statistics. A pooled estimate of the proportion of outcome variables was calculated. To measure the effect size, pooled odds ratios with 95% CI were computed. Results. The pooled prevalence of Implanon discontinuation in Ethiopia was 32.89%, 95% CI: 24.11%, 41.66%. Experiencing side effects ( OR = 2.52 , 95% CI 1.75, 3.65), having no children ( OR = 1.69 , 95% CI 1.15, 2.47), not having received preinsertion counselling ( OR = 1.65 , 95% CI 1.36, 2.00), having no postinsertion appointment ( OR = 2.97 , 95% CI 2.10, 4.21), and not satisfied with the service ( OR = 2.72 , 95% CI 2.47, 5.59) were significantly associated with Implanon discontinuation. Conclusion. The pooled prevalence of Implanon discontinuation in Ethiopia was high. Experiencing side effects, having no child, not receiving preinsertion counselling, having no follow-up appointment, and not being satisfied with the service were significantly associated with Implanon discontinuation. Therefore, healthcare providers should offer preinsertion counselling in accordance with national family planning guidelines, emphasizing the method’s advantages and side effects.
Introduction. Adolescents with disability are often presumed erroneously to be sexually inactive. Though they have the same need for sexual and reproductive health (SRH) services as nondisabled people, they are often overlooked by sexual and reproductive health programs, interventions, and studies. Objective. To assess determinant factors of sexual and reproductive health service utilization among in-school adolescents with disability in Jimma zone, southwest Ethiopia. Method. Institution-based cross-sectional study design was employed among in-school adolescents with disability in Jimma zone, Ethiopia, from September 21 to November 30, 2021. A total of 454 participants were included in the study by using the multistage sampling technique. Data were collected by using a structured questionnaire through face-to-face interviews. Data were entered into Epi-data version 4.2 and analyzed by using SPSS version 23. Bivariate and multivariable logistic regression analyses at a 95% confidence interval were performed, and a P value < 0.05 was considered statistically significant. Result. 454 study participants were included in this study with a respondent rate of 97.4%. Only 38 (8.4%, 95% CI: 5.7-10.8%) of in-school adolescents utilized SRH information and education service. The majority (265, 49%) of adolescents with disability knew family planning as sexual and reproductive health services which were followed by voluntary counselling and testing for HIV/AIDS (116, 21.4%). Seventy-eight (17.2%, 95% CI: 13.7-20.5%) of in-school adolescents with disability visited nearby health facilities for VCT services. Male sex (AOR=2.32, 95% CI: 1.18-4.57), favourable attitude (AOR=3.11, 95% CI: 1.59-6.07), and history of sexual intercourse (AOR=5.34, 95% CI: 2.05–13.92) were significantly associated with SRH service utilization. Conclusion. The overall sexual and reproductive health service utilization of in-school adolescents with disability was low when compared with other studies. Physical impairment, male sex, ever had sexual intercourse, good knowledge, and favourable attitudes were determinant factors of SRH service utilization among in-school adolescents with disabilities. So, it is recommended that the Jimma zone administration, government, and NGOs should give attention to SRH services.
Introduction Worldwide, specifically in developing countries, women believe that a woman cannot become pregnant unless she sees her first postpartum menstruation. Due to this knowledge gap, most women did not use any contraceptives till their 1st postpartum menstruation. Hence, about 44% of women were susceptible to unintended pregnancy in the postpartum period. Assessing women knowledge on possibility of pregnancy after giving birth but before returning of menses and its associated factors will help to increase women's recognition on the issue and for early commencement of appropriate postpartum family planning methods to reduce burden of unintended pregnancy. Objective To assess the level of knowledge on possibility of pregnancy after giving birth but before returning of menses and its associated factors among reproductive women in Ethiopia. Methods A secondary data analysis using the 2016 Ethiopian Demographic Health Survey was employed. Samples were selected using two-stage stratified sampling technique. Descriptive statistics and logistic regressions were used. Adjusted odds ratio (AOR) with 95% confidence interval was used to interpret associations, and a significant association was declared at a p value of <0.05. Result A total of 15,683 reproductive women aged from 15 to 49 years were included. Of them, about 53% did not know that a woman can get pregnant after giving birth but before resumption of her menstruation. Age being 35 years and above (AOR = 1.50; 95%CI = 1.34, 1.67), educational status of secondary and above (AOR = 1.18; 95%CI = 1.06, 1.32), being ever married (AOR = 1.67; 95%CI = 1.47, 1.89), knowledge of any family planning method (AOR = 1.81; 95%CI = 1.52, 2.16), getting counseling on family planning methods (AOR = 1.41; 95%CI = 1.28, 1.55), and being knowledgeable on their ovulatory cycle (AOR = 1.68; 95%CI = 1.55, 1.82) were found to be significantly associated with being knowledgeable on the issue. Conclusion Reproductive women's level of knowledge on the possibility of pregnancy after giving birth but before returning of menses was low. Factors associated with being knowledgeable on the issue were identified. Therefore, strategies should be developed to increase their level of knowledge for reducing unintended pregnancy and its complications by integrating family planning counseling with infant immunization services.
