Factors Associated with Compliance with the Recommended Frequency of Postnatal Care Services in Four Rural Districts of Tigray Region, North Ethiopia

BACKGROUND

The postpartum period has been advocated as a way to improve the survival of mothers and newborns. However, the status of the recommended number of postnatal care (PNC) services has not been well studied. The purpose of this study was to assess the level of full PNC visits and factors associated with it among mothers.

METHODS

A community-based cross-sectional study was performed among 1,109 women from March to April 29, 2017. Data were collected via face-to-face interviews, recorded using EPI INFO ver. 7.0 (Centers for Disease Control and Prevention, Atlanta, GA, USA) and analyzed by STATA ver. 12.0 (Stata Corp., College Station, TX, USA). Multivariate logistic regression was applied to assess the predictors of the recommended frequency of PNC services. Adjusted odds ratios (aORs) at 95% confidence interval (CIs) were performed. P-values <0.05 were declared statistically significant.

RESULTS

Status of compliance with the use of full PNC services was found to be 16.1%. Women who had antenatal care follow-up (aOR, 5.60; 95% CI, 2.50 to 12.55) and women who delivered at health institutions (aOR, 3.66; 95% CI, 1.74 to 7.70) were more likely to have full PNC visits. Proximity of women to health facilities was found to lower the odds of complete PNC visits (aOR, 0.24; 95% CI, 0.10 to 0.56). Moreover, district of residence remains a predictor of service use.

CONCLUSION

The percentage of women with full PNC visits was found to be low. Therefore, to achieve the recommended frequency of PNC in the study area, the results of this study suggest a need to strengthen the uptake of ANC and institutional delivery services.

Diarrheal disease in under-five children among model and non-model families in northern Ethiopia, 2017: a comparative cross-sectional study

Objective

Diarrheal disease in under-five children among model families is expected to be lower than non-model families. Therefore, this study compared the prevalence and associated factors of diarrheal diseases among under-five children between model and non-model families. A comparative cross-sectional study was conducted from May to June 2017 among 322 children from each model and non-model family. Using multistage sampling technique data were collected through interview and observation. Both bi-variable and multivariable analyses were used to compute the statistical associations. Statistical significances were declared at 95% CI and p value < 0.05.

Results

Diarrheal disease in under-five children for those from model families was 26 (8.1%) and 65 (20.2%) to the non-model families with 95% CI 0.117, 0.168. Being non-model family (AOR = 1.9 and 95% CI 1.004, 3.565), maternal history of diarrhea (AOR = 3.3 and 95% CI 1.975, 5.570), improper waste disposal method (AOR = 2.6 and 95% CI 1.251, 5.578) and not latrine use (AOR = 2.1 and 95% CI 1.128, 3.897) were found determinant factors of diarrhea. Health extension model families training and follow up programs are needed to be expanded for all non-model families.

A preliminary survey of major diseases of ruminants and management practices in Western Tigray province, northern Ethiopia

BACKGROUND

Despite the highest population, the productivity of Ethiopian livestock is low, and the direct contribution to the national economy is limited. Poor genetic potential, shortage of feed in quantity and quality, poor health care and management practices are the main contributors to low productivity and production. Data on animal disease and management practices are not in place, in this regard; we estimate the burden of animal health ailments and management practices in ruminants via simple cross-sectional study design in randomly selected peasant associations in western Tigray of northern Ethiopia.

RESULTS

A preliminary disease survey in ruminants and their management practices comprising of cattle, sheep and goats was undertaken to evaluate the existence, burden of ruminant diseases and management practices. A total of 121 randomly selected household respondents of Maikhadrah and Bakhar (26.2%), Dansha (19.7%), Adi-Hirdi (18.0%), Adi-Remets and Inda-Selassie (36.1%) sub-districts were inspected throughout the study period. Most (81%) of farmers feed their animals on free grazing in the open environment travelling from highlands and midlands to lowlands in search of adequate feed (different species of grasses) and crop residues during the wet season up to the beginning of the dry season. Majority of farmers (43.8%) had veterinary access from governmental veterinary officers. Thirty-four (33.9%) of the respondents got veterinary access from illegal drug dealers in mini shops or market. Among the major disease constraints identified; Tick infestation (89.3%), lice infestation (68.6%) mange mite infestation (77.7%) lumpy skin disease (LSD) (42.1%), trypanasomiasis (62.8%) bovine pasteurellosis (52.1) mastitis (13.2%), sheep and goat pox (15.7), abortion (19.0%), dystocia (24.8%), retained fetal membrane (25.6%), prolapsed uterus (13.2%) delayed heat period (38.8%) were most endemic ailments directly affecting livestock production and farmers livelihood.

CONCLUSION

In conclusion management practices in livestock production is poor to a large extent. Burden and endemicity of livestock diseases are substantially higher. The data obtained could be the source of facts for planners in animal health service delivery system in this sub region.

Predictors of postpartum contraceptive use in rural Tigray region, northern Ethiopia: a multilevel analysis

Background

Postpartum family planning services is one of the recommended public health intervention aimed at reducing maternal and child morbidity and mortalities. However, there is a paucity studies in rural Tigray region. Therefore, determining the level and associated factors of contraceptive use among postpartum women has the potential to contribute in achieving the Ethiopian Health Sector Transformation Plan and to the Sustainable Development Goals on maternal and infant survival.

Methods

A community-based cross-sectional study was done among 1109 postpartum women from March 29, 2017 to April 29, 2017. Face –to–face interview was used for data collection. The collected data were entered and cleaned using EPI - INFO version 7statistical software and later exported to and analyzed using STATA version 12. Mixed-effects multilevel logistic regression analysis was used to identify the individual and community-level factors associated with contraception adoption. A two side p-value< 0.05 was considered to be statistically significant.

Results

The level of contraceptive use was 38.3%. Individual-level variables such as women belong to fourth (AOR = 1.2; 95% CI: 1.1–3.2) and fifth (AOR = 1.5; 95% CI: 1.3–2.5) wealth quintiles were identified as key predictors of contraception use. In addition, partner secondary (AOR = 2.3; 95% CI: 1.8–3.5) and diploma (AOR = 1.2; 95% CI, 1.1–2.6) educational-level and postnatal care (AOR = 2.0; 95% CI: 1.9, 4.3) were also significantly affected contraception use. Community-level variables such as high community-level antenatal care services use (AOR = 2.1; 95% CI: 1.9–4.2) and proximity of women to health facility (AOR = 3.0; 95% CI: 2.7–4.6) were also determinants of contraception uptake.

Conclusions

The status of contraceptive use in rural Tigray region was found to be low. It was found that both individual and community-level variables showed a marked determinant on postpartum contraception use. This study suggested that in order to increase contraceptive use the government should focus on increasing postnatal care, antenatal care services use and reduction of poverty level are important avenues for intervention.