BackgroundDespite the efforts to reduce iron deficiency during pregnancy, information on the coverage and factors associated with utilization of iron supplements is lacking. The study is intended to assess the coverage, compliance and factors associated with the use of prenatal iron supplements in eight rural districts of Ethiopia.MethodsThe study comprised two independent surveys conducted among pregnant women (n = 414) and women who gave birth in the preceding year of the survey (n = 1573). In both cases, respondents were selected using multistage sampling technique and data were collected via structured questionnaire. Predictors of iron supplement utilization (ranked categories of number of prenatal supplements taken) were identified using ordinal logistic regression. The outputs of the analysis are given using adjusted Odds Ratio (OR) with 95% Confidence Interval (CI).ResultsAmong women who gave birth in the preceding year, 35.4% (95% CI: 31.3-39.5) were given/prescribed prenatal iron supplement during the index pregnancy and only 3.5% were supplemented for the recommended 91 or more days. Compared to women who had 4 or more ANC visits, those with 0, 1, 2 and 3 visits had 0.04, 0.33, 0.50 and 0.60 times less odds of iron supplement utilization, respectively. Women lacking comprehensive knowledge of anemia (OR = 0. 75 (95% CI: 0.57-0.97)) and those who weren’t informed about the importance of iron supplementation during the pregnancy (OR = 0. 05 (95% CI: 0.04-0.07)) had significantly lower utilization. On the other hand, in pregnant women the prevalence of anemia was 33.2%. Among pregnant women who were given/prescribed supplements, the average level of compliance was 74.9% and about 25.1% had less than 70% adherence. The leading reported reasons for non-adherence were side-effects (63.3%) and forgetfulness (16.7%).ConclusionPromoting early and frequent ANC, enhancing the quality of ANC counseling and promoting the knowledge of women on anemia are essential strategies for improving the utilization of iron supplements.

BackgroundDietary diversity (DD) is useful indicator of dietary quality and nutrient adequacy. In developing countries limited evidence is available regarding predictors of DD during the critical complementary feeding period. The purpose of the study is to assess DD and predictors among children 6–23 months of age in rural Gorche district, Southern Ethiopia.MethodA community based cross-sectional study was conducted among 417 children aged 6–23 months in Gorche district. The children were selected using a stratified two-stage cluster sampling technique. DD in the preceding day of the survey was assessed using the standard 7-food group score without imposing a minimum intake restriction. Factors associated with DD were identified by modeling dietary diversity score (DDS) using linear regression analysis.ResultsOnly 10.6% (95% CI: 7.6–13.6) of the children had the minimum recommended DD (≥4 food groups). In children born to literate fathers, the DD was increased by 0.26 as compared to their counterparts (p = 0.026). Children from households that grow vegetables and own livestock, the DDS was significantly increased by 0.32 (p = 0.032) and 0.51 (p = 0.001). As the age of the child increases by a month, the DD also increased by 0.04 (p = 0.001). Mothers that received Infant and Young Child Feeding (IYCF) education during their post-natal care, the DDS was increased by 0.21 (p = 0.037). Unit increase in maternal knowledge on IYCF was associated with 0.41 rise in DDS (p = 0.001). Other factors that showed positive association were: mother’s participation in cooking demonstration, exposure to IYCF information on the mass media and husband involvement in IYCF.ConclusionNutrition education, promotion of husbands’ involvement in IYCF and implementation of nutrition sensitive agriculture can significantly enhance DD of children.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0764-x) contains supplementary material, which is available to authorized users.

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BackgroundAccording to the World Health Organization, Caesarean Section (CS) rate (percentage of births managed by CS) exceeding 15% lacks medical justification and it could be linked with adverse maternal and child health consequences. Nonetheless, the rate in Addis Ababa city is beyond the aforementioned level. The objectives of the study were to assess the trend and socio-demographic differentials of CS rate in the city.MethodsThe study was made based on the three Ethiopia Demographic and Health Surveys (EDHS) data (EDHS 2000, 2005 and 2011). The trend over the period of 1995–2010 was assessed using simple linear regression analysis whereas the differentials of CS rate were identified based on DHS 2011 data. CS rates were compared across categories of various socio-economic variables using chi-square test.ResultsThe CS rate increased significantly from 2.3% in 1995–1996 to 24.4% in 2009–2010. From 2003 onwards, it persisted above 15%. The rates among women with secondary (32.3%) or higher (33.3%) levels of education were nearly two times higher than the corresponding figures in the illiterates (14.8%) and women with primary education (15.8%) (P < 0.001). The level among women from the ‘rich’ households (28.6%) was higher than those from the ‘poor’ (16.4%) and ‘middle’ (19.5%) households (P = 0.016). The rate also significantly increased with rising parity (P = 0.023). The rate among women who delivered in private health institutions (41.7%) was twice higher than their counterparts who delivered in public institutions (20.6%).ConclusionThe CS rate in Addis Ababa has exceeded beyond the level recommended by the WHO. Accordingly, It should be maintained within the optimum 5-15% range by introducing medical audit for labor management both in the private and public health institutions. Further, during prenatal care pregnant women should be fully informed about the risks of medically unjustified CS.

Background In Ethiopia, limited information is available about the epidemiology of over-nutrition. This study assessed the prevalence of, and factors associated with overweight and obesity among adults in Hawassa city, Southern Ethiopia. Methods A community-based cross-sectional survey was conducted in August 2015 in the city. A total of 531 adults 18–64 years of age were selected using multistage sampling approach. Interviewer administered qualitative food frequency questionnaire was used to assess the consumption pattern of twelve food groups. The level of physical exercise was measured via the General Physical Activity Questionnaire (GPAQ). Based on anthropometric measurements, Body Mass Index (BMI) was computed and overweight including obesity (BMI of 25 or above) was defined. For identifying predictors of overweight and obesity, multivariable binary logistic regression model was fitted and the outputs are presented using Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CI). Results The prevalence of overweight including obesity was 28.2% (95% CI: 24.2–32.2). Significant proportions of adults had moderate (37.6%) or low (2.6%) physical activity level. As compared to men, women had 2.56 (95% CI: 1.85–4.76) times increased odds of overweight/obesity. With reference to adults 18–24 years of age, the odds were three times higher among adults 45–54 (3.06, 95% CI: 1.29–7.20) and 55–64 (2.88, 95% CI: 1.06–7.84) years. Those from the highest income tercile were 3.16 times (95% CI: 1.88–5.30) more likely to be overweight/obese as compared to adults from the lowest tercile. Having moderate (3.10, 95% CI: 1.72–5.60) or low (4.80 95% CI: 2.50–9.23) physical activity was also significantly associated with the outcome. Further, daily intake of alcohol and, frequent consumption of sweets, meat and eggs were associated with overweight/obesity. Conversely, no significant associations were evident for meal frequency, practices of skipping breakfast, behavior of eating away from home and frequency of consumption of fast foods, fruits and vegetables. Conclusions Prompting active lifestyle, limiting intakes of sweets, advocating optimum consumption of alcohol and calorie dense animal source foods, especially amongst the better-off segment of the population, may reduce the magnitude of over-nutrition. Electronic supplementary material The online version of this article (10.1186/s40608-019-0227-7) contains supplementary material, which is available to authorized users.

Background: Globally, 41.8% of pregnant women and 30.2% of non-pregnant women are anemic. Previous studies which attempted to identify determinants of anemia among women of reproductive age reported conflicting findings. Objective: To assess the correlates of anemia among women of reproductive age in Ethiopia. Methods: A quantitative cross-sectional study carried out based on the secondary data of the Ethiopia Demographic Health Survey (EDHS) 2005. Data of a total of 5963 women of reproductive age were included in the analysis. Data were mainly analyzed using ANOVA and binary logistic regression. Result: The prevalence of anemia was 27.4% (95% CI: 26.3-28.5%). Rural residence, poor educational and economic status, 30-39 years of age and high parity were key factors predisposing women to anemia. Lactating women and those who gave birth in the month of the interview had 1.3 (p = 0.000) and 2.2 (p = 0.012) times higher risk than their counterparts. Those not using contraceptive were 1.4 times (p = 0.02) more likely to develop anemia than current contraceptive users. The average Dietary Diversity Score (DDS) was only 4.01, and not more than 15% of the respondents consumed iron rich foods in the preceding day of the survey. Respondents with low DDS and those who did not consume iron rich foods in the reference period had significantly higher risk of anemia with odds ratio of 1.3 (p = 0.01) and 1.3 (p = 0.002), respectively. Utilizing maternity services, taking iron and vitamin A supplement during pregnancy and postpartum period, respectively, didn't have a significant effect in reducing the burden of anemia. Recommendation: Family planning, economic and educational empowerment of women have affirmative inputs in combating anemia. A combination of nutrition, educational and livelihood promotion strategies should be instated to enhance dietary diversity. Maternal nutrition interventions should be integrated in a stronger manner into maternity services. [Ethiop.

Background Dietary diversity (DD) is among the core infant and young child feeding (IYCF) indicators. However, in many developing countries, meeting the minimum standards of DD is challenging and information concerning its determinants is limited. Objective To assess the level and predictors of DD among children aged 6–23 months in rural communities of Aleta Wondo district, Sidama zone, Southern Ethiopia. Method A community-based cross-sectional study was conducted in rural Aleta Wondo in February 2016. Multistage sampling was employed to recruit 502 children aged 6–23 months. DD was assessed by asking the mother whether the index child had received food from the standard seven food groups in the previous day, without setting minimum intake restrictions. Ultimately, the dietary diversity score (DDS) was rated on a 7-point scale, and it was modeled using linear regression analysis. The outputs are presented using adjusted regression coefficients (β). Results Only 12.0% (95% confidence interval: 9.0–15.0%) of the children met the minimum recommended DD, receiving from four or more from seven food groups. The analysis identified eleven significant predictors of DDS. As the maternal knowledge of IYCF increases by a unit, DDS raised by 0.21 units (p = 0.004). Unit increment in the husband's involvement in the IYCF score was linked with 0.32 units improvement in DDS (p = 0.016). One unit change in the ordinal category of household food insecurity was associated with 0.13 reduction in DDS (p = 0.001). Similarly, household wealth index (β = 0.54, p = 0.041), father's literacy (β = 0.48, p = 0.002), ownership of home garden (β = 0.38, p = 0.01), mother's participation in cooking demonstrations (β = 0.19, p = 0.036), and child age in months (β = 0.04, p = 0.001) were all positively associated with DDS. Furthermore, receiving IYCF information via mass media (β = 0.04, p = 0.001) and during antenatal (β = 0.91, p = 0.022) and postnatal checkups (β = 0.21, p = 0.043) were positive predictors of DDS. Conclusions Promoting the socioeconomic status of the community, strengthening of home gardening, involving husbands in IYCF, and enhancing maternal knowledge of IYCF may advance DD.

ObjectiveTo determine the prevalence and differentials of overweight/obesity (body mass index (BMI)-for-age z-score >2) in preschool children in Sub-Saharan Africa (SSA).DesignCross-sectional study.SettingThe study was conducted on the basis of the data of 26 Demographic and Health Surveys carried out in SSA since 2010.ParticipantsThe records of 155 726 children aged 0–59 months were included in the analysis.Primary outcomeOverweight/obesity.ResultsThe prevalence of overweight/obesity was 6.8% (95% CI 6.7% to 6.9%). Among the countries represented, higher figures were reported in Sierra Leone (16.9%), Comoros (15.9%) and Malawi (14.5%), whereas lower prevalence was found in Ethiopia (3.0%), Togo (2.6) and Senegal (2.0%). In 11 of the countries, overweight/obesity was more prevalent than wasting. It is estimated that in the whole subcontinent, 10.7 million children were affected by the problem. The prevalence of overweight/obesity was slightly higher in boys than in girls. Overweight/obesity was three times more frequent in stunted children than in normal children. The risk also significantly increased with increasing maternal BMI and birth weight and decreased with increasing maternal age, maternal education, child's age and number of siblings. On the other hand, no significant association was observed with national gross domestic product per capita, place of residence (urban–rural) and household wealth index.ConclusionChildhood overweight/obesity has become a sizeable problem in the subcontinent.