Department of Reproductive Health
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Item FERTILITY DESIRE AND ITS ASSOCIATED FACTORS AMONG WOMEN ATTENDING ANTIRETROVIRAL THERAPY AT PUBLIC HOSPITALS IN MEKELLE, TIGRAY, ETHIOPIA, 2024: CROSS SECTIONAL STUDY(Mekelle University, 2025-02-25) SOLOMON TEKLUBackground: Fertility desire is defined as having motivation or intention to give birth by individuals in their future life irrespective the number of children. Fertility desire has undesirable effect on the transmission of human immunodeficiency virus to the partner due to unsafe sex, vertical transmission to the children and there will be also disagreement with the strategies developed for elimination of human immunodeficiency virus/acquired immunodeficiency syndrome in countries including Ethiopia. Objective: To assess the prevalence of fertility desire and its associated factors among women attending antiretroviral therapy at public hospitals in Mekelle, Tigray, Ethiopia, 2024. Methods and Materials: Institutional based cross-sectional study was conducted among 355 women and participants were selected using systematic random sampling method. The data were collected from August 1, 2024 to August 30, 2024 using pre-tested and interviewer administer questionnaire. Few variables were recorded from participant’s card. The data were analyzed using statistical package for social science version 27. Binary logistic regression method of analysis was used. All variables with P-value <0.25 in bivariate were included in the multivariable binary logistic regression analysis. The strength of the association was interpreted using an adjusted odds ratio with its 95% confidence interval. Statistically significant variable was declared at P-value < 0.05. Finally, the data were presented with texts, tables, figures, and graphs. Results: This study included 355 women, of them 345(97.2%) responded to the study. The prevalence of fertility desire was 182(52.8%, 95% CI: 46.6%-59.1%). Being single 69.3% (AOR: 0.307, 95% CI: O.111-0.84), being widowed 91% (AOR: 0.09, 95% CI: 0.038-0.214), being divorced 76.7% (AOR: 0.233, 95% CI: 0.109-0.497), number of women’s child 50.8% (AOR: 0.492, 95% CI: 0.382-0.632) and knowledge of women on prevention mother to child transmission 24.5% (AOR: 0.755, 95% CI: 0.608-0.938) were negatively associated with fertility desire. Conclusion and recommendation: This study revealed that more than half of participants had fertility desire and factors associated with it were marital status, number of women’s child, knowledge of the women on prevention mother to child transmission. All stakeholders should take into account the prevalence of fertility and its associated factors while serving the women living with human immunodeficiency virus and counsel the women to decrease their interest on the number of children and promote knowledge on the prevention of mother to child transmission.Item Sero-prevalence and Predictors of Syphilis and HIV Co-infection among pregnant women attending ANC in Mekelle City of Conflict-Affected Tigray Region, Ethiopia: Evidence from Firth Penalized Regression(Mekelle University, 2024-11-21) SENAIT HADDISBackground: Sexually transmitted infections (STIs), particularly syphilis and HIV, significantly impact pregnant women in resource-limited countries, complicating treatment and increasing maternal and neonatal risks. In Mekelle City, Tigray, Ethiopia, barriers including limited antenatal care (ANC) access, physiological vulnerability, behavioral risks, socio-economic constraints, and conflict further exacerbate the burden of these infections, underscoring the critical need for accurate prevalence data and identification of predictive factors. Objective: This study aimed to determine the sero-prevalence of HIV/syphilis co-infection and identify associated predictors among pregnant women attending ANC in Mekelle City. Method: A facility-based cross-sectional study was conducted among pregnant women attending ANC services in selected health facilities across Mekelle City, Tigray, Ethiopia. A two-stage stratified sampling procedure was utilized to draw representative pregnant women under ANC from a health facility in each sub city. Data collection involved an interview-administered questionnaire and pregnant women’s registration books. Due to the relatively small sample size and rarity of co-infection events, Firth penalized logistic regression was employed for statistical analysis to mitigate bias and ensure model stability. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were computed to identify significant predictors. Result: Out of 438 pregnant women enrolled, the sero-prevalence of HIVsyphilis co-infection was 3.7% (95% CI: 1.87–5.43%). Significant predictors included sexual violence (frequency: 13.7%; AOR=2.2, 95% CI: 1.27–3.81, p=0.001), displacement (frequency: 41.1%; AOR=1.6, 95% CI: 1.10–2.32, p=0.043), frequent alcohol consumption (most frequent: 8.9%; AOR=2.1, 95% CI: 1.27–3.46, p=0.004), and limited ANC visits (frequency: 47.5%; AOR=1.8, 95% CI: 1.13–2.87, p=0.014). Conclusion & Recommendation: The high prevalence of HIV and syphilis co-infection rate underscores the need for targeted sexual violence prevention, improved ANC access, and integrated STI screening within ANC services in Mekelle City. Enhanced education on substance abuse and sexual health is essential.Item PERI-CONCEPTION FOLIC ACID INTAKE AMONG PREGNANT WOMEN ATTENDING ANTENATAL CARE FOLLOW-UP IN MEKELLE CITY, TIGRAY REGION, NORTHERN ETHIOPIA MIXED METHOD STUDY/2025(Mekelle University, 2025-05-25) RIGBE TEWELEBIRHANBackground- Although not all birth defects can be prevented, people can increase their chances of having a healthy baby by managing health conditions and adopting healthy behaviors around the time of pregnancy. Findings suggest that daily peri-conceptional intake of 0.4 mg of folic acid reduces the risk of neural tube defects occurrence by approximately 60%. A relatively high dietary intake of folate may also reduce the risk. In Ethiopia, neural tube defect-related deaths are very high with a magnitude of 104/10,000 live births. The overall occurrence of NTDs was 131 per 10,000 births in Tigray. A survey from nine regions of Ethiopia found that only 32.7% of women of reproductive age had optimal levels of serum folate; therefore, 67% had folate insufficiency. The prevalence of folate deficiency and insufficiency means that many Ethiopian women are at risk of poor birth outcomes. Objective- The aim of this study is to assess the peri-conception folic acid intake among pregnant women attending antenatal care follow-up in Mekelle city Tigray Region, Northern Ethiopia/2024. Methods; A mixed method study with facility based cross-sectional design for the quantitative part was conducted in Mekelle City from June/2024 –May/2025. The sample size of this study was 654 mothers. For the qualitative study, 3 focus group discussions of pregnant mothers’ and 6 key informant interviews with health care professionals were conducted. Systematic sampling was used to select the study participants for the quantitative data, while purposive sampling was employed for the qualitative data. Data were collected by interviewer administered questionnaire. The data were entered to Epi-data 3.1 and analyzed by using SPSS version 22. Binary logistic regression analysis was done and the strength of statistical association was measured by adjusted odds ratios at 95% confidence interval. Statistical significance was declared at P-value <0.05. Thematic analysis was employed and result of the qualitative data was presented by triangulating. Result: The prevalence of peri-conception folic acid intake was 18.3%. The main reasons for not taking folic acid supplementation were; lack of awareness, mother not getting sick, not prescribed by a doctor, getting enough folic acid from local food and unintended pregnancy. In the multivariable analysis, marital status (AOR =0.257, 95% CI: .072-0.917), number of antenatal care visits (AOR= 5.09, 95% CI: 1.780, 14.567), employment status (AOR= 2.169, 95% CI: 1.020- 4.614), place of delivery (AOR= 196, 95% CI: .074-.517), gestational age (AOR= .133, 95% CI: .037-.471), level of knowledge (AOR= 3.249, 95% CI: 1.825-5.782) were significantly associated with peri-conception folic acid intake. Conclusion and recommendation: The uptake of peri-conception folic acid in this study was low. Regional health Bureau and health facilities should work on advocating peri-conception folic acid intake in terms of training and supply provision.Item COVID-19 VACCINE UPTAKE AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN OF MEKELLE CITY, TIGRAY, ETHIOPIA: A MIXED STUDY DESIGN(Mekelle University, 2025-02-21) MEKONEN G/MESKELBackground: Adhering to the prevention practices for COVID-19 is paramount than treating the patients. The World Health Organization recommends different prevention and control measures for COVID-19. This study set out to assess COVID-19 vaccine uptake and associated factors among pregnant women in Tigray. Objective: To assess COVID-19 vaccine uptake andassociated factors among pregnant women attending antenatal care in selected public health facilities of Mekelle, Tigray, Ethiopia 2024. Methodology: An institutional-based cross-sectional study design supplemented by a qualitative method was conducted among 228 pregnant women from December to February 2025. A systematic random sampling technique was used to select study participants for the quantitative study, and purposive sampling was used for the qualitative part. Data were collected by trained nurses and midwives using a structured questionnaire. The quantitative data were analyzed using IBM SPSS 27. The qualitative data were analyzed using thematic analysis. A binary logistic regression model was used to assess the association between the dependent and independent variables. Statistical significance was declared at a P value of < 0.05. Result: The mean age of the respondents was 30.3 years, and 54.2% of them were multigravida. Good knowledge and positive attitude about the COVID-19 vaccine were found in 57.5% and 58.9% of the women, respectively. The magnitude of COVID-19 vaccine uptake was 14.5%, and all who took the vaccine reside in urban areas. The odds of uptake were about 6 times higher among pregnant women who attended formal education up to college/university (AOR=5.7, 95% CI: 1.6 to 21.2). The odds of uptake were 4-fold higher among pregnant women who had a history of contact with a confirmed COVID-19 case (AOR=4.1, 95% CI: 1.3 to 13.0). The odds of uptake were 3.6 times higher among pregnant women who had a positive attitude towards the COVID-19 vaccine (AOR=3.6, 95% CI: 1.3 to 9.8). Conclusion and recommendation: This study found that COVID-19 vaccine uptake among pregnant women in Mekelle was low. Hence, health education and discussion about the benefits and safety of COVID-19 vaccination, ensuring that COVID-19 vaccines are readily available and accessible, and conducting outreach COVID-19 vaccination programs can improve uptake of COVID-19 vaccine among pregnant women.Item Antenatal care services satisfaction and related factors, among pregnant women attending antenatal clinic in Public general hospitals of central zone of Tigray region, Ethiopia; 2024: hospital based cross-sectional study design (mixed)(Mekelle University, 2025-04-28) KIDU GEBREYOHANESIntroduction: Antenatal care (ANC) is care offered by skilled healthcare professionals to pregnant women to guarantee the greatest possible health for both the mother and the baby. In Tigray, 78% of health posts, 72% of health centers, and 80% of hospitals had been destroyed during the war according to the Tigray Regional Health Bureau. As a result, ANC coverage decreased from 94% to 16% during the war. Since there is no related research done in the study area, it necessitates undertaking this research. Objective: This study aims to assess ANC services satisfaction and related factors in public general hospitals of central zone of Tigray region, Ethiopia, 2024. Methods: A hospital-based cross-sectional study involving both qualitative and quantitative approaches of data collection was used from September 10 to November 15, 2024. Data were gathered from systematically selected 420 individuals via interviewer administered face-to-face interviews using Kobo toolbox. Data from the kobo toolbox was exported to and analyzed using the Statistical Package for Social Sciences (SPSS) software version 27. Bivariate and multivariable logistic regression analyses were used to identify the factors associated with the outcome variable. For the qualitative part, convenience sampling was used to select respondents, and data were collected through in-depth interviews. Then, inductive thematic analysis was used to manually review qualitative data. Results: Pregnant mothers’ satisfaction with ANC service was found 44.8%. Type of pregnancy, tone of pregnancy, ANC start time, waiting time to see a doctor, getting additional clinical examination, counseling on self-care and on birth preparedness and complication readiness plan and availability of free laboratory service were among the significant predictors of ANC satisfaction. The qualitative findings also highlight that early initiation of ANC, friendly and respectful care, easily accessibility of the institution, etc were frequently raised as a favorable contributors for a satified care. Conclusion and recommendation: pregnant mothers’ satisfaction with ANC was low in this study. Concerned bodies are recommended to undertake continues monitoring, improve financing for health care, staffing and making comprehensive counselling accessible at each service contacts.Item DETERMINANTS OF SUCCESSFUL VAGINAL BIRTH AMONG MOTHERS WITH ONE PREVIOUS CAESAREAN SECTION IN PUBLIC HOSPITALS MEKELLE, TIGRAY, ETHIOPIA 2024: CASE CONTROL STUDY(Mekelle University, 2025-01-28) HADIS DERBEWBackground: The World Health Organization says that 10-15% of babies should be born by C-section in hospitals. But in many countries, including Ethiopia, more babies are born by Csection. This can have bad effects on health and the economy. Having a vaginal birth after a previous C-section (VBAC) is usually safe and a good way to have fewer C-sections. Even though VBAC is successful 60-80% of the time, fewer mothers are trying to have a vaginal birth after a previous C-section, and the number of C-sections is going up. In Tigray have not been studied using case control study approaches on determinants of successful VBAC. So, this study aimed to identify determinants of successful VBAC at public hospitals in Mekelle town. Objective: To assess determinants of successful vaginal birth among women with one previous caesarean delivery in Mekelle public hospitals in 2024. Methods: Institutional based unmatched case control study was conducted in Mekelle public Hospitals from August 1, - September 30, 2024. A total of 194 study participants were included, of which 65 were cases and 129 were controls with cases to controls ratio of 1: 2. Systematic random sampling for controls and cases were selected consecutively. Data were collected using a structured and pre-tested questionnaire then data was entered to Epidata version 4.7 to be cleaned and coded, and exported to statistical package for social science version 27 for analysis. Bivariate, followed by multivariate analysis, were conducted with 95% CI and p-value <0.05 to identify factors associated with successful vaginal birth after cesarean delivery. Result: urban residence (AOR = 2.50, 95%CI: 1.13-5.55), history of SVD (AOR= 2.47, 95%CI: 1.10-5.51), cervical dilatation at admission > 4 cm (AOR = 2.36, 95%CI: 1.01-534), occiputo- anterior position (AOR = 9.69, 95%CI: 2.15-5.55) were determinants significantly associated with successful vaginal birth after previous cesarean section. Conclusion and recommendation: The study shows that urban residence, history of SVD, cervical dilatation at admission > 4 cm, occiputo- anterior position were associated with successful vaginal birth after previous cesarean section. Women live in rural area and cervical dilatation <4 cm at admission health care provider encourage, create awareness and counseled to delivery virginally after c/s. Women with a history of cesarean section should be counseled and encouraged to delivery vaginally as it is not contraindicated.Item PREVALENCE AND FACTORS ASSOCIATED WITH FAILD INDUCTION OF LABOR AMONG WOMEN UNDERGOING INDUCTION AT PUBLIC HOSPITALS OF MEKELLE CITY, TIGRAY(Mekelle University, 2025-06-28) HABEN NIGUSEIntroduction: Induction of labor is more frequently used obstetric procedure, practiced in over 20% of pregnancies globally, with 20% resulting in cesarean delivery. Worldwide, unsuccessful induction of labor is a public health concern. Numerous unfavorable outcomes for both the mother and fetus are linked to it, including postpartum hemorrhage, uterine rupture, birth asphyxia, and prolonged hospital stays. This study aimed to assess the prevalence and factors associated with failed induction of labor among women undergoing induction at public hospitals of Mekelle city, Tigray origin, Ethiopia. Objective: To determine the prevalence and factors associated with failed induction of labor among women undergoing induction at public hospitals of Mekelle city, Tigray, 2024/25 Method: A facility-based cross-sectional study design was implemented on 312 samples from women undergoing labor induction at public hospitals of Mekelle city from September to October, 2024. The sample size was allocated to the selected hospitals proportionally. A structured questionnaire was used for interview of woman on induction and checklist was used to extract data from medical records. Data was analyzed using Statistical Package for Social Science version 27. Binary logistic regression model was used to see the association between dependent and independent variables and multivariable logistic regression was used to identify the independent predictors of failed labor induction. Odds ratio with 95% confidence interval computed and level of significance declared at P-value <0.05. Result: This study showed that the prevalence of failed induction was 26.3% (95% CI: 21.6- 31.4). Factors associated with failed inductions were; Lack of labor induction history (AOR: 10.6; 95% CI: 1.61-70.29), no artificial rupture of membrane (AOR: 4.1; 95% CI: 1.28–13.27), shorter maternal height, (AOR=0.9, 95% CI: 0.88–0.99), and longer induction-to-delivery time (AOR= 0.9, 95% CI: 0.80–0.98). Conclusion: The prevalence of failed induction was high in this study. Lack of labor induction history, no artificial rupture of membrane, shorter maternal height, and longer induction-todelivery time were independent predictors for failed induction of labor. Recognizing these factors and timely interventions can help reduce the risk of failed inductions and improve both maternal and neonatal outcomes.Item PREVALENCE AND ASSOCIATED FACTORS OF CLINICAL MANIFESTATIONS OF VITAMIN -A DEFICIENCY(BITOT’S SPOT AND NIGHT BLINDNESS) AMONG PRESCHOOL CHILDREN IN ENDAMOHONI RURAL DISTRICTS, SOUTHERN TIGRAY, ETHIOPIA, CROSS SECTIONAL STUDY, 2024(Mekelle University, 2025-05-17) YEMANE GITETBackground Vitamin A deficiency (VAD) remains a significant public health issue, particularly among preschool children in low-income countries. In Ethiopia, despite national efforts to address micronutrient deficiencies, clinical signs of VAD—such as night blindness and Bitot’s spots—persist, especially in rural communities. However, existing research has largely focused on biochemical assessments or national-level data, with limited attention to the clinical presentation and contextual risk factors of VAD in rural districts. This study was conducted to assess the prevalence of clinical Vitamin A deficiency and its associated factors among preschool-aged children in a rural district of Southern Tigray, Endamokoni wereda, where local evidence is scarce and the problem remains poorly addressed. Methods A community-based cross-sectional study was conducted among 609 preschool children of Endamohoni District Southern Tigrai, from August to October, 2024. A multi-stage sampling, followed by a systematic sampling technique was employed to select study participants. A structured interviewer-administered questionnaire was used to collect data. Quantitative data were entered using Epi Data statistical software and analysed by using SPSS version 20 statistical software package.Using a descriptive, binary logistic regression model and multivariable analysis was fitted to identify the associated factors of vitamin-A deficiency. The adjusted odds ratio (AOR) with a 95 % confidence interval was computed to assess the strength of the association, and variables with a p value of <0.25 in binarylogistic regression model and <0.05 in multivariable analysis were considered as statistically significant. Results Six hundred nine preschool children were included in the study, The overall prevalence of Clinical vitamin A deficiency was 3.3%,and prevalence of Bitot’s spot and night blindness was 1.8% and 1.5%, respectively. The result of the multivariable analysis revealed that Children aged 12–35 months are at the highest risk of Vitamin A deficiency(AOR = 56.028 (95% CI: 2.545 – 1233.445, p = 0.011) , followed by those aged 36–47 months(AOR = 20.120 (95% CI: 1.706 – 237.224, p = 0.017), when compared to older preschool children (48–72 months). Both groups are statistically significant predictors of VAD in the multivariate model, indicating that younger preschool children are more vulnerable to Vitamin A deficiency. Children who had both diarrhea and respiratory infections were found to have significantly higher odds of Vitamin A deficiency (AOR = 10.001; 95% CI: 0.000–20.604; p = 0.035). However, the extremely wide confidence interval indicates considerable uncertainty in the estimate, likely due to a small sample size or sparse data. Mothers who had experienced stillb irth had significantly lower odds of having a child with Vitamin A deficiency compared to those who had not (AOR = 0.142; 95% CI: 0.023–0.867; p = 0.034). Conclusions Based on WHO thresholds, the overall finding indicates that clinical vitamin A deficiency is a severe public health problem in the population studied. All three indicators — clinical VAD (3.3%), Bitot’s spots (1.8%), and night blindness (1.5%) — exceed the WHO cutoff of 1%, which classifies the situation as severe and requiring urgent public health intervention,and is associated with age of the child,a child with diarrhea and respiratory tract infection and a mother who had experienced still birth which could be used to target interventions to further reduce existing VAD.Overall, the findings highlight the need for targeted nutritional interventions among younger children and those with frequent infections in rural settings. Further strengthening antenatal and postnatal care utilization and giving emphasis to preschool children will help to mitigate vitamin-A deficiency in the study area.Item Magnitude and associated factors of kangaroo mother care among postpartum mothers in Endamekoni Woreda in Tigray north Ethiopia 2024.(Mekelle University, 2025-05-25) Workie YihunBackground: Kangaroo mother care is the skin to skin contact of preterm or LBW infants in continuous and prolonged (8–24 hours per day. Infant mortality remains a major public health dilemma that disproportionally affects low-income countries. In Ethiopia 46.4% of eligible newborns received KMC in the first years. KMC coverage in the country remained low and its implementation was largely limited to specialized hospitals located in Ethiopia's major cities in the first consecutive years of its inception. Objective: To assess the magnitude and associated factors of kangaroo mother care among postpartum mothers in Endamekoni woreda in 2024. Methods: A Cross-sectional study design was used to assess the Magnitude and associated factors of kangaroo mother care among postpartum mothers in Endamekoni woreda in 2023.A Simple random sampling technique was used to select the required sample. Sample size was determined by single population proportion formula and a total of 321 was used .Pretested structure questioners was used by trained diploma nurse’s data collectors to collect the required information. The magnitude of kangaroo mother care was measured by dichotomous in to (Yes/No). The collected data was presented in the ways of narration, graphs, frequencies and percentages. Binary logistic regression was employed to generate reports based on the data. Level of significance was declared at p-value < 0.05. Result: The sample has a mean age of 28.76 years, with most mothers aged between 22.5 and 35. The mean monthly income is 2892.88, indicating income disparity. Most respondents are married (56.7%), with 32.2% single. Over half are illiterate (55.7%), with only 4.3% having college-level education or above. The majority of participants live in rural areas (95%), with only 5% in urban settings. This study revealed that, 63.5% (58.1% and 68.6%) has good KMC practice. Marriage significantly increases the likelihood of practicing good KMC practices, while having a college education decreases it, suggesting that individuals with higher education are less likely to engage in such practices. Conclusion and Recommendations: The study found low Kangaroo Mother Care practice among participants. Improving maternal and infant health outcomes requires support for single mothers, educational interventions, targeted training for healthcare providers, awareness of KMC benefits, and access to family planning and immunization services. Local health departments, community organizations, NGOs, and public health agencies should enhance support systems for single and divorced mothers by developing community-based programs, promoting KMC through tailored awareness campaigns, training healthcare providers, improving access to family planning services, and promoting KMC regardless of the child's health status. .Item MAGNITUDE OF PRE-ECLAMPSIA AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN AT DELIVERY WARD CROSS SECUTIONAL PUBLIC HOSPITALS OF SOUTHERN TIGRAY, ETHIOPIA(Mekelle University, 2025-05-28) MESFIN BERIHUNBack ground: Pre-eclampsia is still one of the four groups of Hypertension disorder of pregnancy that requires the most public involvement to improve outcomes for both the mother and the fetus. Objectives: To assess the magnitude of pre-eclampsia and associated factors among pregnant women at delivery ward in selected public hospitals of southern Tigray, Ethiopia, 2024. Methods: An institution based cross sectional study was employed from 1 to 30, June, 2024. Two public Hospitals was selected from five public hospitals found in southern Tigray using simple random sampling. A systematic random sampling technique was used to select a sample of 351 participants. One day training was held for data collectors and supervisor. Verbal consent was obtained and data were collected via face-to-face interview using a structured and pretested questionnaire. The collected data were entered into EPI- Data version (3.1) and then exported to Statistical packages for social science Version-27 for analysis. Missing values, outliers and normality of data checked by data exploration. Descriptive statistics, bi-variable and multiple variable logistic regression analysis were carried out. . Result: Thirty-six (10.3%) (CI: 7.1-13.7) pregnant mothers had Pre-eclampsia. The results of logistic regression analysis showed that Pre-eclampsia was statistically associated with history of diabetic mellitus disease (AOR; 2.99:95%CI 1.14-7,8), family history of hypertension (AOR; 3.61:95% CI1.13-11.5) and age 15-19 (AOR;0.177:95% CI 0.34-0.91) and 20-34 (AOR;0.39:95% CI0.171-0.86) with PV <0.05. Conclusion and Recommendation: Pre-eclampsia was similar prevalent in this study than other most similar studies in Ethiopia context. Factors such as having history of diabetic mellitus, family history of hypertension and Age of respondent were significant predictors of pre-eclampsia among pregnant women. Thus, those women should receive close prenatal care to monitor for signs and symptoms of pre-eclampsia and to manage their underlying conditions and it needs more attention for advanced age of women during pregnancy.