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.