Background Substantial global progress has been made in reducing under-five mortality since 1990, yet progress is insufficient to meet the sustainable development goal of 2030 which calls for ending preventable child deaths. There are disproportional survivals among children in the world. Therefore, the study aimed to assess the Survival status of under-five mortality and determinants in Sub-Saharan African Countries using the recent DHS data. Methods The data was retrieved from the birth record file from the standard Demographic and Health Survey dataset of Sub-Saharan Africa countries. Countries that have at least one survey between 2010 and 2018 were retrieved. Parametric shared frailty survival analysis was employed. Results A total of 27,221 (7.35%) children were died before celebrating their fifth birthday. Children at an early age were at higher risk of dying and then decrease proportionally with increased age. The risk of death among rich and middle family were lowered by 18 and 8% (AHR =0.82, 95% CI: 0.77-0.87) and (AHR = 0.92, 95% CI: 0.87-0.97) respectively, the hazard of death were 11, 19, 17, 90 and 55% (AHR = 1.06, 95% CI: 1.00-1.12), (AHR = 1.11,95%CI:1.04-1.19), (AHR = 1.17, 95% CI:1.12-1.23), (AHR = 1.90, 95%CI: 1.78-2.04) and (AHR = 1.55, 95% CI:1.47-1.63) higher than among children in rural, use unimproved water, delivered at home, born less than 18 months and between 18 and 23 months birth intervals respectively. The hazard of death was 7% among females and low birth weights (AHR = 0.93, 95%CI: 0.90 – 0.97) and (AHR = 0.93 95%CI: 0.89-0.97) respectively. There was also a significant association between multiple births and birth orders (AHR = 2.11, 95%CI: 2.51 – 2.90), (AHR = 3.01, 95%CI: 2.85-3.19) respectively. Conclusions Death rate among under-five children was higher at an early age then decreases as age advanced. Wealth status, residence, water source, place of delivery, sex of the child, plurality, birth size, preceding birth interval, and birth order were the most predictor variables. The health care program should be designed to encourage a healthy family structure. The health care providers should intervene in the community to inspire maternal health services.
Background Person-centered maternity care is providing care that is respectful and responsive to individual women’s preferences, needs, and values and ensuring that their values guide all clinical decisions during childbirth. Although person-centered health care is one of the factors that increase client satisfaction and increased health service utilization in Ethiopia, little is known about predictors of person-centered maternity care. Therefore, the aim of this study was to identify the determinant factors of person-centered maternity care among mothers who gave birth in selected health facilities in Dessie town, Northeastern, Ethiopia. Methods A community-based cross-sectional study was conducted with a total of 317 study participants at Dessie town selected by a simple random sampling technique. The data was coded and entered Epi-data version 4.4 and analyzed using SPSS version 23. Descriptive statistics was presented using tables and figures. Multivariable linear regression analysis was used to identify factors associated with Person-Centered Maternity Care. Two sides P-value < 0.05 was taken to declare statistically significant. Results Overall, 310 study participants participated with a response rate of 97.8%. In multivariable linear regression, rural residence (β = -4.12; 95% CI: -7.60, -0.67), family average monthly income ≤ 3000 birr (β = -6.20, 95% CI: -9.40, -3.04), night time delivery(β = -2.98, 95%CI: -5.90, -0.06), dead fetus outcome during delivery (β = -12.7; 95% CI: -21.80, -3.50), and 2–7 days health facility length of stay (β = -5.07, 95% CI: -9.20, -0.92) were significantly decreased Person Center Maternity Care score, whereas private health institution delivery (β = 14.13, 95% CI: 7.70, 20.60) is significantly increased Person centered maternity care score. Conclusions This study revealed that most of the factors that affect person-centered maternity care are modifiable factors. Therefore, Primary attention should be given to improve the quality of care through effective communication between clients and providers at each level of the health care delivery system to increase the uptake of high-quality facility-based births.
IntroductionGlobally, opportunistic infections are the leading causes of morbidity and mortality among HIV-infected children, contributing to more than 90% of HIV-related deaths. In 2014, Ethiopia launched and began to implement a “test and treat” strategy aiming to reduce the burden of opportunistic infections. Despite this intervention, opportunistic infections continue to be a serious public health issue, with limited evidence available on their overall incidence among HIV-infected children in the study area.ObjectiveThe study aimed to assess the incidence of opportunistic infections and to identify predictors of their occurrence among HIV-infected children receiving antiretroviral therapy at Amhara Regional State Comprehensive Specialized Hospitals in 2022.MethodsA multicenter, institution-based retrospective follow-up study was conducted among 472 HIV-infected children receiving antiretroviral therapy at Amhara Regional State Comprehensive Specialized Hospitals from May 17 to June 15, 2022. Children receiving antiretroviral therapy were selected using a simple random sampling technique. Data were collected using national antiretroviral intake and follow-up forms via the KoBo Toolbox. STATA 16 was used for data analyses, and the Kaplan–Meier method was used to estimate probabilities of opportunistic infection-free survival. Both bi-variable and multivariable Cox proportional hazard models were employed to identify significant predictors. A P-value <0.05 was taken to indicate statistical significance.ResultsMedical records from a total of 452 children (representing a completeness rate of 95.8%) were included and analyzed in the study. The overall incidence of opportunistic infections among children receiving ART was 8.64 per 100 person-years of observation. The predictors of elevated incidence of opportunistic infections were: a CD4 cell count below a specified threshold [AHR: 2.34 (95% CI: 1.45, 3.76)]; co-morbidity of anemia [AHR: 1.68 (95% CI: 1.06, 2.67)]; ever having exhibited only fair or poor adherence to ART drugs [AHR: 2.31 (95% CI: 1.47, 3.63)]; never having taken tuberculosis-preventive therapy [AHR: 1.95 (95% CI: 1.27, 2.99)]; and not having initiated antiretroviral therapy within 7 days of HIV diagnosis [AHR: 1.82 (95% CI: 1.12, 2.96)].ConclusionIn this study, the incidence of opportunistic infections was high. Early initiation antiretroviral therapy has direct effect on boosting the immunity, suppressing viral replications and increases the CD4 count, so that the occurrence of opportunistic infection will reduce the incidence of OIs.
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