Background Implanon discontinuation closely related to higher rates of overall fertility rate, unwanted pregnancies, and induced abortion. This might have social and economic consequences. In Ethiopia the magnitude of early Implanon discontinuation and contributing factors is not well studied. Objective To assess early Implanon discontinuation and associated factors among Implanon user women in Debre Tabor town, 2016. Methods A facility based cross-sectional study was conducted from May 1 to August 2016 through face-to-face interview. A total of 449 Implanon user women were selected by systematic random sampling technique. Epi Info version 7 and SPSS version 20 were used for data entry and analysis, respectively. Factors associated with early Implanon discontinuation were analyzed using binary and multivariable logistic regression model. Variables with p value of <0.05 and 95% confidence interval were considered as statistically significant. Results The overall proportion of early Implanon discontinuation among mothers was 65 % (95%, CI: 60.4%–69.5%). Having no children (AOR = 2.0, 95% CI = [1.3–4.5]), being not counseled for possible side effects (AOR = 1.50, 95% CI = [1.1–3.4]), having no appointment for follow-up (AOR = 2.6, 95% CI = [1.2–4.3]), and having developing side effects (AOR = 1.7, 95% CI = [1.5–4.4]) were found to be statistically significant factors associated with early Implanon discontinuation. Conclusion and Recommendation Early Implanon discontinuation among mothers was found to be high. Hence, counseling about Implanon side effects and appointment for follow-up of Implanon users should be made to increase Implanon retention.

Background. Postpartum depression is an umbrella, which encompasses several mood disorders that follow childbirth within 6 weeks. Screening for postpartum depression would improve the ability to recognize these disorders and enhance care that ensures improved clinical outcomes. Early identification of postpartum depression is important in order to plan for implementation strategies that allow for timely treatment and support of women with postpartum depression. Objective. To determine the prevalence and associated factors of postpartum depression among women who gave birth in the last six weeks in Gondar town, Northwest Ethiopia, 2018. Methods. A community based cross-sectional study was conducted among 526 women who gave birth in the last 6 weeks from July 1 to 30, 2018 in Gondar town. Cluster sampling technique was used. Data were collected by semi-structured and pretested questionnaire and entered into epi-Info version 7.0 and then analyzed by SPSS version 20.0. Both bivariate and multivariable logistic regression model were fitted. Adjusted odds ratio with 95% confidence interval has been computed and variables with p-value <0.05 were considered statistically significant. Results. The prevalence of postpartum depression among 526 postnatal women was 25% (95% CI: 21, 28). Abortion history (AOR = 1.79, 95% CI: 1.07, 2.97), birth weight <2.5 kg (AOR = 3.12, 95% CI: 1.78, 5.48), gestational age below 36 weeks (AOR = 2.18, 95% CI: 1.22, 3.88) unplanned pregnancy (AOR = 2.02, 95% CI: 1.24, 3.31), relatives’ mental illness (AOR = 1.20: 1.09–3.05), had no antenatal visit (AOR = 4.05, 95% CI: 1.81, 9.05), had no postnatal visit (AOR = 1.82, 95% CI: 1.11, 3.00) were factors significantly associated with postpartum depression. Conclusion and Recommendations. The prevalence of PPD was found to be higher. Variables like abortion history, low birth weight, gestational age below 36 weeks, unplanned pregnancy, relatives’ mental illness, had no antenatal visit, and had no postnatal visit were predisposing factors to postpartum depression. Preventive measures to avoid low birth weight and pregnancy complications are also identified as proactive ways to reduce postpartum depression. Early identification and treatment of depression during ANC and postpartum care can mitigate the impact of PPD on the mother-baby dyad. Emphasis must be given women to have ANC and PNC follow up.

Introduction: Maternity continuum of care is the continuity of maternity health care services that a woman uses antenatal care, skill birth attendant, and postnatal care. This Continuum of care in maternal health has become one of the government concern and program for planning and evaluating strategies within currently existing maternal health system of Ethiopia. It is an important intervention in reducing maternal and neonatal morbidity and mortality. However, there is no clear information on the proportion of dropout from maternity continuum of care in Ethiopia. Objective:The aim of this study was to assess proportion and associated factors of dropout from maternity continuum of care among mothers who gave birth in the last 12 months in Debre Markos town, Northwest Ethiopia, 2018. Methods:A community-based cross-sectional study with cluster sampling technique was conducted among 605 mothers who gave birth in the last 12 months in Debre Markos town. The data were collected from August 1-30/ 2018 by face to face interview through pretested and semi-structured questionnaire. Binary logistic regressions (Bivariable and Multivariable) logistic regression model were done. In multivariable analysis variables with P-value < 0.05 in 95% confidence interval for Adjusted odds ratio (AOR) was used to determine factors associated with dropout from maternity continuum of care. Results:The proportion of drop out from maternity continuum of care was found to be 32.2 %( 95%CI: 28.4-36.2). Have not exposure to media (AOR= 2.62, CI: 1.465-4.675), women who heard about PNC (AOR= 0.07, 95%CI: 0.035-0.154), unplanned pregnancy (AOR= 3.40, CI: 1.114-10.389), and having<4 ANC follow up (AOR = 3.0 3, CI: 1.963-4.685) were statistically significant variable with the dropout from maternity continuum of care. Conclusion and recommendationsIn this study, the proportion of dropout from maternity continuum of care is found to be high. The greatest gap and predictors for dropout was observed at postnatal care level, to reduce this drop out interventions on specified associated factors need to be implemented.

Introduction. Midwifery training needs intensive skill practice. Simulation based teaching is found to be a good alternative to fill skill teaching gaps and to safeguard human patients. Objective. To assess self-efficacy, learner satisfaction, and associated factors of simulation based education among Midwifery students in Gondar University, 2015. Methods. Cross-sectional study was conducted among Midwifery students. A total of 144 students participated in the study. SPSS version 20 statistical software was used for analysis. Binary and multivariable logistic regression analysis were done to assess associations of explanatory variables with outcome variables. Finally the strength of association was determined by adjusted odds ratio with 95% confidence interval and value < 0.05. Result. In this study the proportion of satisfaction and confidence in simulation learning was 54.2% and 50.7% among participants, respectively. Students who perceived instructors' assistance during skill practice as "good" showed statistically significant satisfaction, while those students who were satisfied and perceived instructors' assistance as "good" showed statistically significant confidence during skill practice. Conclusion and Recommendation. levels of satisfaction and self-efficacy of simulation based teaching among Midwifery students are low. Designing a mechanism to improve instructors' assistance at simulation based teaching is recommended.

Background Birth-preparedness and complication readiness is a comprehensive strategy aimed at promoting the timely utilization of skilled maternal and neonatal health care. Pregnancy-related complications both on the mother and the newborn could be largely alleviated if there is a well-consolidated birth preparedness and complication readiness plan developed during pregnancy and implemented at the time of delivery. Objective To determine the prevalence of birth preparedness and complication readiness practice (BPCR) and associated factors among pregnant women in North Gondar Zone, Northwest Ethiopia, 2018. Methods A community based cross-sectional study was conducted among pregnant women in North Gondar Zone from March 2017 to February 2018. A multistage clustered sampling technique was used to enroll a total of 1620 participants. The data were collected by face to face interviews using pretested and semi-structured questionnaires at baseline and following delivery. The data were entered using EPI-data version 3.1 and analyzed using STATA version 14 software. Bivariate and multivariable logistic regression model was fitted to assess factors with BPCR practice. Adjusted odds ratio (AOR) with 95% confidence interval was used to determine the association between covariates and the outcome variable. Results From a total of 1620 pregnant women only 1523 (94.0%) mothers were followed at the end line. The prevalence of BPCR plan during pregnancy was 66.1% [95% CI: 63.8, 68.5] and the practice at the time of delivery was 73.5% [95% CI 71.3, 75.7]. Of the total respondents who mentioned having a BPCR plan, 76.4% practiced at the time of delivery. Frequency of ANC visits [AOR = 1.97; 95% CI: 1.67, 2.32], larger number of family in the household [AOR = 1.14; 95%CI: 1.00, 1.30], highest wealth asset [AOR = 1.87; 95%CI: 1.16, 3.01], Multigravidity [AOR = 0.30; 95% CI: 0.15, 0.62], husband involvement in decision making [AOR = 2.2; 95% CI: 1.25, 3.82], counseled on BPCR [AOR = 2.35; 95% CI: 1.51, 3.68], were found to be significantly associated with BPCR practice. Conclusion BPCR practice at the time of delivery was higher than previous studies conducted in the country. However, BPCR practice was found to be lower than the standard that every woman should practice the plan at the time of delivery. Intersectoral collaborative interventions required to improve the economic status and living standard of families in the community as well as various awareness creation strategies should be implemented to support women to attend ANC follow-up visits.

Background. Life-threatening situations might arise unexpectedly during pregnancy. Maternal near-miss can be a proxy for maternal death and explained as women who nearly died due to obstetric-related complications. It is recognized as the predictor of level of care and maternal death. Maternal near-miss evaluates life-threatening pregnancy-related complications, and it directs the assessment of the quality of obstetric care. Objective. To determine the proportion and factors associated with maternal near-miss at maternity wards at the University of Gondar Referral Hospital, Northwest Ethiopia, 2019. Methods. A cross-sectional study design was carried out from March 1 to June 20, 2019, using WHO criteria for maternal near-miss at the University of Gondar Referral Hospital. The data are from the interviews and review of 303 systematically selected participants’ medical files at maternity wards. Bivariate and multivariable logistic regression analyses were performed to analyze factors associated with maternal near-miss, including estimation of crude and adjusted odds ratios and their respective 95% confidence intervals and p value less than 0.05 through SPSS version 20. Result. The study revealed that the proportion of maternal near-miss was found to be 15.8% (95%CI=11.9%-20.1%). In the adjusted analyses, maternal near-miss was significantly associated with low (≤1000 ETB) monthly income (AOR=399; 95%CI=1.65, 9.65), seven or more days of hospital stay (AOR=5.43; 95%CI=2.49, 11.83), vaginal bleeding (AOR=2.75, 95%CI=1.17, 6.47), and pregnancy-induced hypertension (AOR=5.13; 95%CI=2.08, 12.6). Conclusion and Recommendation. The near-miss proportion was comparable to that in the region. Associated factors were low monthly income, seven or more days of hospital stay, vaginal bleeding, and pregnancy-induced hypertension. Thus, giving attention on early identification and treatment of these potential factors can be the opportunity in the reduction of maternal morbidity and mortality.

Background The majority of maternal deaths occur during delivery and the immediate postnatal period as a result of delays in seeking care, failure to reach health institutions, and receiving inappropriate health care. In developing countries, delayed access to timely healthcare contributes to high maternal mortality and morbidity. Objective This study aimed to assess the delays during emergency obstetric care and associated factors with delays during emergency obstetric care. Method A cross-sectional study design was conducted. We chose five hospitals at random in the South Gondar zone, Ethiopia. Face-to-face Interviews were conducted with 459 participants using a systematic sampling technique. For this analysis, bi-variable and multivariable logistic regression models were used. The Adjusted Odds Ratio was used to determine the statistical association with delays during emergency obstetric care at p-value <0.05 with a 95% confidence interval. Results The proportion of delays during emergency obstetric care were found to be 59.7% in this study. The respondents’ mean age was 27.23 years old, with a standard error of 5.67. Pregnant mothers living in the rural areas (AOR: 4.1, 95%, CI: 2.36 to 6.25), no ANC visit (AOR: 1.8, 95% CI: 1.32 to 3.18), uneducated women (AOR: 4.6, 95% CI: 2.45 to 8.59) and referral to a higher level of care (AOR: 2.7, 95% CI: 1.60 to 4.44), were all significantly associated with delay. Conclusion Delay during emergency obstetric care was found to be 59.7 percent. Rural residency, absence of ANC visit, uneducated mothers, and referred mothers from one level to the next level of care were factors that contributed to delays in emergency obstetric care in the study area.

Introduction mental health during pregnancy is a very important but neglected problem in most African countries including Ethiopia. In general, there was a scarce of studies on antenatal depression at the community level in Ethiopia. Therefore, this study was aimed at assessing the prevalence and correlates of antenatal depression among postpartum women in Gondar city, Northwest Ethiopia. Methods a community-based cross-sectional study was conducted in Gondar city among 526 women from July 01 st to 30 th /2018. A cluster sampling technique was employed and an interviewer-administered semi-structured questionnaire was utilized to collect the data. The data were entered into Epi-info version 7.0 and exported to SPSS version 20. Both bivariate and multivariable logistic regression analyses were performed. The level of statistical significance was declared based on the AOR with 95% CI and P-value ≤0.05. Results the prevalence of ante partum depression was 24.1% (95% CI: 20.5-27.5) and it was independently predicted by relatives’ mental illness (AOR = 2.30; 95% CI: 1.17-4.53), sex preference (AOR = 1.80; 95% CI: 1.07-3.02), lack of relatives’ support (AOR = 2.07; 95% CI: 1.12-3.87), unhappy marriage (AOR = 2.94; 95% CI: 1.81-4.76), history of depression (AOR = 5.23; 95% CI: 2.87-9.50) and no or one alive child (AOR = 1.78; 95% CI: 1.13-2.79). Conclusion the prevalence of ante partum depression was high and connected to poor psycho-social experiences. Therefore, building-up of family's network, fortifying relatives' support, resolving unhappy spousal relationships, and assuming early screening and intervention would degrade its burden.