Background Short Birth Interval negatively affects the health of both mothers and children in developing nations, like, Ethiopia. However, studies conducted to date in Ethiopia upon short birth interval were inconclusive and they did not show the extent and determinants of short birth interval in developing (Afar, Somali, Gambella, and Benishangul-Gumuz) regions of the country. Thus, this study was intended to assess the short birth interval and its determinants in the four developing regions of the country. Methods Data were retrieved from the Demographic and Health Survey program official database website (http://dhsprogram.com). A sample of 2683 women of childbearing age group (15-49) who had at least two alive consecutive children in the four developing regions of Ethiopia was included in this study. A multilevel multivariable logistic regression model was fitted to identify the independent predictors of short birth interval and Akaike's Information Criterion (AIC) was used during the model selection procedure. Results In this study, the prevalence of short birth interval was 46% [95% CI; 43.7%, 47.9%]. The multilevel multivariable logistic regression model showed women living in rural area [

Introduction: Women’s decision-making autonomy has a positive effect on the scale-up of contraceptive use. In Ethiopia, evidence regarding women’s decision-making autonomy on contraceptive use and associated factors is limited and inconclusive. Therefore, this study was intended to assess married women’s decision-making autonomy on contraceptive use and associated factors in Ethiopia using a multilevel logistic regression model. Methods: The study used data from the 2016 Ethiopia Demographic and Health Survey that comprised of a weighted sample of 3668 married reproductive age women (15–49 years) currently using contraceptives. A multilevel logistic regression model was fitted to identify factors affecting married women’s decision-making autonomy on contraceptive use. Akaike’s information criterion was used to select the best-fitted model. Results: Overall, 21.6% (95% confidence interval = 20.3%–22.9%) of women had decision-making autonomy on contraceptive use. Community exposure to family planning messages (adjusted odds ratio = 2.22, 95% confidence interval = 1.67–3.05), media exposure (adjusted odds ratio = 2.13, 95% confidence interval = 1.52–3.23), age from 35 to 49 years (adjusted odds ratio = 2.09, 95% confidence interval = 1.36–4.69), living in the richer households (adjusted odds ratio = 1.67, 95% confidence interval = 1.32–3.11), and visiting health facility (adjusted odds ratio = 2.01, 95% confidence interval = 1.34–3.87) were positively associated with women’s decision-making autonomy on contraceptive use. On the contrary, being Muslim (adjusted odds ratio = 0.53, 95% confidence interval = 0.29–0.95), being married before the age of 18 years (adjusted odds ratio = 0.33, 95% confidence interval = 0.12–0.92), and residing in rural residence (adjusted odds ratio = 0.48, 95% confidence interval = 0.23–0.87) were negatively associated with women’s independent decision on contraceptive use. Conclusion: Less than one-fourth of married reproductive age women in Ethiopia had the decision-making autonomy on contraceptive use. Media exposure, women’s age, household wealth, religion, age at marriage, visiting health facilities, community exposure to family planning messages, and residence were the factors associated with women’s decision-making autonomy on contraceptive use. The government should promote women’s autonomy on contraceptive use as an essential component of sexual and reproductive health rights through mass media, with particular attention for adolescent women, women living in households with poor wealth, and those residing in rural settings.

BackgroundThe care given to newborns immediately within the first few hours of birth is critical for their survival. However, their survival depends on the health professional’s knowledge and skills to deliver appropriate newborn care interventions. Therefore, this study aimed to assess the knowledge and practice of immediate newborn care among nurses and midwives in public health facilities of Afar Regional State, Northeast Ethiopia.MethodsInstitution based cross-sectional study design was employed on 357 nurses and midwives working in 48 public health facilities (45 health centers and 3 hospitals) during April 2018. Data were collected using interviewer-administered questionnaire and observation checklist. Then, data were entered into Epi-info version 7.0 and exported to SPSS version 20 for analysis. Univariable and multivariable logistic regression analyses were carried out to estimate odds ratio with 95% confidence interval. A p-value less than 0.05 was used to declare statistical significance.ResultsOverall, 53.8% [95% CI: (48.6, 59.0%)] and 62.7% [(95% CI: (57.7, 67.8%))] of the health professionals (midwives and nurses) had adequate knowledge and good practice on immediate newborn care, respectively. Working in hospital [AOR: 4.62; 95% CI (1.76, 12.10)], being a female [AOR: 0.59; 95% CI (0.39, 0.98)] and interested in providing newborn care [AOR: 0.29; 95% CI (0.13, 0.68)] were positively associated with having adequate knowledge on immediate newborn care. On the other hand, having work experience of < 5 years [AOR: 0.33; 95% CI (0.14, 0.78)], inadequate knowledge [AOR: 0.39; 95% CI (0.25, 0.64)], having work load [AOR: 2.09; 95% CI (1.17, 3.73)], being not interested to provide immediate newborn care [AOR: 0.35; 95% CI (0.16, 0.74)] and working in health center [AOR: 8.56; 95% CI (2.39, 30.63)] were negatively associated with good immediate newborn care practices.ConclusionsA significant number of nurses and midwives had inadequate knowledge and poor practice on immediate newborn care. Therefore, providing a comprehensive newborn care training and creating an opportunity for nurses and midwives working at health centers to share experience from those hired in hospitals are very crucial to improve their knowledge and skills on newborn care.

Background: Iron-folic acid (IFA) intake for the recommended period during pregnancy reduces the risk of anemia and congenital anomalies. However, IFA intake for the recommended period is still very low in low-income countries including Ethiopia. Thus, the aim of this study was to assess both individual-and community-level determinants of IFA intake for the recommended period among pregnant women in Ethiopia. Methods: Data were retrieved from the Demographic and Health Survey program's official database website (htt p://dhsprogram.com). A two-stage stratified cluster sampling technique was employed to conduct the 2016 Ethiopian Demographic and Health Survey. A sample of 3088 pregnant women who had received at least one dose of IFA in Ethiopia were included in this study. A multivariable multilevel logistic regression analysis model was fitted to identify the determinants of IFA intake below the recommended period [< 90 days] during pregnancy. Akaike's Information Criterion (AIC) was used during the model selection procedure. Results: This study revealed that 87.6% [95% CI; 86.3%, 88.6%] of the women took IFA below the recommended period during the index pregnancy. After adjusting for the covariates: living in rural areas [AOR ¼ 1.74: 95% CI 1.37, 2.50], and women's illiterate proportion [AOR ¼ 1.43: 95% CI 1.06, 1.70] were community level factors. Whereas, primary education level [AOR ¼ 0.63: 95% CI 0.40, 0.78], poorer wealth index [AOR ¼ 1.53: 95% CI 1.08, 3.09], 4 þ antenatal care visits [AOR ¼ 0.43: 95% CI 0.31, 0.69], and receive nutritional counseling during pregnancy [AOR ¼ 0.63: 95% CI 0.37, 0.84] were the individual-level factors of IFA intake below the recommended period during pregnancy. Conclusions: In this study, nearly nine out of ten pregnant women did not take IFA for the recommended period. Thus, promoting recommended ANC visits, enhancing the quality of nutritional counseling, strengthening the expansion of media, and educate rural women towards the importance of optimal intake of IFA during pregnancy. Besides, the policymakers should design essential strategies based on identified barriers to improve the IFA intake for the recommended period.

Background In Ethiopia, nearly one-third of people living with human immunodeficiency viruses do not adhere to antiretroviral therapy. Moreover, information regarding non-adherence and its associated factors among adults on first-line antiretroviral therapy in Northeast Ethiopia is limited. Therefore, this study aimed to assess the level of non-adherence and its associated factors among adults on first-line antiretroviral therapy in North Shewa Zone, Amhara Regional State, Ethiopia. Methods A facility-based cross-sectional study was conducted on 326 participants selected by systematic random sampling technique from the five randomly selected public health facilities. Data were collected using the questionnaire adapted from the studies conducted previously and the collected data were entered into Epi data version 3.1 and exported to Stata version 14 for further analysis. Multivariable logistic regression analysis was done and an adjusted odds ratio with its corresponding 95% confidence interval was used to declare a statistical significance. Results The overall prevalence of non-adherence was 17.4% [95% CI: (12.8%, 21.2%)]. Patients with no formal education [AOR (95% CI) = 5.57 (1.97, 15.88)], those who did not use memory aids to take their medications [AOR (95% CI) = 3.01 (1.27, 7.11)], travel more than 10 kilometers to visit the nearby antiretroviral therapy clinics [AOR (95% CI) = 2.42 (1.22, 25.86)], those who used substance [AOR (95% CI) = 3.57 (1.86, 28.69)], and patients whose medication time interfered with their daily routine activities [AOR (95% CI) = 15.46 (4.41, 54.28) had higher odds of having non-adherence to first-line antiretroviral therapy compared to their counter groups. Conclusion The level of non-adherence to first-line antiretroviral therapy was 17.4%, higher compared to WHO’s recommendation. Hence, patients counseling focused on avoiding substance use, use memory aids, and adjusting working time with medication schedule are very crucial. Furthermore, the ministry of health and the regional health bureau with other stakeholders should expand antiretroviral therapy service delivery at health facilities that are close to the community to address distance barriers.

Background Undernutrition is responsible for a significant proportion of maternal and child morbidity and mortality. Lactating women are nutritionally vulnerable groups because this period places a high nutritional demand on the mother and leads to nutritional stress. Poor nutrition during lactation has a significant negative consequence to mothers and children’s survival, growth, and development. Therefore this study aimed to assess the nutritional status of lactating mothers and associated factors in pastoral community, Afar region, Ethiopia. Methods A community-based cross-sectional study was conducted from January 5/2020 to February 10/2020, in the Abala district. The data were collected from a sample of 366 lactating mothers whose children aged less than 24 months. Data was collected through face-to-face interviews and anthropometric measurements. Study participants were recruited using a systematic sampling technique. Anthropometric measurements (both body mass index and mid-upper arm circumference) were taken from each mother using calibrated equipment and standardized techniques. Data were entered into Epi-data version 4.2 and exported to SPSS version 22 for analysis. Predictor variables with a P-value < 0.25 at bivariable analysis were candidates for the final model. Statistical significance was declared at P-value of < 0.05 in the multivariable logistic regression. Result This study showed that 120(32.8%) and 122(33.3%) surveyed mothers were undernourished using a cut-off body mass index <18.5 kg/m2 and mid-upper arm circumference <23 Centimeter, respectively. Lactating mothers who didn’t meet the minimum dietary diversity score were more than five (Adjusted odds ratio (AOR) = 5.103; 95% confidence interval (CI): 2.128, 12.238) times more likely to be undernourished than those who met the minimum dietary diversity score. Mothers with short birth intervals were also more than four (AOR = 4.800; 95% CI: 2.408, 9.567) time more likely to be undernourished. Conclusion Nearly one-third of lactating mothers were undernourished. Undernutrition among lactating mothers was significantly associated with maternal dietary diversity score and birth interval. Health education on proper and adequate maternal dietary feeding practices, and proper family planning utilization during lactation should be emphasized.

Introduction: In Ethiopia, only one in ten reproductive-age women use long-acting reversible contraceptives. Evidence on the utilization of these methods and associated factors among sexually active reproductive-age women in the pastoral area of Northeast Ethiopia is limited. Thus, this study aimed to assess the utilization of long-acting reversible contraceptives and associated factors among sexually active reproductive-age women in the pastoral community of Northeast Ethiopia. Methods: A community-based cross-sectional study was conducted from 1 to 30 April 2021 among 572 reproductive-age women selected by a systematic random sampling method. Data were collected using a structured interviewer-administered questionnaire and entered into Epi-info version 7 and then finally exported to Stata version 16 for further analysis. Bivariable and multivariable binary logistic regression analyses were done to identify factors affecting the utilization of long-acting reversible contraceptives. Odds ratio with the corresponding 95% confidence interval were computed and the statistical significance of the explanatory variables was declared at p-value < 0.05. Results: Overall, the utilization of long-acting reversible contraceptives was (24.3%; 95% confidence interval = 20.9%–28.0%). It was also revealed that being Orthodox (adjusted odds ratio = 4.10; 95% confidence interval = 2.20–7.65) and Protestant (adjusted odds ratio = 7.86; 95% confidence interval = 1.26–18.97) religion followers, attending higher education (adjusted odds ratio = 3.31; 95% confidence interval = 1.37–7.98), and having a husband who attended higher education (adjusted odds ratio = 4.37; 95% confidence interval = 1.98–9.67) were associated with an increased odds of using long-acting reversible contraceptive methods. Besides, having a good (adjusted odds ratio = 6.69; 95% confidence interval = 2.64–16.95) and moderate (adjusted odds ratio = 3.03; 95% confidence interval = 1.06–8.56) knowledge, and positive attitude (adjusted odds ratio = 3.65; 95% confidence interval = 1.90–7.01) toward long-acting reversible contraceptives were also associated with the utilization of these methods. Conclusion: Less than one-fourth of sexually active reproductive-age women in the study area were using long-acting reversible contraceptives. Thus, improving women’s and husbands’ education and women’s knowledge and attitude toward long-acting reversible contraceptives is important to scale up the uptake of these contraceptive methods.

Background In Ethiopia, about two-third of women in the reproductive-age do not use any method of contraception. Moreover, evidence on non-use of contraceptives among women who do not have future fertility desires are limited. Therefore, this study intended to identify both individual and community-level determinants of non-use of contraceptives among this group in Ethiopia using a multilevel mixed effect analysis. Methods Data retrieved from the demographic and health survey program official database website (http://dhsprogram.com) were used in this study. The suvey was conducting using a multistage cluster sampling technique and a weighted sample of 4398 reproductive-age women with no fertility desire was used in this study. Four models were fitted using a multilevel multivariable logistic regression to identify determinants of non-use of contraceptives and model with the lowest Akaike’s Information Criterion was selected as a best fitted model. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the independent variables. Results Overall, 65.3% [95% CI (63.9%, 66.7%)] of women with no fertility desire were not using any contraceptive method. Living in large central [AOR (95% CI)  0.45 (0.31, 0.67)] and metropolitan regions [AOR (95% CI) 0.39 (0.22, 0.68)] and being from household with middle [AOR (95% CI)  0.65 (0.42, 0.93)] and rich wealth index [AOR (95% CI)  0.67 (0.44, 0.98)] were negatively associated with non-use of contraceptives. Besides, being from a community with high women illiteracy [AOR (95% CI)  1.38 (1.15, 1.67)], being Muslim [AOR (95% CI)  1.86 (1.22, 2.85)], having history of pregnancy termination [AOR (95% CI) 1.59 (1.10, 2.31)], having a husband who desire to have more children [AOR (95% CI)  1.46 (1.02, 2.09)] were the positive determinants of non-utilization of contraceptives. Conclusion Nearly two-third of reproductive-age women with no fertility desire in Ethiopia do not use any contraceptive method. Awareness creation interventions on the benefits of contraceptives targeting Muslim religion followers and improving women education and their economic empowerment at household level may decrease the proportion of non-use of contraceptives at a national level.