Background: Discontinuation of contraceptives without any change in fertility intention is often associated with unintended pregnancy which ends up with induced abortion and unplanned birth. Despite the Ethiopian government’s emphasis on the provision of long-acting contraceptive methods, little attention has been paid to the study of its discontinuation; particularly, no study has been reported in the study area. Thus, this study aimed to assess the discontinuation rate of long-acting reversible contraceptives and associated factors among reproductive-age women in Butajira town, Central Ethiopia, 2020. Methods: Community-based cross-sectional study was conducted from 1 April to 1 May 2020. A systematic random sampling method was used to select 227 women. Data were collected by a structured and pretested questionnaire. Epi-data (version 4.6.2) and Statistical Package for the Social Sciences (version 25) were used for data entry and analysis, respectively. A multivariable logistic regression model was used to predict the relation between dependent and independent variables. Finally, a significant statistical association was assured using an adjusted odds ratio at a 95% confidence interval and p value < 0.05. Results: This study revealed that the discontinuation rate of long-acting reversible contraceptives was 50 (22.5%; 95% confidence interval: 17.8–27.2). The main reason for discontinuation was facing side effects 26(52%); from these menstrual disruption 19 (73.1%) was the main reason. Time consumed to reach the health facility (adjusted odds ratio: 6.16, 95% confidence interval: 1.46–25.97), desire to have more children (adjusted odds ratio: 5.3, 95% confidence interval: 1.13–24.81), and counseled about the benefit of long-acting reversible contraceptives (adjusted odds ratio: 0.08, 95% confidence interval: 0.02–0.39) were predictors of discontinuation of long-acting reversible contraceptives. Conclusions and Recommendations: This study showed that the discontinuation rate was high when compared to Ethiopian Demographic Health Survey 2016. Routine pre-insertion counseling about the benefits and side effects of long-acting reversible contraceptives by healthcare providers is highly recommended. In addition, we recommend further trials using larger sample sizes on predictors of discontinuation of long-acting reversible contraceptives.
Background Premenstrual syndrome (PMS) is used to describe physical, cognitive, affective, and behavioral symptoms that affect young and middle-aged women occurring cyclically during the luteal phase of the menstrual cycle. Despite the considerable prevalence and impact of PMS on individuals, their families and communities that interferes with the development of nations, many professionals are still unaware of it and little attention has been given in developing countries like Ethiopia, especially for university students. Therefore, this study was aimed for assessing the magnitude of premenstrual syndrome, associated factors and coping mechanisms among Wolkite university female regular students, 2021. Methods Institutional-based cross sectional study was conducted among Wolkite University regular female students from June 15/10/2021 to 30/10/2021 by using simple random and multistage with systematic random sampling technique to select the study participants (n = 591). Data were collected using a self-administered, pre-tested, semi-structured questionnaire. Premenstrual syndrome scales comprised of 40 questions with three sub-scales were used to determine Premenstrual syndrome. Data were cleaned, coded and entered into Epi-data version-3.1, and analyzed using SPSS software version 25. Descriptive statistics were computed for independent variables as well as for coping mechanisms and presented in narration, tables and graphs. Analytic analysis schemes including bi-variable and multivariable logistic regression were computed to identify factors associated with premenstrual syndrome and those variables with a P value of < 0.05 in multivariable analysis were declared as statistically significant. Result From the total of 631 study subjects, only 591 had completed the questionnaire, giving a response rate of 93.7%. From 591 study participants, 224 (37.9%) [95% CI: (34, 40.9)] of them had premenstrual syndrome. Abdominal cramp (78.8%), depression (73.3%) and fatigue (72.9%) were frequent premenstrual symptoms experienced by students. Having family history of PMS [AOR: 4.05; 95% CI: (2.49, 6.58)], no history of sexual intercourse [AOR: 2; 95% CI: (1.12, 3.47)], severe menstrual pain intensity [AOR: 3.09; 95% CI: (1.58, 6.05)], irregular menstrual cycle [AOR: 2.26; 95% CI: (1.41, 3.62)], early age of menarche (< 13 years) [AOR: 2.64; 95% CI: (1.34, 5.19)], long duration of menses (≥ 7 days) [AOR: 3.56; 95% CI: (1.53, 8.37)] and using many pads (> 8) during menstruation [AOR: 4.44; 95% CI: (2.16, 9.12)] were factors significantly associated with premenstrual syndrome. 93.4% of students apply at least one coping mechanism for premenstrual symptoms, of which; taking rest (67.6%) and sleeping (60.7%) were common strategies. Conclusion In this study, premenstrual syndrome was found to be a problem of many students. Abdominal cramp, depressed feeling and fatigue were the predominant premenstrual symptoms experienced by students. Taking rest and sleeping were mostly applied by students as a coping mechanism. Family history of PMS, no history of sexual intercourse, intense menstrual pain, use of many pads during menstruation, irregular menstrual cycle, early menarche, and long duration of menses were found to be predictors of premenstrual syndrome. PMS needs great attention as part of the health care service in Ethiopia by involving all stockholders, including policy makers and health care professionals, to reduce its impact on the academic performance of university students.
Background. Dietary diversification is considered the proxy indicator of dietary quality and nutrient adequacy during pregnancy. Pregnant women have been considered susceptible to malnutrition because of their increased nutrient demands and thus consuming a variety of foods in their diet plays a lion’s role in ensuring adequate nutrient intake. So understanding bottleneck factors associated with dietary diversity practice is very crucial to encouraging adequate dietary diversity practice. Therefore, this paper aimed to assess determinants of dietary diversity practice among pregnant women in the Gurage zone, Southwest Ethiopia. Methods. A community-based cross-sectional analytical study was conducted among 726 pregnant women, 13 key informants, and 27 focus group discussion discussants in the Gurage zone, southwest Ethiopia, from 1 September to 1 November 2021. A face-to-face interviewer-administered questionnaire was used to collect the data. According to the Minimum Dietary Diversity Score for Women (MDD-W) tool, women who consumed more than or equal to 5 of 10 food groups in the previous 24 hours had a diverse diet. Epi data version 3.1 was used for data entry, while SPSSversion 26 was used for analysis. To determine factors associated with dietary diversity, bivariate and multivariable logistic regression models were used to obtain crude odds ratio (COR), adjusted odds ratios (AOR), and 95 percent confidence intervals (CIs). Statistical significance was determined using adjusted odds ratios (AORs) with 95 percent confidence intervals (CIs) and p values less than 0.05. In narrative form, qualitative results were triangulated with quantitative data. Results. The overall prevalence of the adequate dietary diversity practice was found to be 42.1% with 95% CI (48.4–46.1%) and the mean dietary diversity score was 5.30 ± 1.49 standard deviation (SD). Multivariable analysis revealed that primary school level [AOR = 6.471 (2.905, 12.415)], secondary school level (9–12) [AOR = 7.169 (4.001, 12.846)], college and above level [AOR = 32.27 (15.044, 69.221)], women with higher empowerment [AOR = 3.497 (2.301, 5.315)], women with a favorable attitude toward dietary diversity [AOR = 1.665 (1.095, 2.529)], women from wealthier households [AOR = 2.025 (1.252, 3.278)], and having well-secured food status [AOR = 3.216 (1.003, 10.308)] were variables that influence dietary diversity practice. Three FGD and 13 key informant interviews were conducted, and the results of qualitative data generated three major themes. Conclusion. The overall prevalence of adequate dietary diversity practice was found to be low in this study when compared to studies conducted in Ethiopia. Maternal educations, mothers’ attitudes toward dietary diversity, women empowerment, food security status, and wealth index level of the household were determinant factors that influence dietary diversity practice in this study. Therefore, programs aimed to improve pregnant women’s dietary diversity practice should focus on improving the socioeconomic status and creating a congenial environment to promote women's empowerment.
Background. Pelvic floor disorders encompass a broad range of interrelated clinical conditions. Pelvic floor disorders are a common public health concern that affects the lives of millions of adult females. This disorder is expected to be more widespread and probably more severe among women in low-income countries. However, there is limited knowledge about pelvic floor disorders and their determinants among women in Ethiopia. Objective. The purpose of the study was to assess the determinants of pelvic floor disorders among women who visited the gynecology outpatient service at the Wolkite University Specialized Hospital, Wolkite, Ethiopia, in 2021. Methods. A cross-sectional hospital study was conducted on 275 randomly chosen women from June 1 to July 1, 2021. A systematic sampling technique was used when selecting the study subjects. The data were gathered using interviewer administered structured questionnaires. The data collected was entered in version 3.1 of EpiData, and version 23 of Statistical Package for Social Sciences was used for the analysis. The variables with a P -value <0.25 in the bivariate analysis were considered for a subsequently built multivariable model, and factors with P < 0.05 in the final model were statistically significant. The results were presented in an adjusted odds ratio with a 95% confidence interval. Result. The prevalence of pelvic floor disorder was reported to be 17.8% with 9.3% of the women experiencing urinary incontinence, 8.9% experiencing pelvic organ prolapse, and 5.9% experiencing anal incontinence. Two hundred thirty-two (85.9%) were currently married, while 110 (40.7%) were housewives. Statistically, a significant association was found between age at first pregnancy (AOR = 5.193; 95% CI = 1.905–14.157), many vaginal deliveries (AOR = 15.858; 95% CI = 5.305–47.400), history of episiotomy (AOR = 7.508 95% CI = 1.556–36.224), and menopause (AOR = 7.665; 95% CI = 2.440–24.078) when analyzed with a multivariate logistic regression model. Conclusion. In this study, age at first pregnancy, number of vaginal births, history of episiotomy, and menopause were independently associated with pelvic floor disorder. Therefore, educating women about the year of their first pregnancy, promoting family planning, and advice on the prevention of routine episiotomy by a health professional is recommended.
Background: Provision of preconception care is significantly affected by the health care provider’s knowledge of preconception care. In Ethiopia, preconception care is rare, if even available, as part of maternal health care services. Thus, this study aimed to determine the level of knowledge of preconception care and associated factors among health care providers working in public health facilities in Eastern Ethiopia. Methods: A multicenter cross-sectional study was conducted from 1 March to 1 April 2020. A simple random sampling technique was used to select a total of 415 maternal health care providers. We utilized a structured, pretested, and self-administered questionnaire to collect data. Data were entered into EpiData (version 3.1) and exported to STATA (version 16) for analysis. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed. All covariates with a p value ⩽0.20 in bivariate logistic regression were entered into a multivariate logistic regression analysis to control the confounding variables; variables with a p value <0.05 were considered statistically significant. Results: Out of 410 respondents, 247 (60.2%; 95% confidence interval: 55.4–65.1) had good knowledge of preconception care. Having an educational level of Bachelor of Science degree and above (adjusted odds ratio: 6.97, 95% confidence interval: 3.85–12.60), 5 or more years work experience (adjusted odds ratio: 2.60, 95% confidence interval: 1.52–4.49), working in a hospital (adjusted odds ratio: 2.50, 95% confidence interval: 1.25–4.99), reading preconception care guidelines (adjusted odds ratio: 3.06, 95% confidence interval: 1.40–6.68), and training on preconception (adjusted odds ratio: 2.90, 95% confidence interval: 1.37–6.15) were significantly associated with good knowledge of preconception care. Conclusions and Recommendations: Three out of five maternal health care providers in this study had good knowledge of preconception care. Facilitating continuous refreshment training and continuous professional development for health workers, preparing comprehensive preconception care guidelines for health institutions, and reading preconception care guidelines were highly recommended.
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