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Background Indoor air pollution from different fuel types has been linked with different adverse pregnancy outcomes. The study aimed to assess the link between indoor air pollution from different fuel types and anemia during pregnancy in Ethiopia. Method We have used the secondary data from the 2016 Ethiopian Demographic and Health Survey data. The anemia status of the pregnant women was the dichotomous outcome variable and the type of fuel used in the house was classified as high, medium, and low polluting fuels. Logistic regression was employed to determine the association between the exposure and outcome variables. Adjusted Odds Ratio was calculated at 95% Confidence Interval. Result The proportion of anemia in the low, medium, and high polluting fuel type users was 13.6%, 46%, 40.9% respectively. In the multivariable logistic regression analysis, the use of either kerosene or charcoal fuel types (AOR 4.6; 95% CI: 1.41-18.35) and being in the third trimester (AOR 1.72; 95% CI: 1.12-2.64) were significant factors associated with the anemia status of the pregnant women in Ethiopia. Conclusion According to our findings, the application of either kerosene or charcoal was associated with the anemia status during pregnancy in Ethiopia. An urgent intervention is needed to reduce the indoor air pollution that is associated with adverse pregnancy outcomes such as anemia.

Background The World Health Organization recommends a 24-h recall period to estimate breastfeeding practice of mothers of infants aged younger than six-months. Though 24-h recall was preferred for its low recall bias and for practical reasons, it can overestimate exclusive breastfeeding practice (EBF). Validating this indicator will help account for the deviation from the true estimate. This prospective cohort study measured accuracy of the 24-h recall method and validates a week recall as an alternative approach for use in a small sample population. Method The study was conducted from March to April 2018 involving 408 mother-infant pairs living in Butajira Health and Demographic Surveillance Site (HDSS), Southern Ethiopia. Participants were prospectively followed for 14 consecutive days; where their breastfeeding practice in the past 24 h was measured daily. Exclusive breastfeeding prevalence estimate obtained using the 24-h recall method and recall periods spanning a varying number of days (short period recalls) was compared against the cumulative of the responses from a prospectively measured repeated 24-h recalls over the course of 14 days. McNemar statistics was used to assess statistical significance of the difference in the EBF prevalence estimates of the single 24-h recall and the reference standard. Sensitivity, specificity, positive predictive value and negative predictive values were calculated to determine the level of accuracy. Receiver Operating Characteristics curve was used to measure the difference in performance between the two methods. Result The highest prevalence (71.4%) of exclusive breastfeeding practice was estimated using the single 24-h recall method whereas the lowest breastfeeding practice (47.1%) was obtained from a cumulative of 14 repeated 24-h recalls. A week recall (a recall over 7 days’ period), resulted in the smallest discrepancy in estimate (7.1%) as compared to cumulative estimate of 14 repeated 24-h recalls. Comparing against our reference standard, a week recall had 96.7% sensitivity and 83.5% specificity in estimating exclusive breastfeeding practice. Conclusions Using single 24-h recall method overestimated exclusive breastfeeding prevalence. However, a week recall gave an estimate close to the estimate from the standard method. A week recall has a potential to balance the tradeoff between the accuracy of EBF estimates and the resource implication of using multiple prospective measurements that have a proven superior accuracy.

Background: Household air pollution from using biomass fuels has been associated with Low birth weight in many developing countries. This study aimed to investigate the effect of indoor air pollution from biomass fuels and kitchen location on maternal report of birth size among new born children in Ethiopia. Method: A secondary data analysis was conducted using 2016 Ethiopian Demographic Health Survey data. Birth weight from child health card and/or mothers recall was the dependent dichotomous variable. Fuel type was classified as high pollution fuels (wood, straw, animal dung, and crop residues kerosene, coal and charcoal), and low pollution fuels (electricity, liquid petroleum gas, natural gas and biogas). Hierarchical logistic regression was used to assess the effect of fuel type on birthweight. Adjusted Odds Ratios and their 95% Confidence Interval were calculated. A p-value less than 0.05 were considered as significant. Result: The prevalence of low birthweight was 17% and 26.2% among low and high polluting fuel users respectively. Compared to low polluting fuels, the use of high polluting cooking fuels, was associated with higher odds of having low birthweight baby (Unadjusted COR 1.7; 95% CI 1.3, 2.3). AOR was still 1.7; 95% CI (1.26, 2.3) after controlling for child factors. AOR after controlling for both child and maternal factors was 1.5 (95% CI 1.1, 2.1). In final model the association turned insignificant with AOR, 1.3 (95% 0.9, 1.9). Kitchen location, Gender of the baby, Mothers Anemia Status, Maternal Chat chewing, and wealth Index were significant factors in the final model. Conclusion: In this study, use of biomass fuels and kitchen location were associated with reduced child size at birth. Further observational studies should investigate this association using more direct methods. Key words: Biomass fuel, Kitchen location, Low Birth Weight, Ethiopia

Background Food insecurity refers to a lack of consistent access to sufficient food for active, better health. Around two billion people worldwide suffer from food insecurity and hidden hunger. Food insecurity and associated factors among pregnant women in Gedeo Zone Public Hospitals, Southern Ethiopia, are the focus of this study. Method From May to June 2021 G.C. institutional-based cross-sectional study was conducted among pregnant women in Gedeo zone public hospitals. A sample of 506 women has been used, and a multistage cluster sampling technique was used. An adjusted odds ratio (AOR) and their 95% confidence intervals (CI) were calculated to determine the association between various factors and outcomes. A p-value of less than 0.05 was considered significant in multivariable regression. Results Food insecurity was found to be prevalent in 67.4% of pregnant mothers. The results of a multivariable logistic regression revealed that pregnant women from rural areas [AOR=0.532, 95% CI: 0.285, 0.994], married [AOR=0.232, 95% CI: 0.072, 0.750], have a secondary education [AOR=0.356, 95%CI: 0.154, 0.822], and be employed [AOR=0.453, 95% CI: 0.236, 0.872], income between 1000 and 2000 [AOR=0.163, 95% CI: 0.066, 0.399], and income greater than 2000 [AOR=0.125, 95% CI: 0.053,0.293], the wealth index middle and rich [AOR=0.441, 95% CI: 0.246, 0.793] were significant predictors of food insecurity among pregnant mothers [AOR=0.24, 95% CI: 0.128, 0.449]. Conclusion The study area had a high prevalence of food insecurity. Food insecurity was reduced in those who lived in rural areas, were married, had a secondary education, earned between 1000 and 2000 ETB and more than 2000 ETB, and had a wealth index of middle and rich.