Background Pelvic organ prolapse (POP) is the descent of the vaginal wall, cervix, uterus, bladder, and rectum downward into the vaginal canal. Its prevalence is higher among women in developing countries because women are more prone to risk factors. In Ethiopia, women with prolapse seek treatments at advanced stages of prolapse; hence, surgical management has been widely practicing. Therefore, it was found to be very important to conduct research that assesses factors hindering early treatments in Southern Ethiopia. This study aimed to find out factors associated with the delay in seeking treatment of pelvic organ prolapse among patients at selected general and referral hospitals of Southern Ethiopia. Methods Cross-sectional study design was employed in 123 participants of seven randomly selected General and Referral Hospitals of Southern Ethiopia from February 01 to April 30, 2020, by using a structured questionnaire. Pre-trained two midwives in each center were deployed to collect data. Physicians performed diagnosis and physical examination. Data were entered and coded using EPI INFO version 7 and exported into SPSS version 25 for analysis. Bivariate and multivariable logistic regression analyses were performed. The goodness of fit was assessed by using the Hosmer and Lemeshow goodness test. Results In this study, out of 123 clinically diagnosed POP cases, nearly half of them were stage III, and over one-third were stage IV. Therefore, 84.6% (104 participants) of the respondents were delayed for the treatment of POP. The mean length of delay for POP treatments was 36.41 ± 3.95 months. After adjusting for covariates, lack of supports [AOR (Adjusted Odds Ratio) = 5.2 (95% CI 1.4–19.5)], low-income [AOR = 5.8 (95% CI 1.1–19.66)], and fear of social stigma [AOR = 4.7 (95% CI 1.2–18.59)] were significant factors for delayed treatments. Conclusions Most of the POP patients were delayed for POP treatments. Factors like lack of support, low-income, and fear of losing social value/stigma were associated with treatment delay. Screening for the POP cases, educating (making awareness) the community about this devastating disease to facilitate early treatment and to avoid social stigma, and raising access to treatment by making the nearby hospitals equipped with facilities to treat POP are recommended.

Background: In Ethiopia, the prevalence of exclusive breastfeeding (EBF) is 60.1%, which is lower than the national Health Sector Transformation Plan 2016‐2020, National Nutrition Program 2016-2020 and WHO global target. This may be attributed to multidimensional factors. Objective: The aim of this meta-analysis was to investigate the association between EBF and educational status, household income, marital status, media exposure, and parity in Ethiopia. Methods: Databases used were PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library, and key terms were searched using interactive searching syntax. It was also supplemented by manual searching. Observational studies published between September 2000 and March 2019 were included. The methodological quality of studies was examined using the Newcastle-Ottawa Scale (NOS) for cross-sectional studies. Data were extracted using the Joanna Briggs Institute (JBI) data extraction tool. To obtain the pooled odds ratio (OR), extracted data were fitted in a random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran Q test, τ2, and I2 statistics. Additional analysis conducted includes Jackknife sensitivity analysis, cumulative meta-analysis, and meta-regression analysis. Results: Out of 553 studies retrieved, 31 studies fulfilled our inclusion criteria. Almost all studies were conducted on mothers with newborn less than 23 months. Maternal educational status (OR = 1.39; p = 0.03; 95% CI = 1.03 - 1.89; I2 = 86.11%), household income (OR = 1.27; p = 0.02; 95% CI = 1.05 - 1.55; I2 = 60.9%) and marital status (OR = 1.39; p = 0.02; 95% CI = 1.05 - 1.83; I2 = 76.96%) were found to be significantly associated with EBF. We also observed an inverse dose-response relationship of EBF with educational status and income. Significant association was not observed between EBF and parity, media exposure and paternal educational status. Conclusions: In this meta-analysis, we depicted the relevant effect of maternal education, income, and marital status on EBF. Therefore, multifaceted, effective, and evidence-based efforts are needed to increase national breastfeeding rates in Ethiopia.

Objectives To investigate the association between EBF and educational status, household income, marital status, media exposure, and parity in Ethiopia. Methods PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases were searched using key terms for all studies published in English between September 2009 and March 2019. The methodological quality of studies was examined using the Newcastle-Ottawa Scale (NOS) for cross-sectional studies. To obtain the pooled odds ratio (OR), extracted data were fitted in a random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ 2 , and I 2 statistics. In addition, Jackknife sensitivity analysis, cumulative meta-analysis, and metaregression analysis were conducted. Results Out of 553 studies retrieved, 31 studies fulfilled our inclusion criteria. Almost all included studies were conducted among mothers with newborn less than 23 months old. Maternal primary school education (OR 1.39; 95% CI 1.03-1.89; I 2 = 86.11%), medium household income (OR 1.27; 95% CI 1.05-1.55; I 2 = 60.9%) and being married (OR 1.39; 95% CI 1.05-1.83; I 2 = 76.96%) were found to be significantly associated with EBF. We also observed an inverse dose-response relationship of EBF with educational status and income. However, EBF was not significantly associated with parity, media exposure, and paternal educational status. Conclusions In this meta-analysis, we showed the relevant effect of maternal education, income, and marital status on EBF. Therefore, multifaceted, effective, and evidence-based efforts are needed to increase the national level of exclusive breastfeeding in Ethiopia.

AbstractsBackground: Although neonatal death is a global burden, it is the highest in Sub Saharan Africa countries such as Ethiopia. This study was aimed to provide pooled national prevalence and predictors of neonatal mortality in Ethiopia. Objective:To assess the pooled prevalence and predictors of neonatal mortality in Ethiopia.Search Strategy: global databases were systematically explored. Systematically searched using the following databases: Boolean operator, Cochrane library, PubMed, EMBASE, HINARI, and Google Scholar. Selection, screening, reviewing and data extraction was done by two reviewers independently using Microsoft excel spread sheet. The modified Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute Prevalence Critical Appraisal tools were used to assess the quality of evidence Selection criteria: All studies conducted in Ethiopia and reporting the prevalence and predictors of neonatal mortality were included Data Collection and Analysis: Data were extracted using a Microsoft Excel spreadsheet software and imported into STATA Version 14 s for further analysis. The pooled effect size with 95% confidence interval of neonatal mortality rate was determined using a weighted inverse variance random-effects model. Publication bias was checked using funnel plots, Egger's and bagger's regression test. Heterogeneity also checked by Higgins's method. A random effects meta-analysis model was computed to estimate the pooled effect size (i.e. prevalence and odds ratio). Moreover, subgroup analysis based on region, sample size and study design were done. Results:After reviewing 88 studies, 12 studies fulfilled the inclusion criteria and were included in the meta-analysis. The pooled national prevalence of neonatal mortality in Ethiopia was 16.3% (95% CI: 11.9, 20.7, I 2 =88.6%). The subgroup analysis indicated that the highest prevalence was observed in Amhara region with a prevalence of 20.3% (95% CI: 9.6, 31.1, I 2 =98.8) followed by Oromia, 18.8% (95%CI: 11.9,49.4, I 2 =99.5). Gestational age AOR,1.14 (95% CI: 0.94 ,1.3), neonatal sepsis (OR:1.2(95% CI: 0.8, 1.5), respiratory distros (OR: 1.2(95% CI: 0.8, 1.5) and place of residency (OR:1.93 (95% CI:1.1,2.7) were the most important predictor.Conclusions: neonatal mortality in Ethiopia was significantly decreased than the national report.There was evidence that neonatal sepsis, gestational age, respiratory distress were the significant predictors. We strongly recommended that health care workers should give a priority for the identified predictors.

Background Pelvic organ prolapse (POP) is the descent of the vaginal wall, cervix, uterus, bladder, and rectum downward into the vaginal canal. It occurs owing to the weakness of the structures supporting and keeping pelvic organs in anatomic position. Prolapse occurs due to exposure to risk factors; women in developing countries are highly predisposed to the risk factors of the prolapse. No study assesses POP in Southern Ethiopia. Methods A case-control study design was employed in 369 participants (123 cases and 246 controls) of seven randomly selected Public Hospitals of Southern Ethiopia from February-June, 2020, using a structured questionnaire. All patients diagnosed with prolapse (stage I- IV) were included as cases; patients free of prolapse (stage 0) were taken as controls after physicians had performed a diagnosis and vaginal examination. Bivariate and multivariable logistic regression analyses were performed using SPSS. Results In this study, after adjusting for covariates, age of the women ≥ 45 years (AOR = 5.33, 95% CI: 1.47, 9.05), underweight (AOR= 4.54, 95% CI: 1.4, 15.76), low income (AOR = 2.5, 95% CI:1.14, 5.59), parity ≥5 (AOR = 5.2, 95% CI: 2.2, 12.55), assisted vaginal delivery (AOR= 4, 95% CI: 1.55, 11.63), instrumental delivery (AOR= 3.5, 95% CI:1.45, 84), sphincter damage and vaginal tear (AOR = 3.2, 95% CI:1.44,7.1), carrying heavy loads (AOR= 2.5, 95% CI:1.2, 5.35), and prolonged labor ≥24 hours (AOR = 3.3, 95% CI:1.12, 97) were significant associated factors of prolapse. The odds of developing prolapse is lower among women attended school. Most(84.55%) of the women with prolapse were delayed for the treatments and only surgical interventions were done as treatments. Most of them claimed lack of social support, lack of money, and social stigma as the main reasons for the delay in seeking treatments. Conclusions Older age, low educational status, underweight, low income, higher parity, assisted vaginal delivery, prolonged labor, sphincter damage, and carrying heavy loads were significant associated factors of POP. It is better to screen older age women by doing campaigns against the prolapse. Also, responsible bodies should work on raising awareness of women as well as awareness of the community about the prolapse through expanding health education. Moreover, informing women to practice pelvic muscle training daily, raising women’s income to empower them, and help of family members to reduce carrying an overload of mothers are recommended.