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Yalew M, Getachew S, Mohammed K, Hankarso H, Bayile A, Asmamaw SD, Assefa MG, Bazie GW, Mebratu W, Kefale B, Damtie Y, Arefaynie M, Birhane T, Dewau R, Cherie N, Addisu E, Mitiku K, Tadese F, Wendie TF, Habtie A, Mekonnen TC, Tadesse SE, Bedane GT, Wasihun Y, Tsega TD, Taddele M, Tefera Z, Adane B, Wagaye B, Ayele FY, Zerga AA, Molla A, Desalegn B, Birkie M, Bewket B, Alemu BK, Zewdie S, Tsegaye MK, Bitew A, Mehari K, Derseh L. Individual and contextual-level factors associated with iron-folic acid supplement intake during pregnancy in Ethiopia: a multi-level analysis. BMC Pregnancy Childbirth 2023; 23:260. [PMID: 37072714 PMCID: PMC10111777 DOI: 10.1186/s12884-023-05593-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/10/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Anemia is still one of the major public health problems in many developing countries including Ethiopia. Thus, this study aimed to assess individual and contextual-level factors associated with iron-folic acid supplement intake during pregnancy in Ethiopia. METHODS A secondary analysis was done on the 2019 mini-Ethiopian Demographic and Health Survey (EDHS) dataset. A total of 3,927 pregnant women who gave birth five years before the survey were included in the analysis. Multi-level mixed-effect logistic regression analysis was done by STATA/SE version 14.0 to identify individual and contextual-level factors. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to show the strength and direction of the association. The level of statistical significance was declared at a P value less than 0.05. RESULTS Those primary educated [AOR = 1.83, 95% CI: (1.24, 2.74)], secondary educated [AOR = 2.75, 95% CI: (1.57, 4.824)], women who had greater than 5 living children [AOR = 2.02, 95% CI: (1.25, 3.27)], women who had ANC visit [AOR = 21.26, 95% CI: (13.56, 33.32)] and women who lived in a cluster with high proportion of women had ANC visit [AOR = 1.72, 95% CI: (1.17, 2.54)] and women who lived in Somali [AOR = 0.44 0.73, 95% CI: (0.22, 0.87)] were significantly associated with iron-folic acid intake during pregnancy. CONCLUSIONS Both individual and contextual-level factors were significantly associated with iron-folic acid intake during pregnancy. From individual-level factors: education status of women, the total numbers of living children, and ANC follow-up are significant and from contextual-level factors: region and living in a high proportion of women who had ANC follow-up were found to have a statistically significant association. Promoting women's education and maternal health services like ANC and intervention targeting the Somali region would be the recalled area of the government.
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Affiliation(s)
- Melaku Yalew
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Injibara University, Injibara, Ethiopia.
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Shiferaw Getachew
- Head office manager of Mida Weremo woreda, North Shewa, Amhara Regional State, Ethiopia
| | - Keriya Mohammed
- Independet researcher, Dessie, Amhara Regional State, Ethiopia
| | - Hailu Hankarso
- Yirgalem Medical College, Hawassa University, Hawassa, Ethiopia
| | - Adane Bayile
- Head manager of Maternal and Child Health, Boru Meda Hospital, Amhara Regional State, Bahir Dar, Ethiopia
| | | | | | - Getaw Walle Bazie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Wondwosen Mebratu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- Department of Reproductive and Family Health, School of Public Health, College of Health Sciences, Injibara University, Injibara, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tesfaye Birhane
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Reta Dewau
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Nigus Cherie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Elsabeth Addisu
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Kefale Mitiku
- Department of Physiology, College of Health Sciences, Injibara University, Injibara, Ethiopia
| | - Fentaw Tadese
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | | | - Adane Habtie
- Department of Health Promotion, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Tefera Chane Mekonnen
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Eshete Tadesse
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | | | - Yitbarek Wasihun
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tilahun Degu Tsega
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Injibara University, Injibara, Ethiopia
| | - Mekuanint Taddele
- Department of Health Promotion and Behavior, School of Public Health, College of Health Sciences, Injibara University, Injibara, Ethiopia
| | - Zenebe Tefera
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Injibara University, Injibara, Ethiopia
| | - Birhanu Wagaye
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Fanos Yeshanew Ayele
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Aregash Abebayehu Zerga
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abebaw Molla
- Department of Public Health Nutrition, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Biruk Desalegn
- Department of Epidemiology and Biostatistics, Kotebe Health Science College, Kotebe University, Addis Abab, Ethiopia
| | - Mengesha Birkie
- Department of Psychiatry Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Bekalu Bewket
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Belete Kassa Alemu
- Department of Pharmacy, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Segenet Zewdie
- Department of Pharmacy, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Meseret Kefale Tsegaye
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abebayehu Bitew
- Department of Gynecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kassu Mehari
- Department of Statistics, College of Natural Sciences, Wollo University, Dessie, Ethiopia
| | - Lemma Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Deribew A, Kebede B, Tessema GA, Adama YA, Misganaw A, Gebre T, Hailu A, Biadgilign S, Amberbir A, Desalegn B, Abajobir AA, Shafi O, Abera SF, Negussu N, Mengistu B, Amare AT, Mulugeta A, Kebede Z, Mengistu B, Tadesse Z, Sileshi M, Tamiru M, Chromwel EA, Glenn SD, Stanaway JD, Deribe K. Mortality and Disability-Adjusted Life-Years (Dalys) for Common Neglected Tropical Diseases in Ethiopia, 1990-2015: Evidence from the Global Burden of Disease Study 2015. Ethiop Med J 2017; 55:3-14. [PMID: 28878427 PMCID: PMC5582634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Neglected tropical diseases (NTDs) are important public health problems in Ethiopia. In 2013, the Federal Ministry of Health (FMOH) has launched a national NTD master plan to eliminate major NTDs of public health importance by 2020. Benchmarking the current status of NTDs in the country is important to monitor and evaluate the progress in the implementation of interventions and their impacts. Therefore, this study aims to assess the trends of mortality and Disability-adjusted Life-Years (DALY) for the priority NTDs over the last 25 years. METHODS We used the Global Burden of Disease (GBD) 2015 estimates for this study. The GBD 2015 data source for cause of death and DALY estimation included verbal autopsy (VA), Demographic and Health Surveys (DHS), and other disease specific surveys, Ministry of Health reports submitted to United Nations (UN) agencies and published scientific articles. Cause of Death Ensemble modeling (CODEm) and/or natural history models were used to estimate NTDs mortality rates. DALY were estimated as the sum of Years of Life Lost (YLL) due to premature mortality and Years Lived with Disability (YLD). RESULTS All NTDs caused an estimated of 6,293 deaths (95% uncertainty interval (UI): 3699-10,080) in 1990 and 3,593 deaths (95% UI: 2051 - 6178) in 2015, a 43% reduction over the 25 years. Age-standardized mortality rates due to schistosomiasis, STH and leshmaniasis have declined by 91.3%, 73.5% and 21.6% respectively between 1990 to 2015. The number of DALYs due to all NTDs has declined from 814.4 thousand (95% UI: 548 thousand-1.2million) in 1990 to 579.5 thousand (95%UI: 309.4 thousand-1.3 million) in 2015. Age-standardized DALY rates due to all NTDs declined by 30.7%, from 17.6 per 1000(95%UI: 12.5-26.5) in 1990 to 12.2 per 1000(95%UI: 6.5 - 27.4) in 2015. Age-standardized DALY rate for trachoma declined from 92.7 per 100,000(95% UI: 63.2 - 128.4) in 1990 to 41.2 per 100,000(95%UI: 27.4-59.2) in 2015, a 55.6% reduction between 1990 and 2015. Age-standardized DALY rates for onchocerciasis, schistosomiasis and lymphiaticfilariasis decreased by 66.2%, 29.4% and 12.5% respectively between 1990 and 2015. DALY rate for ascariasis fell by 56.8% over the past 25 years. CONCLUSIONS Ethiopia has made a remarkable progress in reducing the DALY rates for most of the NTDs over the last 25 years. The rapid scale of interventions and broader system strengthening may have a lasting impact on achieving the 2020 goal of elimination of most of NTDs. Ethiopia should strengthen the coverage of integrated interventions of NTD through proper coordination with other health programs and sectors and community participation to eliminate NTDs by 2020.
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Affiliation(s)
- A Deribew
- St. Paul Millennium Medical College, Addis Ababa, Ethiopia
- Dilla University, Dilla, Ethiopia
- Micronutrient Initiative, Ethiopia
| | - B Kebede
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - GA Tessema
- Department Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - YA Adama
- School of Medicine, The University of Adelaide, Adelaide South Australia
- School of Public Health, Mekelle University, Mekelle, Ethiopia
| | - A Misganaw
- Institute for Health Metrics and Evaluation, University of Washington
| | - T Gebre
- International Trachoma Initiative, the Task Force for Global Health, Addis Ababa, Ethiopia
| | - A Hailu
- School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - B Desalegn
- University of South Australia, Adelaide, Australia
| | - AA Abajobir
- School of Public Health, the University of Queensland, Queensland, Australia
- Debremarkos University, Debremarkos, Ethiopia
| | - O Shafi
- Rollind schools of public Health, Emory University, USA
| | - SF Abera
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Institute of Biological Chemistry and Nutrition, Hohenheim University, Stuttgart, Germany
| | - N Negussu
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - B Mengistu
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - AT Amare
- School of Medicine, The University of Adelaide, Adelaide South Australia
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - A Mulugeta
- World Health Organization, Addis Ababa, Ethiopia
| | - Z Kebede
- World Health Organization, Addis Ababa, Ethiopia
| | - B Mengistu
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Z Tadesse
- The Carter Centre, Addis Ababa, Ethiopia
| | - M Sileshi
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - M Tamiru
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - EA Chromwel
- Institute for Health Metrics and Evaluation, University of Washington
| | - SD Glenn
- Institute for Health Metrics and Evaluation, University of Washington
| | - JD Stanaway
- Institute for Health Metrics and Evaluation, University of Washington
| | - K Deribe
- Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, UK
- School of Public Health, Addis Ababa University, Ethiopia
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