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Background: Despite the demonstrated benefits of breast milk, the prevalence of breastfeeding, in-particular exclusive breastfeeding (EBF), in many developing countries including Ethiopia is lower than the international recommendation of EBF for the first six months of life Objective: To assess the practice of EBF and explore its determinants in Ethiopia and provide policy makers and NGOs with relevant information for future planning and interventions. Methods: Raw data collected from nine regions and two city administrations using stratified cluster sampling method by the Ethiopian Demographic Health Survey (EDHS) 2005 were used to study the practice and determinants of EBF countrywide. Analysis was based on children whose age was less than six months and alive at the time of interview that was extracted from the women's database. Results: The overall rates of exclusive and full breastfeeding were 49.0% and 68.2% respectively. Maternal education, marital status, wealth index and age of the child were closely associated with EBF practices, nonetheless, in the hierarchical analysis; being not married, middle/ richer/ richest wealth index, and child age 0-1and 2-3 month were retained as the predictors of EBF (P<0.05). Conclusion:A range of maternal and child health attributes such as marital status, economical status and child age were found to influence the practice of EBF in Ethiopia. Actions to empower women and promotion of EBF campaign are recommended to achieve the fourth millennium development goal. [Ethiop.J.Health Dev. 2009;23(1):12-18]

A cross-sectional community-based study with analytic component was conducted among Ethiopian women during June-July 2005 to assess the magnitude of anaemia and deficiencies of iron and folic acid and to compare the factors responsible for anaemia among anaemic and non-anaemic cases. In total, 970 women, aged 15-19 years, were selected systematically for haematological and other important parameters. The overall prevalence of anaemia, iron deficiency, iron-deficiency anaemia, deficiency of folic acid, and parasitic infestations was 30.4%, 50.1%, 18.1%, 31.3%, and 13.7% respectively. Women who had more children aged less than five years but above two years, open-field toilet habits, chronic illnesses, and having intestinal parasites were positively associated with anaemia. Women who had no formal education and who did not use contraceptives were negatively associated with anaemia. The major determinants identified for anaemia were chronic illnesses [adjusted odds ratio (AOR)=1.1, 95% confidence interval (CI) 1.15-1.55), deficiency of iron (AOR=0.4, 95% CI 0.35-0.64), and deficiency of folic acid (AOR=0.5, 95% CI 0.50-0.90). The odds for developing anaemia was 1.1 times more likely among women with chronic illnesses, 60% more likely in the iron-deficient and 40% more likely in the folic acid-deficient than their counterparts. One in every three women had anaemia and deficiency of folic acid while one in every two had iron deficiency, suggesting that deficiencies of both folic acid and iron constitute the major micronutrient deficiencies in Ethiopian women. The risk imposed by anaemia to the health of women ranging from impediment of daily activities and poor pregnancy outcome calls for effective public-health measures, such as improved nutrient supplementation, health education, and timely treatment of illnesses.

The contribution of various factors to malnutrition, particularly stunting, may differ among areas and communities. This cross-sectional study aimed to estimate the level of malnutrition and identify factors associated with the high level of stunting in breast-fed infants aged 5-11 mo living in Dodota-Sire District, Ethiopia. Infants (n = 305) and their mothers were examined physically, and anthropometric and demographic data were collected. The content of zinc, calcium and copper in breast milk was measured, and data collected on the type, frequency of consumption, and time of introduction of supplementary feeding. Overall, 36% were stunted, 41% underweight and 13% wasted. The highest prevalence of malnutrition was seen in infants aged 9-11 mo. Among mothers, 27% had chronic energy deficiency (body mass index, <18.5 kg/m(2)) and 20% were night blind, indicating that vitamin A deficiency was a serious problem. Infants fed >3 times/d, consuming >600 mL/d or consuming cow's milk in addition to cereals and/or legumes had markedly higher length-for-age Z-scores than their peers fed less frequently, consuming less food or not consuming cow's milk [differences: 0.39, 95% confidence interval (CI): 0.04-0.74; 0.17, 95% CI: 0.02-0.32; 0.40, 95% CI: 0.07-0.72, respectively). Infants of mothers with low concentrations of zinc in their breast milk were more stunted. In conclusion, the quality and quantity of foods consumed by infants is insufficient to prevent stunting. Thus it is necessary to increase the nutrient supply to infants by increasing intake and nutrient concentration of breast milk and of supplementary foods they consume, and by providing supplements to infants where appropriate.

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BackgroundDespite its prominence, intimate partner violence (IPV) against women has received little attention in Ethiopia. And as many of sub-Saharan African countries, maternal health care services utilization remains poor. Full access and utilization of maternal health care services is a key to significant reduction in maternal and child mortality, and eliminate new HIV infection in infants. Identifying the factors that contribute to the poor access and utilization should aid the design of appropriate policy and intervention strategies. Thus the objective of this study was to examine the association between IPV and use of maternal health care services in Addis Ababa, Ethiopia.MethodsA cross sectional study on couples (N = 210; male/female pairs) with an infant less than 6 months of age was conducted. The dependent variable was use of maternal health care services and the main independent variable was IPV. Data was collected using face-to-face self-reported questionnaires and analyzed using SPSS version 20.0. Bivariate and multivariate logistic regression models were used to examine the relationship between the dependent and independent variables.ResultsThe mean age of the women was 28.7 years (SD = 5.4), on average women were 7.4 years (SD = 7.4) younger than their partners. Although most of the women (95.2%) had at least one antenatal care (ANC), only 35 (2%) had ≥4 ANC visits and about half (49.0%) had their first ANC visit within the first trimester. Women who experienced emotional IPV in their relationship were less likely to have their 1st ANC within three months of pregnancy (AOR = 0.69; 95%CI = 0.49–0.96). Women who reported physical IPV in their relationship were less likely to use ≥4 ANC (AOR = 0.48; 95%CI = 0.21–0.71), be tested for HIV (AOR = 0.26; 95%CI = 0.09–0.79), have skilled delivery attendant (AOR = 0.31; 95%CI = 0.12–0.98), and deliver in a health facility (AOR = 0.35; 95%CI = 0.14–0.88). Likewise, women experienced sexual IPV or partner control in their relationship were less likely to use ANC ≥4 times (AORsexual-IPV = 0.91; 95%CI = 0.84–0.98 and AORpartner-control = 0.38; 95%CI = 0.17–0.85 respectively).ConclusionsIPV is prevalent among couples in Addis Ababa, Ethiopia where three out of four women reported having experienced one or more type of IPV in their current relationship. And all types of IPV showed significant association with poor utilization of one or more maternal health care services. Thus efforts to sustain the recent success in maternal health and further improvement should give due consideration to IPV.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2121-7) contains supplementary material, which is available to authorized users.

Background: Avoidance of all breast-feeding by HIV infected mothers is recommended when replacement feeding is acceptable, feasible, affordable, sustainable, and safe. Whereas for women whose HIV status is unknown or negative, exclusive breastfeeding for the first six months is the single infant feeding option recommended. Objective: To assess the infant feeding practice of HIV positive mothers and its determinants. Methods: A cross sectional study with analytical component was conducted in 13 purposively selected health institutions with ART and PMTCT facilities in Addis Ababa during March, 2008. A total of 327 HIV positive mothers with their young infants visiting the respective health institutions were recruited in order of arrival, and assessed for their infant feeding practices. Results: Exclusive replacement feeding (ERF), exclusive breastfeeding (EBF) and mixed feeding (MF) were 46.8%, 30.6%, and 15.3% respectively. The predictors for choosing ERF were mode of delivery (p<0.05), household income (p<0.05) and disclosure of HIV status to spouse (p<0.01). The predictor for EBF, was mode of delivery (p<0.05) while for MF, disclosure of HIV status to spouse (p<0.05), parental infant feeding attitude (p<0.01) and infant illnesses (p<0.01) were the predictors. Furthermore, sticking to mothers' informed safer feeding options is challenged by some social factors. Conclusion: The present study delineated the predictors involved in making safer choices for infant-feeding options.To achieve success in exclusivity of feeding options, mothers' decision should be respected and pressure from the family/neighbors to introduce other food to the infant needs to be discouraged. Furthermore, the risks involved in each infant feeding option should be communicated and advocated to the mother/father during PMTCT to make informed choices. [Ethiop.

BackgroundOne way of addressing malnutrition among HIV/AIDS patients is through the Food by Prescription program (FBP) and many studies have explained the treatment outcomes after therapeutic food supplementation, though available evidences on adherence levels and factors associated with these sorts of programs are limited. The findings of this study would therefore contribute to the existing knowledge on adherence to Ready-to-Use Therapeutic/Supplementary Food (RUF) in Ethiopia.MethodsA facility-based, cross-sectional study supplemented with qualitative methods was conducted among 630 adult HIV + patients. Their level of adherence to RUF was measured using the Morisky 8-item Medication Adherence Scale (MMAS-8). The total score on the MMAS-8 ranges from 0 to 8, with scores of <6, 6 to <8, and 8 reflecting low, medium, and high adherence, respectively. Patients who had a low or a moderate rate of adherence were considered non-adherent.ResultsThe level of adherence was found to be 36.3% with a 95.0% response rate. With the exception of the educational status, other socio-demographic variables had no significant effect on adherence. Those who knew the benefits of the FBP program were 1.78 times more likely to adhere to the therapy than the referent groups. On the other hand, patients who were not informed on the duration of the treatment, those prescribed with more than 2 sachets/day and had been taking RUF for more than 4 month were less likely to adhere. The main reasons for non-adherence were not liking the way the food tasted and missing follow-up appointments. Stigma and sharing and selling food were the other reasons, as deduced from the focus group discussion (FGD) findings.ConclusionThe observed level of adherence to the FBP program among respondents enrolled in the intervention program was low. The major factors identified with a low adherence were a low level of education, poor knowledge on the benefits of RUF, the longer duration of the program, consuming more than two prescribed sachets of RUF per day, and not being informed about the duration of the treatment. Therefore, counseling patients on the program’s benefits, including the treatment plans, would likely contribute to improved adherence.