Dataset Information

Family planning utilization and associated factors among postpartum women in Addis Ababa, Ethiopia, 2018.

ABSTRACT:

Background

Pregnancies that occur in the first year after birth can result in adverse outcomes for the mothers and their babies. Postpartum family planning (PPFP) can save lives of many mothers and children. Only few data are available about the magnitude of PPFP use and its determinants in Addis Ababa, Ethiopia.

Objective

To assess PPFP utilization and associated factors in Addis Ababa, Ethiopia.

Method

A facility-based cross-sectional study was conducted from April to June 2018. A total of 625 women were enrolled in the study. Statistical Package for the Social Sciences (SPSS) software was used to analyze the data. Binary logistic regression model with adjusted odd ratio (AOR) and 95% confidence interval (CI) was used to identify the factors associated with PPFP use. A p-value less than 0.05 was considered as significant.

Result

The magnitude of PPFP utilization in Addis Ababa was 71.8%. Previous family planning (FP) information (AOR = 13.2; 95% CI: (1.96, 88.07)), FP information from health facility visit (AOR = 2.23; 95% CI: (1.45, 3.43)), antenatal care (AOR = 4.96; 95% CI: (1.58, 15.64)), counseling on FP at postnatal care (AOR = 1.97; 95% CI: (1.27, 3.05)), menses resumption after birth (AOR = 1.75; 95% CI: (1.11, 2.76)), and commencing sexual activity after birth (AOR = 9.34; 95% CI: (5.39, 16.17)) were the factors associated with PPFP use.

Conclusion and recommendation

Though the magnitude of PPFP use is encouraging, still three out of the ten postpartum women did not use PPFP. The determinants of PPFP use were having FP information, having FP information from health facility visit, antenatal care, counseling about FP during postnatal care, menses resumption after birth, and commencing sexual activity after birth. The health system in the City and the healthcare providers should strive to reach every woman who is not accessing the PPFP services and antenatal care services, and improve counseling services on PPFP during delivery and postnatal care services.

SUBMITTER: Tafa L

PROVIDER: S-EPMC7822255 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Family planning utilization and associated factors among postpartum women in Addis Ababa, Ethiopia, 2018.

Tafa Lema L Worku Yoseph Y

PloS one 20210122 1

<h4>Background</h4>Pregnancies that occur in the first year after birth can result in adverse outcomes for the mothers and their babies. Postpartum family planning (PPFP) can save lives of many mothers and children. Only few data are available about the magnitude of PPFP use and its determinants in Addis Ababa, Ethiopia.<h4>Objective</h4>To assess PPFP utilization and associated factors in Addis Ababa, Ethiopia.<h4>Method</h4>A facility-based cross-sectional study was conducted from April to Jun ...[more]

PMID: 33481796

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Project description:BackgroundThe occurrence of pregnancy in the postpartum period poses a risk to women and their infants, and it also has increased risks of adverse health outcomes if a pregnancy happens less than two years after the preceding birth. Utilization of immediate postpartum family planning is a possible and simple way to reduce these unfavourable outcomes. However, only a small proportion of mothers use the service; but the reasons appear unclear. Thus, this study aimed to determine the level and factors associated with the utilization of immediate postpartum family planning in Bole sub-city, Addis Ababa, Ethiopia.MethodsA facility-based cross-sectional study was carried out from August 15 to September 15, 2022, among mothers who gave birth one year before the data collection period. A total of 425 mothers were selected with a systematic random sampling technique. A pretested and structured questionnaire was administered to collect data. Data entry and analysis were done by Statistical Package for Social Sciences 25. Chi-square, multicollinearity and Hosmer-Lemshaw model fitness tests were tested. The level of utilization was determined by descriptive statistics and the associated factors were determined by a binary logistic regression model, and presented with the adjusted odds ratios (AOR) with their respective 95% confidence intervals (95%CI). All statistical tests were conducted at a 5% level of significance.ResultsUtilization of family planning method immediately after birth was 12.9% (95% CI = 11.3-14.5%), and it was statistically significantly associated with ages between 25 and 34 years (AOR = 5; 95% CI [1.38-18.41]) and 35 years and above (AOR = 6[1.47-25.70]), unfavourable attitude (AOR = 0.2[0.11-0.31]) and no counselling about immediate postpartum family planning during antenatal care visit (AOR = 0.43[0.20-0.89]).Conclusion and recommendationsThe level of utilization of immediate postpartum family planning is low in the study area. To improve it, dealing with younger women, working to achieve a positive attitude amongst women towards immediate postpartum family planning, and incorporating counselling about postpartum family planning methods during antenatal care visits are all recommended.

Project description:BackgroundFamily planning integration in areas where women contact the healthcare system routinely is essential for addressing the high unmet need for family planning among postpartum women and reducing the risk of short interpregnancies. Immediate postpartum family planning (IPPFP) is an integrated service, and opportunities exist for women by providing family planning (FP) counseling and contraceptives as part of care following childbirth within 48 h. Therefore, this review aimed to assess the pooled estimate of immediate postpartum family planning utilization and its associated factors in Ethiopia.MethodElectronic databases were used to conduct an extensive search of all published studies, and the digital library was used to identify any unpublished studies. An observational study that reports the prevalence/magnitude and/or associated factors/predictors/determinants of IPPFP utilization in Ethiopia was included. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA Version 11. A random-effects model was applied to determine the pooled prevalence of immediate postpartum family planning utilization with a 95% confidence interval (CI). Inverse variance (I2) was used to identify the presence of heterogeneity, and a funnel plot and Egger's test were used to check the presence of publication bias. Subgroup analysis was conducted based on the sample size, region, and year of study to identify the source of heterogeneity.ResultOf 15 primary studies, the overall pooled prevalence of immediate postpartum family planning utilization among postpartum women in Ethiopia was 21.04% (95% CI: 13.08, 29.00). Received counseling on FP [OR: 3.59; 95% CI (1.84, 7.01; P < 0.001), having a positive attitude toward FP [OR: 3.2; 95% CI (1.23, 8.35); P = 0.017], and partner support to use FP [OR: 5.85; 95% CI (1.12, 30.54; P = 0.036) were significant predictors of immediate postpartum family planning utilization.ConclusionGenerally, IPPFP utilization in Ethiopia was insufficient. Therefore, to enhance the utilization, integrating FP counseling at all maternal service care points, strengthening community awareness to develop a favorable attitude toward family planning, and promoting partner involvement in family planning counseling are essential.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=239053, identifier: CRD42021239053.

Project description:BackgroundMother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) remains the major source of HIV infection in young children. Targeting pregnant women attending antenatal clinics provide a unique opportunity for implementing prevention of mother-to-child transmission (PMTCT) programmes against HIV infection of newborn babies. This study aimed to investigate factors associated with the acceptability and utilization of PMTCT of HIV.MethodsAn institution based cross-sectional study was conducted in April 2010 using exit interviews with 843 pregnant women attending antenatal care (ANC) clinics of 10 health centers and two hospitals in Addis Ababa, Ethiopia. Trained nurses administered structured questionnaires to collect data on socio-demographic characteristics, knowledge about MTCT, practice of HIV testing and satisfaction with the antenatal care services. Six focus group discussions among pregnant women and 22 in-depth interviews with service providers complemented the quantitative data.ResultsAbout 94% of the pregnant women visited the health facility for ANC check-up. Only 18% and 9% of respondents attended the facility for HIV counselling and testing (HCT) and receiving antiretroviral prophylaxis, respectively. About 90% knew that a mother with HIV can pass the virus to her child, and MTCT through breast milk was commonly cited by most women (72.4%) than transmission during pregnancy (49.7%) or delivery (49.5%). About 94% of them reported that they were tested for HIV in the current pregnancy and 60% replied that their partners were also tested for HIV. About 80% of the respondents reported adequacy of privacy and confidentiality during counseling (90.8% at hospitals and 78.6% at health centers), but 16% wished to have a different counselor. Absence of counselors, poor counselling, lack of awareness and knowledge about HCT, lack of interest and psychological unpreparedness were the main reasons cited for not undergoing HIV testing during the current pregnancy.ConclusionsHIV testing among ANC attendees and knowledge about MTCT of HIV was quite high. Efforts should be made to improve the quality and coverage of HCT services and mitigate the barriers preventing mothers from seeking HIV testing. Further research should be conducted to evaluate the uptake of antiretroviral prophylaxis among HIV-positive pregnant women attending ANC clinics.

Project description:BACKGROUND:Rubella is a vaccine-preventable contagious disease causing an estimated 100,000 children to be born with congenital rubella syndrome each year globally. Studies documented that 18 rubella outbreaks were occurred each year in Ethiopia. Yeka sub-city woreda 13 public health emergency management office reported two measles suspected cases on 8 February, 2018. We investigated this outbreak to identify its etiology, describe the outbreak and implement control measures. METHODS:We described the outbreak using descriptive epidemiology. The study population was defined as students learning in the school where the outbreak occurred. Suspected rubella case was defined as student with generalized rash whereas confirmed case was suspected case tested positive for rubella IgM. Questionnaires, checklists and students record review were used to collect data. We searched for new cases in classes daily and excluded them from classes. The school environment was assessed and the outbreak was described in person and time. RESULTS:We identified 58 cases (median age: 4.6 years; IQR: 4-5 years) with six of them rubella IgM positive and 52 epidemiologically linked. The outbreak began on 8 February 2018 having multiple intermittent peaks during its course reaching its highest peak at 2 April, 2018 and ended on 20 April, 2018. Index cases were reported from two classes; however, cases were occurred in 13/15(86.67%) of the classes during the entire outbreak. Fifty five percent (32/58) and 45/58(77.59%) of the cases were females and 3-5 years children, respectively. Overall attack rate was 58/531(4.05%). Attack rate was higher in females 32/252 (12.7%) than in males 26/279 (9.32%), and higher 45/275(16.36%) in 3-5 years than those in 5-8 years 13/256(5.08%) children. Case fatality ratio was zero. All cases were vaccinated against measles but unvaccinated against rubella. CONCLUSIONS:Attack rate was higher in females than in males and higher in 3-5 years than 5-8 years children. We recommended establishing rubella surveillance system, conducting sero-prevalence of rubella among child bearing age females and establishing CRS surveillance among young infants to provide evidence-based information for RCV introduction. It was also recommended to develop a national rubella surveillance guideline which aid to exclude rubella cases from schools during outbreak.

Project description:BackgroundPublic health resources are often deployed in developing countries by foreign governments, national governments, civil society and the private health clinics, but seldom in ways that are coordinated within a particular community or population. The lack of coordination results in inefficiencies and suboptimal results. Organizational network analysis can reveal how organizations interact with each other and provide insights into means of realizing better public health results from the resources already deployed. Our objective in this study was to identify the missed opportunities for the integration of HIV care and family planning services and to inform future network strengthening.MethodsIn two sub-cities of Addis Ababa, we identified each organization providing either HIV care or family planning services. We interviewed representatives of each of them about exchanges of clients with each of the others. With network analysis, we identified network characteristics in each sub-city network, such as referral density and centrality; and gaps in the referral patterns. The results were shared with representatives from the organizations.ResultsThe two networks were of similar size (25 and 26 organizations) and had referral densities of 0.115 and 0.155 out of a possible range from 0 (none) to 1.0 (all possible connections). Two organizations in one sub-city did not refer HIV clients to a family planning organization. One organization in one sub-city and seven in the other offered few HIV services and did not refer clients to any other HIV service provider. Representatives from the networks confirmed the results reflected their experience and expressed an interest in establishing more links between organizations.ConclusionsBecause of organizations not working together, women in the two sub-cities were at risk of not receiving needed family planning or HIV care services. Facilitating referrals among a few organizations that are most often working in isolation could remediate the problem, but the overall referral densities suggests that improved connections throughout might benefit conditions in addition to HIV and family planning that need service integration.

Project description:BackgroundThere has been a paradigm shift in understanding homelessness. The shift is from the belief that homelessness results from lack of secure housing towards the view which explains homelessness in terms of the complex interactions of factors which determine the pathways into and out of homelessness. The evidence base for women's homelessness is less robust than men's homelessness. The effect of gender and its relationship with homelessness has been neglected. Addis Ababa, the capital city of Ethiopia, is estimated to be home for around 50,000 homeless people. This study aims to explore pathways through homelessness in women who were sheltered in a facility for the homeless in Addis Ababa.MethodsIn-depth interviews were conducted in 2019 with 14 women who were 'roofless', and were gathered for support in a temporary shelter in Addis Ababa, Ethiopia. The shelter was one of the eight such facilities established in Addis Ababa few months earlier than the study. For data analysis the QDA Miner 5.0.30 software was used and data was analyzed using thematic analysis approach.ResultsThe analysis revealed that determinant factors for pathways into homelessness among women occurred on the background of predisposing factors, such as poverty, being raised by caregivers other than biological parents, child marriage, unstable employment history. On top of the predisposing factors listed above the occurrence of precipitating factors such as problems with marriage, migration, death of parents, deception, became the immediate cause of homelessness. Despite mentions of positive experiences of homelessness such as mutual support and good social life within network of homeless people, the net effect of the interaction between negative and positive experiences of the homeless life, together with the effectiveness of coping strategies by the participants resulted in the participants' decision of whether homelessness is tolerable. Finally, the presence of perpetuating factors such as lack of affordable house, feeling of shame to go back home, and unfavorable situation at home discouraged participants from exiting the homeless situation.ConclusionFrom the findings of the study we conclude that the predisposing factors and the precipitating factors resulted in the occurrence of onset of homelessness among the participants. Once homeless, the experiences of life as homeless, and the availability of the means to exit from it determined whether the participants would stay homeless or exit from it.

Project description:IntroductionRoutine cervical screening has been shown to greatly reduce both the number of new cervical cancers diagnosed each year and the number of deaths resulting from the disease. Nevertheless, cervical screening knowledge and screening uptake is very low in developing countries. In Ethiopia, the coverage of cervical cancer screening is only 1%. In this study, we aimed to assess cervical cancer screening knowledge and barriers for screening uptake among women in Addis Ababa Ethiopia.MethodsA facility-based cross-sectional study was conducted from February to March 2015 in Addis Ababa, Ethiopia. A total of 520 women were selected by a multi-stage sampling procedure. Interview based questioner was used to collect the data. Descriptive statistics was used to describe the socio-demographic and clinical profiles of the women. Multivariate logistic regression using adjusted odds ratio (AOR) and 95% confidence interval (CI) was used to identify independent predictors for cervical screening knowledge. A p-value of <0.05 was set to determine level of statistical significance.ResultsAmong all women, 42.7% had heard of cervical cancer screening and 144 (27.7%) women had adequate knowledge of cervical cancer screening. The mean (±SD) age of women was 27.7 (±5.49) years. In total, a quarter (25%) of eligible women had experience of cervical cancer screening. Not being married (adjusted odds ratio (AOR) = 1.8, 1.1-3.3), having an awareness of cervical cancer (AOR = 5.0, 2.7-9.1) and receiving information from health professionals (AOR = 1.9, 1.1-3.2) were the predictors for good cervical cancer screening knowledge. An absence of symptoms (57%), a lack of knowledge about screening (56.3%) and the lack of a screening service in their living area (42.2%) were the perceived barriers for screening uptake.ConclusionsCervical screening knowledge was low among women and less than half had heard of screening. Women also had low experience of screening. The lack of a screening service, the absence of symptoms and not knowing about screening were the perceived reasons for the low uptake. Hence, awareness campaigns and education should be undertaken by health professionals. Access and availability of screening service is also essential to improve screening uptake.

Project description:IntroductionPeople in Ethiopia, including pregnant women, highly consume both home-made and manufactured alcohol beverages due to lack of awareness about the harmful effect of risky alcohol use, and cultural acceptance of alcohol consumption. Alcohol consumption and other hazardous patterns of use like binge drinking have tremendous adverse effects on fetus and mothers. Therefore, this study aimed to assess the magnitude of alcohol consumption, binge drinking and its determinants among pregnant women residing in Kolfe sub-city, Addis Ababa, Ethiopia.MethodsInstitutional based cross-sectional study was conducted among a total of 367 pregnant women. The participants were selected using a systematic random sampling method. Data were collected through a structured questionnaire. A binary logistic regression was conducted using SPSS version 20 software to identify determinants of alcohol consumption and binge drinking. A p-value < 0.05 was used to declare a statistical significance in multiple logistic regression. The results were described using adjusted odds ratio with a 95% confidence interval.ResultsThis study revealed that the prevalence of alcohol consumption, binge drinking, and weekly alcohol consumption of four or more units among pregnant women was 39.78%, 3.54% and 4.9%, respectively. Not having formal education [AOR 95% CI = 8.47 (2.42, 29.62), having primary education [AOR 95% CI = 4.26 (1.23, 14.74), being a housewife [AOR 95% CI = 4.18 (2.13, 8.22), having an unplanned pregnancy [AOR 95% CI = 2.47(1.33, 4.60), having a history of abortion [AOR 95% CI = 3.33 (1.33, 6.05)], not having awareness about the harmful effect of alcohol consumption [AOR 95% CI = 4.66 (2.53, 8.61)], and not having family social support [AOR 95% CI = 2(1.14,3.53) were determinants of alcohol consumption among pregnant women.ConclusionsThis study found a high level of alcohol consumption among pregnant women. Interventions to create awareness on the harmful effects of alcohol are needed. Moreover, strengthening social support during pregnancy and family planning services to reduce unplanned pregnancy and abortion should be considered.

Project description:BACKGROUND:Tuberculosis remains a major public-health problem in the world, despite several efforts to improve case identification and treatment compliance. It is well known cause of ill-health among millions of people each year and ranks as the second leading cause of death from infectious disease worldwide. Despite implementation of the World health organization recommended strategy, the reductions in the incidence of TB have been minimal in high burden countries. OBJECTIVES AND METHODS:A case control study was carried out to assess the risk factors of TB, where cases were newly registered bacteriologically confirmed pulmonary TB patients with age greater than 15 years who present at twenty health centres in Addis Ababa. Controls were age and sex matched attendees who presented in the same health centers for non-TB health problems. RESULTS:A total of 260 cases and 260 controls were enrolled in the study and 45.8% of cases and 46.2% of controls were in the 26-45 years age bracket. According to the multivariable logistic regression analysis, seven variables were found to be independent predictors for the occurrence of TB after controlling possible confounders. Patients who live in house with no window or one window were almost two times more likely to develop tuberculosis compared to people whose house has multiple windows (AOR = 1.81; 95% CI:1.06, 3.07). Previous history of hospital admission was found to pose risk almost more than three times (AOR = 3.39; 95% CI: 1.64-7.03). Having a household member who had TB was shown to increase risk of developing TB by three fold (AOR = 3.00; 95% CI: 1.60, 5.62). The study showed that illiterate TB patients were found to be more than twice more likely to develop TB compared to subjects who can atleast read and write (AOR, 95% CI = 2.15, 1.05, 4.40). Patients with household income of less than 1000 birrs per month were more than two times more likely to develop TB compared to those who had higher income (AOR = 2.2; 95% CI: 1.28, 3.78). Smoking has also been identified as important risk factor for developing TB by four times (AOR = 4.43; 95% CI: 2.10, 9.3). BCG was found to be protective against TB reducing the risk by one-third (AOR = 0.34; 95% CI: 0.22, 0.54). CONCLUSION:This study showed that TB is more common among the most agile and economically active age group, and number of windows, history of hospital admission, a household member who had TB, illiteracy, low household income and smoking and lack of BCG scar were identified as independent risk factors. Therefore it is imperative that the TB control effort need a strategy to address socio economic issues such as poverty, overcrowding, smoking, and infection control at health care facilities level is an important intervention to prevent transmission of TB within the facilities.

Dataset Information

Family planning utilization and associated factors among postpartum women in Addis Ababa, Ethiopia, 2018.

Background

Objective

Method

Result

Conclusion and recommendation

Publications

Family planning utilization and associated factors among postpartum women in Addis Ababa, Ethiopia, 2018.

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