Background. Ethiopia has one of the highest child malnutrition rates in the world. Food insecurity is one of the determinant factors of malnutrition in developing countries; however its role remains unclear. Objective. To assess household food insecurity and its association with the nutritional status of children 6–59 months of age in East Badawacho District, South Ethiopia. Methods. A community based cross-sectional study was conducted from February 20 to 30, 2014 on a sample of 508 mother/child pairs of 6–59-month-old children. Sample households with eligible children were selected using systematic random sampling technique. Both bivariate and multivariate analysis were used to identify factors associated with nutritional status of children. P value of <0.05 was considered as statistically significant. Result. The prevalence of household food insecurity was 75.8%. The prevalence rates of stunting, underweight, and wasting among children were 45.6%, 26.3%, and 14.6%, respectively. Household food insecurity was significantly associated with underweight (AOR = 3.82; CI = 1.78–8.19) and stunting (AOR = 6.7; CI = 3.71–12.1) but not with wasting. Conclusion and Recommendation. Household food insecurity and the prevalence rates of stunting, underweight, and wasting, among children 6 to 59 months, were high. Intervention programs should focus on improving household food insecurity and nutritional status of children.
Background Community-based health insurance (CBHI) is a risk-pooling approach that tries to disperse health expenditures across families with varying health profiles to provide greater access to healthcare services by allowing cross-subsidies from wealthy to poor populations. It is crucial to assess the level of CBHI enrolment and its determinants in Ethiopia, where government health spending is limited to less than 5% of GDP, far below the Alma Ata Declaration’s benchmark of 15%. Although various epidemiological studies on CBHI enrolment status and its determinants have been undertaken in Ethiopia, the results have been inconsistent, with significant variability. However, no nationwide study assessing the pooled estimates exists today. Furthermore, the estimated strength of association at the country level varied and was inconsistent across studies. Hence, this systematic review and meta-analysis aimed at estimating the pooled prevalence of CBHI enrolment and its determinants in Ethiopia. Methods A comprehensive search of studies was done by using PubMed, EMBASE, Science Direct, HINARI, Scopus, Web of Science, and the Cochrane Library. The database search was complemented by google scholar and some repositories for grey literature. The search was carried out from February 11 to March 12, 2022. The relevant data were extracted using a Microsoft Excel 2013 spreadsheet and analyzed using STATATM Version 16. Studies reporting the level and determinants of CBHI enrolment in Ethiopia were considered. A weighted DerSimonian Laired random effect model was applied to estimate the pooled national prevalence of CBHI enrolment. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A funnel plot, Begg’s and Egger’s tests, were used to check for the presence of publication bias. Results Fifteen studies were eligible for this systematic review and meta-analysis with a total of 8418 study participants. The overall pooled prevalence of CBHI enrolment in Ethiopia was 45.5% (95% CI: 32.19, 58.50). Affordability of premium for the scheme[OR = 2.58, 95% CI 1.68, 3.47], knowledge of respondents on the CBHI scheme[OR = 4.35, 95% CI 2.69, 6.01], perceived quality of service[OR = 3.21, 95% CI 2.04, 4.38], trust in the scheme[OR = 2.32, 95% CI 1.57, 3.07], and the presence of a person with a chronic disease in the household [OR = 3.58, 95% CI 2.37, 4.78] were all found to influence CBHI enrolment. Conclusion Community health workers (CHWs) need to make a high effort to improve knowledge of CBHI in rural communities by providing health education. To deal with the issue of affordability, due emphasis should be placed on building local solidarity groups and strengthening local initiatives to aid poor members. Stakeholders in the health service delivery points need to focus on the dimensions of high service quality. The financial gap created by the adverse selection of households with chronically ill members should be rectified by implementing targeted subsidies with robust plans.
Objective: Preconception care is aimed to promote optimal health in women before conception to reduce or prevent poor pregnancy outcomes. Although there are several published primary studies from sub-Saharan African countries on preconception care, they need to quantify the extent of preconception care utilization, the knowledge level about preconception care, and the association among women in the reproductive age group in this region. This systematic review and meta-analysis aimed to estimate the pooled utilization of preconception care, pooled knowledge level about preconception care, and their association among women in the reproductive age group in sub-Saharan Africa. Methods: Databases including PubMed, Science Direct, Hinari, Google Scholar, and Cochrane library were systematically searched for relevant literature. Additionally, the references of included articles were checked for additional possible sources. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A random-effect meta-analysis model was used to estimate the pooled prevalence of preconception care, knowledge level of preconception care, and their correlation among reproductive-aged women in sub-Saharan African countries. Results: Of the identified 1593 articles, 20 studies were included in the final analysis. The pooled utilization of preconception care and good knowledge level about preconception care among women of reproductive age were found to be 24.05% (95% confidence interval: 16.61, 31.49) and 33.27% (95% confidence interval: 24.78, 41.77), respectively. Women in the reproductive age group with good knowledge levels were greater than two times more likely to utilize the preconception care than the women with poor knowledge levels in sub-Saharan African countries (odds ratio: 2.35, 95% confidence interval: 1.16, 4.76). Conclusion: In sub-Saharan African countries, the utilization of preconception care and knowledge toward preconception care were low. Additionally, the current meta-analysis found good knowledge level to be significantly associated with the utilization of preconception care among women of reproductive age. These findings indicate that it is imperative to launch programs to improve the knowledge level about preconception care utilization among women in the reproductive age group in sub-Saharan African countries.
Pregnancy-related death is a cause for maternal and newborn mortality and morbidity as well as an obstacle for economic growth. Three-quarters of mothers’ lives can be saved if women have access to a skilled health worker at delivery and emergency obstetric care. This evaluation was conducted to assess skilled delivery service implementation level by using three dimensions (availability, compliance, and acceptability) and identify major contributing issues for underutilization of the service. The evaluation design is cross-sectional. The study included 846 mothers who gave birth in Hadiya zone within one year prior to study period, using one year delivery records. Epi Info 3.5.3 and SPSS version 16 were employed for data analysis. Based on selected indicators, resource availability was inadequate for health facilities, human resource medical equipment, and rooms. On the compliance dimension, skilled delivery service coverage (34.8%), active management of third stage labor (32.7%), and health information at discharge and in postnatal care (PNC) visit (7.1%) critically complied with or poorly agreed to the guidelines and targets. Regarding skilled delivery service acceptability, welcoming, privacy keeping, reassurance during labor pain, follow-up, baby care, comfortability (rooms, beds, and clothing), cost of service, and episiotomy (without local anesthesia) were not acceptable.
Background: Childhood underweight is one of the major public health problems in Ethiopia. In Ethiopia, most of the available evidence is related to the general community children, which had different risk and severity levels than orphan children. Even though under-five orphan children have a higher risk of being underweight, they are the most neglected population. Objective: The study aims to determine the prevalence and factors associated with childhood underweight among orphaned preschool children in Southern Ethiopia. Methods: A community-based analytical cross-sectional study was conducted among 367 orphans. The burden of childhood underweight was assessed using World Health Organization standard cutoff points below −2 SD using z-scores. All variables with a p-value of < 0.25 during binary logistic regression analysis were entered into a multivariate logistic regression analysis to identify predictor variables independently associated with underweight at a p-value of 0.05 with 95% CI. Results: In this study, the prevalence of underweight among orphan children was 27.4%. The main factors associated with underweight were female child (adjusted odds ratio (aOR) = 5.29, 95% confidence interval (CI) (2.83–9.92)), adult food as type of first complementary food (aOR = 2.47; 95% CI (1.24–4.94)), food insecurity (aOR = 1.98; 95% CI (1.23–3.21)), and child age from 24–59 months (aOR = 7.19; 95% CI (3.81–13.60)). Conclusion: Childhood underweight is a public health problem in the study area. The sex of a child, type of first complementary food, household food security status, and child age were the major predictors of underweight. Therefore, appropriate dietary interventions, nutrition education, and increased food security status of orphan children are highly recommended.
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