BackgroundExclusive breastfeeding is giving only breast milk to an infant from birth up to six months of age, with the exception of medications and vitamins. For the first six months of life, breast milk alone is the ideal nourishment to meet the nutritional demand of the growing child. Although breastfeeding is a universal practice, in Ethiopia only 52% of children aged less than six months old were exclusively breastfed. The study aimed to investigate the predictors of exclusive breastfeeding duration among women who had children aged between 6–12 months in Gurage zone, South Ethiopia.MethodsA mixed method cross-sectional study was conducted to assess predictors of exclusive breastfeeding duration in south Ethiopia. Eight hundred and twenty eight study participants were recruited using a multistage sampling technique for the quantitative survey. Interviewer administered close ended questionnaire was used to collect the quantitative data. Data were entered using Epi Data and analyzed using SPSS version 21. The Kaplan-Meier curve with log rank test was used to compare the survival difference due to the selected covariates. A binary and multivariable Cox regression model was used to identify the independent predictors of exclusive breastfeeding duration. Three focus group discussions were conducted to generate the qualitative data. Qualitative data is transcribed and analyzed by thematic approach using open-code software.ResultsThe median duration of exclusive breastfeeding was six months. About 21.9% of women introduced complementary food before six months of child age. Women with education status of diploma and above (Adjusted Hazard Ratio [AHR]: 2.89, 95% CI: 1.05, 7.97), perceived inadequate breast milk (AHR: 11, 95% CI: 6.7, 18.0) and cesarean section delivery (AHR: 3.8, 95% CI: 2.0, 7.2) were more likely to cease exclusive breastfeeding before six months of child age; while women who had infant feeding counseling during postnatal care (AHR: 5.1, 95% CI: 2.5, 10.23) were less likely to cease exclusive breastfeeding before the child was six months of age.ConclusionsA significant proportion of women cease exclusive breastfeeding before the recommended six months duration. Maternal education of diploma and above, perceived inadequacy of breast milk, cesarean section delivery, postnatal counseling on child feeding are factors significantly associated with the duration of exclusive breastfeeding. Encouraging behavioral change and improving communication regarding the duration of exclusive breastfeeding, and increasing the utilization of postnatal counseling about exclusive breastfeeding are recommended.

BackgroundMaternal mortality and morbidity remain unacceptably high in developing countries. Behind every maternal death, many other women suffered from acute and chronic obstetric complications. Women who survive severe acute maternal morbidities/near miss have many characteristics in common with maternal death events particularly on risk factors. Ethiopia is among countries with high maternal mortality and morbidities in sub-Saharan Africa. However there is scarce evidence on risk factors of severe acute maternal morbidities in Ethiopia. Therefore this study aimed to identify predictors of maternal near miss among women admitted in Gurage zone hospitals, south Ethiopia, 2017.MethodsHospital based case control study was conducted to assess predictors of maternal near miss among women admitted in five hospitals of Gurage zone, South Ethiopia. Data of 229 (77 cases and 152 controls) women were included in the analysis. Cases were women admitted due to severe acute maternal morbidity while controls were women admitted for normal labor or women admitted due to mild to moderate obstetric complications. Cases were identified by validated-disease specific criteria. Then, two controls were selected for each verified case using lottery method among eligible women.Data were collected using interviewer administered questionnaire and reviewing patients’ records. Data were entered using Epi Info 7 and analyzed by SPSS 21. Multivariable logistic regression analysis was done to identify independent predictors of maternal near miss.ResultMajority of cases were admitted due to dystocia (57.1%) and obstetric hemorrhage (26%). The median first delay (delay to seek health care) among cases and controls was six and 4 h respectively. Prior history of cesarean section {AOR 7.68, 95%CI, 3.11–18.96}, first delay {AOR 2.79, 95%CI, 1.42–5.50}, and being referred from other health facilities {AOR 7.47, 95% CI, 2.27–24.51} were independent predictors of maternal near miss.ConclusionsPrior history of cesarean section, being referred from other health facilities and first delay were factors associated with maternal near miss. Timely health care seeking behavior of women is uncommon in the study area. Therefore primary health care programs need to enhance the existing efforts to improve timely health care seeking behavior of women.

BackgroundGlobally, an estimated 289,000 maternal deaths occurred in 2013. Majority of these deaths occurred in sub-Saharan Africa and Southern Asia. Mobility of pastoralists is a well-recognized survival strategy in arid and semi-arid land of sub-Saharan Africa. However governments often encourage settlement as a solution to the difficulty of providing health services for mobile pastoralists. This study aimed to assess utilization of institutional delivery and associated factors among women of reproductive age in the mobile pastoral community of the Liban District in Guji zone, Oromia, Ethiopia.MethodsA Community based cross-sectional survey was conducted among the mobile pastoralist community of the Liban District. Seven hundred ninety-one (791) randomly selected women, who had birth within the last 2 years preceding the survey, were interviewed using a pretested structured questionnaire. Data were entered into Epi-Info version 3.5.4 and analyzed by Statistical Package for Social Science (SPSS) version 16. Bivariate and multivariate analyses were done.ResultsOut of 791 women who gave birth within the last 2 years preceding the survey, only 110 (13.9%) gave birth in health institutions. Majority (74.1%) of the women gave birth at their home. Ninety-one women (11.5%) gave birth at traditional birth attendant’s home; assisted by traditional birth attendants. Multiple logistic regression shows that women who had readily available cash at the onset of labor (aOR 2.79, 95% CI: 1.29–6.25), delivered the birth preceding the most recent birth in a health institution (aOR 6.8, 95% CI: 3.44–13.45) and had birth related complications during the birth preceding the most recent birth (aOR 1.90, 95% CI: 1.08–3.36) were more likely to deliver at health institutions.ConclusionMajority of the pastoral women seek institutional delivery, only when labor related complications are perceived. Mechanisms of alleviating indirect health care costs affecting institutional delivery need to be addressed in future studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1325-5) contains supplementary material, which is available to authorized users.

Objectives: Globally, novel coronavirus disease 2019 (COVID-19) has spread rapidly since it was first identified and challenging the provision of essential services for low-resource countries. Healthcare workers involved in providing care are at high risk of developing mental health problems. The aim of this was to determine the prevalence of depressive symptoms due to COVID-19 and associated factors among healthcare workers in the West Guji zone in public health facilities, southern Ethiopia. Methods: A facility-based cross-sectional study was conducted in public health facilities found in the West Guji zone. A simple random sampling technique was employed to select 283 study subjects. This study was used to assess the prevalence of depression symptoms using Depression, Anxiety and Stress Scale-21, a depression subscale. Descriptive statistics, binary and multiple logistic regressions were used. Adjusted odds ratios (AORs) with 95% confidence interval will be estimated to assess the strength of associations and statistical significance will be declared at a p-value < 0.05. Results: Out of 283 eligible healthcare workers, 275 respondents had participated in this study with a 97.2% response rate. The prevalence of depressive symptoms was 21.5%. The independent predictors associated with depressive symptoms due to COVID-19 were age (adjusted odds ratio = 2.35, 95% confidence interval = 1.126–3.95), family size (adjusted odds ratio = 3.56, 95% confidence interval = 1.09–11.62), alcohol use (adjusted odds ratio = 4.31, 95% confidence interval = 1.76–10.55), medical illness (adjusted odds ratio = 9.56, 95% confidence interval = 3.71–24.59), having training on COVID-19 (adjusted odds ratio = 0.37, 95% confidence interval = 0.17–0.81), and lack of knowledge on COVID-19 (adjusted odds ratio = 15.34, 95% confidence interval = 6.32–37.21). Conclusion: The prevalence of depressive symptoms among healthcare workers due to COVID-19 was high. Factors associated with depressive symptoms were age, family size, alcohol use, medical illness, having training on COVID–19, and lack of knowledge on COVID-19.

BackgroundEarly initiation of breast feeding (EIBF) and exclusive breast feeding (EBF) are the cheapest, feasible and simplest nutritional interventions for infants. Effects of maternal education on EIBF and EBF are not consistent across studies. This study assessed the effects of maternal education on EIBF and EBF.MethodsA cross-sectional study was done based on data collected for phase 7 Demographic and Health Surveys conducted in 16 sub-Saharan African countries from 2015 to 2019. Data of the last-born children younger than 6 (n=19 103) and 24 (n=75 293) months were analysed to assess associations between maternal education and EIBF and EBF practices, respectively. To assess the associations, X2 test and logistic regression were done. Adjusted ORs (AORs) and their 95% CIs were used to declare statistical significance of the associations.ResultsAfter controlling for all other potentially confounding variables, mothers who completed primary school were 1.29 (95% CI AOR: 1.24 to 1.34) times more likely to initiate breast feeding within the first 1 hour of delivery compared with mothers without education. However, mothers with secondary (AOR: 1.01; 95% CI: 0.96 to 1.06) or higher (AOR: 0.96; 95% CI: 0.87 to 1.05) level of education were not significantly different from mothers without education concerning EIBF. Similarly, mothers educated to primary school were 1.37 (95% CI AOR: 1.27 to 1.48) times more likely to exclusively breast feed compared with mothers without education. However, mothers educated to secondary (AOR: 1.07; 95% CI: 0.98 to 1.17) or higher (AOR: 1.07; 95% CI: 0.89 to 1.27) level of education were not significantly different from uneducated mothers regarding EBF practices.ConclusionsEffects of maternal education on EIBF and EBF depend on the level of educational attainment. Future studies should look for reasons for the lower rate of EIBF and EBF among mothers with higher educational status.