BackgroundThough there is a marked decline in burden of undernutrition, about 44 and 10% of children under five are stunted and wasted, respectively in Ethiopia. The highest prevalence of wasting occurs in young children (6–23 months), however literature are limited in these population groups. Therefore, this study aimed to assess stunting, wasting and associated factors among children aged 6–24 months in Dabat Health and Demographic Surveillance System (HDSS) site, northwest Ethiopia.MethodsA community based cross-sectional study was conducted in Dabat HDSS site from May 01 to June 29, 2015. A total of 587 mother-child pairs were included in the study. A multivariate logistic regression analysis was carried out to identify factors associated with stunting and wasting, separately.ResultsThe prevalence of stunting and wasting among children aged 6–24 months were 58.1 and 17.0%, respectively. Poor wealth status [Adjusted Odds Ratio (AOR) = 2.20; 95% Confidence Interval (CI): 1.42, 3.40], unavailability of latrine [AOR = 1.76; 95% CI: 1.17, 2.66], child age: 12–24 months [AOR = 3.24; 95% CI: 2.24, 4.69], not receiving maternal postnatal vitamin-A supplementation [AOR = 1.54; 95%: 1.02, 2.33] and source of family food: own food production [AOR = 1.71; 95% CI: 1.14, 2.57] were significantly associated with higher odds of stunting. However, only history of diarrheal morbidity was significantly associated with wasting [AOR = 2.06; 95% CI: 1.29, 3.30].ConclusionsIn this community, the magnitude of stunting and wasting exists as a severe public health concern. Therefore, improving socio-economic status, latrine and maternal postnatal vitamin-supplementation coverage are essential to mitigate the high burden of stunting. Besides, reducing the childhood diarrheal morbidity as well as strengthening early diagnosis and management of the problem are crucial to curve the high prevalence of wasting.

BackgroundExclusive breastfeeding is defined as feeding an infant breast milk only, for the first six months. In Ethiopia, more than half of infants do not receive exclusive breastfeeding. Workplace barriers contribute to these low rates of exclusive breastfeeding practices. Understanding the sociodemographic, health related, behavioral and economic factors is crucial to promote the practice of exclusive breastfeeding in Ethiopia. Therefore, the aim of this study was to assess the extent of exclusive breastfeeding practice and associated factors among employed and unemployed mothers with children of age 7–12 months in Gondar town, northwest Ethiopia, 2015.MethodsA community based comparative cross-sectional study was conducted in October 2015. Simple random sampling technique was used to select 649 eligible mothers with children age 7–12 months during the study period. A structured and pretested interviewer administered questionnaire was used to collect the data. Three logistic regression models: whole sample, employed and not employed, were fitted.ResultsA total of 649 (333 unemployed and 316 employed) mothers were interviewed. The mean duration of mothers to exclusively breastfeed was 4.77 months (± 1.36 Standard Deviation [SD]). Exclusive breastfeeding was higher among unemployed 48.0% with 95% Confidence Interval (CI) (42.0%, 54.0%) than employed (20.9%) with 95% CI (16.0%, 25.0%). Parity of three children and above (Adjusted Odds Ratio [AOR] = 3.48), and having social support (AOR = 3.45) were positively associated with exclusive breastfeeding while poor knowledge (AOR = 0.30), wealth index of the medium level (AOR = 0.38) were negatively associated among employed mothers. In the case of unemployed mothers, vaginal delivery (AOR = 2.60) and having social support (AOR = 3.03) were positively associated with exclusive breastfeeding while, poor knowledge (AOR = 0.28), and not having antenatal care (AOR = 0.56) were negatively associated.ConclusionsThe overall exclusive breastfeeding practice of mothers was low. However, unemployed mothers breastfeed more than employed mothers. Providing a special support for employed mothers and revising either the legislation of the two month postpartum maternity leave or applying different alternatives is recommended.Electronic supplementary materialThe online version of this article (doi:10.1186/s13006-017-0118-9) contains supplementary material, which is available to authorized users.

BackgroundImmunization against childhood disease is one of the most important public health interventions with cost effective means to preventing childhood morbidity, mortality and disability. However, complete immunization coverage remains low particularly in rural areas of Ethiopia. This study aimed to assess the level of immunization coverage and associated factors in Lay Armachiho District, North Gondar zone, Northwest Ethiopia. A community based cross-sectional study was conducted in March, 2014 among 751 pairs of mothers to children aged 12–23 months in Lay Armachiho District. A two stage sampling technique was employed. Logistic regression analysis was carried out to compute association between factors and immunization status of children. Backwards stepwise regression method was used and those variables significant at p value 0.05 were considered statistically significant.ResultsSeventy-six percent of the children were fully immunized during the study period. Dropout rate was 6.5% for BCG to measles, 2.7% for Penta1 to Penta3 and 4.5% for Pnemonia1 to Pnemonia3. The likelihood of children to be fully immunized among mothers who identified the number of sessions needed for vaccination were higher than those who did not [AOR = 2.8 (95% C1 = 1.89, 4.2)]. Full immunization status of children was higher among mothers who know the age at which the child become fully immunized than who did not know [AOR = 2.93 (95% CI = 2.02, 4.3)]. Taking tetanus toxoid immunization during pregnancy showed statistically significant association with full immunization of children [AOR 1.6 (95% CI = 1.06, 2.62)]. Urban children were more likely to be fully immunized than rural [AOR = 1.82 (95% CI = 1.15, 2.80)] and being male were more likely to be fully immunized than female [AOR = 1.80 (95% CI = 1.26, 2.6)].Conclusion and recommendationVaccination coverage was low compared to the Millennium Development Goals target. It is important to increase and maintain the immunization level to the intended target. Efforts should be made to promote women‘s’ awareness on tetanus toxoid immunization, when the child should start vaccination, number of sessions needed to complete immunization, and when a child become complete vaccination to improve immunization coverage through health development army and health professionals working at antenatal care, postnatal care and immunization units.

BackgroundFor the first six months of life, breast milk is the ideal food to provide adequate quality and quantity of nutrients. Exclusive breastfeeding has a profound effect to reduce the risk of respiratory and gastrointestinal related morbidities as well as all-cause and infection-related neonatal mortalities. Despite the immense benefits of exclusive breastfeeding, the practice is suboptimal in Ethiopia. The aim of this study was to assess whether antenatal care and institutional delivery contributes to mothers' practice of exclusive breastfeeding in rural communities of northwest Ethiopia.MethodsA community-based nested case–control study was conducted in northwest Ethiopia from November 2009 to August 2011. About 1769 mother-infant pairs were included and followed for six months after birth. Interviews with mothers were conducted in the first week, at 1st, 4th, and 6th month. Bivariate and multivariate logistic regression were carried out to determine associations between independent variables and exclusive breastfeeding practice.ResultsOf the total respondents, 30.7 % (95 % CI: 27 %, 35 %) of mothers exclusively breastfed their infants. In multivariate analysis, own business activity (AOR= 3.06; 95 % CI: 1.29, 7.25), being a housewife (AOR= 3.41; 95 % CI: 1.28, 9.11), having antenatal care (AOR= 1.32; 95 % CI: 1.01, 1.73), giving birth in a health institution (AOR= 1.29; 95 % CI: 1.02, 1.62), and possessing a microfinance bank account (AOR= 2.35; 95 % CI: 1.80, 3.07) were positively associated with exclusive breastfeeding practice.ConclusionsDespite underutilization of maternal health services, these services contributed to mothers exclusive breastfeeding practice. Strengthening utilization of antenatal care and institutional delivery would have an added benefit in improving exclusive breastfeeding practice. Moreover involving mothers in business activities is important.

BackgroundThe fifth Millennium Development Goal calls for a reduction of maternal mortality ratio by 75% between 1990 and 2015. A key indicator to measure this goal is the proportion of births attended by skilled health personnel. The maternal mortality ratio of Ethiopia is 676 deaths per 100,000 live births. Skilled birth attendance is correlated with lower maternal mortality rates globally and in Sub-Saharan Africa. However, the proportion of births with a skilled attendant is only 10% in Ethiopia. Therefore identifying the determinants of skilled attendance for delivery is a priority area to give policy recommendations.MethodsA community based nested case control study was conducted from October 2009 – August 2011 at the University of Gondar health and demographic surveillance systems site located at Dabat district, Northwest Ethiopia. Data were obtained from the infant mortality prospective follow up study conducted to identify the determinants of infant survival. A pretested and structured questionnaire via interview was used to collect data on the different variables. Logistic regression analysis was used to identify the determinants of skilled birth attendance. Strength of the association was assessed using odds ratio with 95% CI.ResultsA total of 1065 mothers (213 cases and 852 controls) were included in the analysis. Among the cases, 166 (77.9%) were from urban areas. More than half (54%) of the cases have secondary and above level of education. Secondary and above level of education [AOR (95%CI) = 2.8 (1.29, 3.68)] and urban residence [AOR (95%CI) = 8.8 (5.32, 14.46)] were associated with skilled attendance for delivery. Similarly, women who had ANC during their pregnancy four or more times [AOR (95%CI) = 2.8 (1.56, 4.98)] and who own TV [AOR (95%CI) = 2.5 (1.32, 4.76)] were more likely to deliver with the assistance of a skilled attendant.ConclusionsWomen’s education, place of residence, frequency of antenatal care visit and ever use of family planning were found to be determinants of skilled birth attendance. Encouraging women to complete at least secondary education and to have antenatal care frequently are important to increase skilled attendance during delivery.