Department of Reproductive Health

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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 GEBREYOHANES
Introduction: 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.
Assessment of Reproductive Health Service Utilization & Associated Factors Among youths in Selected Schools, Tigray, Ethiopia
(Mekelle University, 2025-06-25) GIRMAY TOLOSA
Introduction: Youths (15–24 years old) worldwide are at risk, particularly women, for unsafe abortions, poor contraceptive services, high rates of unwanted pregnancies, and STIs. Students in secondary schools, especially in our country, are more vulnerable to several reproductive health problems. In Tigray, due to the war, there is no clear information on reproductive health service utilization in secondary schools. Additionally, there are many new cases of HIV/AIDS, early pregnancies, illegal abortions, and poor utilization of family planning. Therefore, this study aims to investigate how youths in Mekelle secondary schools utilize these services and identify factors that influence their use. Objective: To assess reproductive health service utilization and associated factors among youths attending secondry schools in Mekelle, Tigray, Ethiopia 2024. Methods: An institutional-based cross-sectional study was conducted on 630 secondary school students in Mekelle town from December to March 2024/25. A structured interviewed questioner was used to collect the data. The samples were distributed proportionally to each school, and participants from each school were selected by systematic random sampling technique. Bivariate and multivariable logistic regression was carried out to assess the association between dependent and independent variables. Level of significance was declared from p-value < 0.05 and adjusted Odds ratio with 95% confidence interval for the predictors of reproductive health service utilization. Result: Among the 630 students who participated in this study, 279 (39.4%) reported utilizing reproductive health services. Among these, most of the respondents (400 (63.5%)) were from governmental school. Most of the respondents (480 (76.2%)) were from urban areas. About 364 (57.8%) were females. the majority of the respondents (351(55.7%)) were within the age group of 15–19 years (Table 1). And the mean age of the participant were 18.96. And the predictors of reproductive health service utilization included the availability of an RHS facility in school (AOR = 2.203, 95% CI (1.507, 3.222)), the mother's educational status, prior awareness of Reproductive Health services, and knowledge of Reproductive Health services delivery facility. Conclusion and Recommendation: Reproductive health service utilization is the prevalent public health problem in our study area. Predictors which are availability of an RHS facility in school, mother's educational status, prior awareness of Reproductive Health services, and knowledge of Reproductive Health services delivery facility can be minimized by establishing reproductive health service centers within schools and stakeholders should work to scale up the service utilization in schools by considering the students’ background.
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/MESKEL
Background: 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.
Determinants of First-Line Antiretroviral Treatment Failure among HIV Patients Enrolled in ART after Post-war at Alamata General Hospital in Southern Tigray, Northern Ethiopia, 2024
(Mekelle University, 2025-01-28) HABTU BERIHUN
Introduction: Antiretroviral therapy (ART) has revolutionized HIV management by targeting different stages of the HIV lifecycle. However, first-line ART failure remains a significant challenge globally, affecting both patients and the healthcare system. In Sub-Saharan Africa, where the HIV epidemic is disproportionately burdened, achieving viral suppression remains a challenge. Factors contributing to ART failure include poor adherence, advanced HIV disease, co-infections, and limited access to viral load monitoring. This can lead to virus replication and resistance, compromising the effectiveness of the initial drug regimen. The recent conflict in Tigray, Ethiopia, has exacerbated the issue, putting a greater strain on the healthcare system and increasing costs. Objective: The aim of this study is to assess the determinants of first-line antiretroviral treatment failure among HIV patients after post-war enrollment in ART at Alamata General Hospital in southern Tigray, in 2024. Methods: An unmatched case control study was conducted among 689 HIV clients enrolled in ART at Alamata General Hospital from May 2024 to September 2024. The study population includes all HIV positive adult patients who were on first-line treatment and controls who met the study criteria. The study will use systematic sampling techniques and structured questionnaires to gather data from medical records and registers of patients on ART. Adherence variables will be categorized into poor, fair, and good adherence. Data quality control established through pre-testing and validation of questionnaires. Data was analyzed using Epi data version 4.2.Softwareand will be exported to SPSS for analysis and a binary logistic regression model to identify variables determining first-line antiretroviral failure. Variables will interpret as having a statistically significant association when the p-value is< 0.05. Results: A study found that a significant number of HIV patients and controls aged 25-34 years were enrolled in antiretroviral therapy (ART). Most were female, married, illiterate, self-employed, and lived below the poverty line. Most patients were on TDF-based ARV regimens at baseline, with a higher proportion in WHO clinical stage 3. A higher proportion of cases developed tuberculosis after starting ART. A significant proportion of cases exhibited poor adherence to ART, with 44.6% being regular coffee drinkers while taking ARV pills. Treatment started with partners, with 59% of cases and 67% of controls starting treatment six months apart. Support groups were involved in 67.4% of cases and 67.4% of controls. Treatment failure rates are higher in individuals aged 25-34, male patients, rural residents, WHO stage III/IV patients, patients with a baseline CD4 count <100 cells/mm³, and those with a BMI <16.5 kg/m². Poor adherence to ART is associated with a 3.6-fold increased risk of failure. Conclusion: In conclusion, this study identified several important determinants of first-line ART failure among HIV patients in post-war settings. Addressing these factors through comprehensive interventions, including early diagnosis, timely initiation of ART, adherence counseling, nutritional support, and conflict-mitigation strategies, is crucial to improve treatment outcomes and reduce the burden of HIV in affected populations.
DETERMINANTS OF LATE INITIATION OF ANTENATAL CARE CONTACT AMONG PREGNANT WOMEN IN HEALTH FACILITIES OF MEKELLE, TIGRAY, NORTHERN ETHIOPIA, 2024
(Mekelle University, 2025-02-25) GENET TESFAMICHAEL
Background: Late antenatal care is the most common issue in developing countries, including Ethiopia. In Ethiopia, 72% of pregnant women come late for their first antenatal care contact. Late antenatal care initiation is more likely to be linked to poor perinatal health outcomes. Where the effects of late antenatal care initiation are significant in Ethiopia, a scarcity of data hinders for understanding of its determinants. Objective: To identify determinants of late initiation of antenatal care contact among pregnant women in health facilities of Mekelle, Tigray, Northern Ethiopia,2024. Method: Facility based unmatched case control study was conducted in health facilities of Mekelle, Tigray, Northern Ethiopia, from 7 August -5 September, 2024. The data were collected using pre-tested structured questionnaire. In this study 592 study participants (296 cases and 296 controls) were selected using systematic random sampling technique. Cases to controls ratio was 1 to 1. Bivariate and multivariable logistic regression analysis were used to identify determinants of late antenatal care initiation and adjusted odds ratio with corresponding 95% confidence interval was used to measure strength of association. Statistical significance was declared at 𝑃-value <0.05. Result: A total of 592 study participants were included in the study with 98% response rate. Low educational level [AOR=5.60;95%CI:2.766-11.357], recognizing pregnancy by missed period [AOR=2.552; 95%CI:1.588-4.102], unplanned pregnancy [AOR=3.216; 95%CI:1.934-5.347], not accompanied by their husband to ANC contact [AOR=4.306; 95%CI:2.757-6.726] and poor knowledge of the mothers about ANC [AOR=2.049; 95%CI: 1.326-3.168] were identified as determinants of late initiation of ANC among pregnant women. Conclusion and recommendation: Low educational level, recognizing pregnancy by missed period, unplanned pregnancy, not accompanied by their husband to ANC contact and poor knowledge of the mothers about ANC were identified as determinants of late initiation of ANC among pregnant women. Therefore, Health offices and healthcare providers should focus on increasing awareness to improve women's knowledge on ANC services, and to support spouse involvement in ANC.
DETERMINANTS OF PRECANCEROUS CERVICAL LESIONS AMONG WOMEN SCREENED FOR CERVICAL CANCER IN PUBLIC HOSPITALS OF TIGRAY, ETHIOPIA, 2024. CASE-CONTROL STUDY
(Mekelle University, 2025-01-28) HAFTOM BIRHANE
Back ground: - Cervical cancer is a common health problem in sub-Saharan countries, mainly in Ethiopia, where a significant number of women are diagnosed, and pre-cancerous lesions are being detected at a late stage, leading to high mortality. The prevalence of precancerous cervical lesions has increased dramatically in Ethiopia (from 7% to 28%), with some regions showing even higher rates. However, the determinants contributing to this rise remain unstudied in Tigray, especially in a case-control study design. Objective: To assess determinants of precancerous cervical lesions among women screened for cervical cancer in public hospitals of Tigray, Ethiopia, 2024. Methods: This study employed a case-control design among (112 cases and 336controls) from August 1 to October 30/2024. Cases and controls were selected by systematic random sampling method and data was collected via a structured questionnaire then data were entered to Epi Data version 4.7 then exported to statistical package for social sciences, p value less than 0.2 in bivariate analysis were included multivariable logistic regression with 95% confidence interval. Finaly p value <0.05 were decided as determinates of precancerous cervical lesions. Result: - Women with a secondary school (AOR=0.044; 95% CI: 0.018-0.107), diploma and above of the women (AOR=0.008; 95% CI: 0.002-0.028), women with two or more life time sexual partners (AOR=9.001, 95% CI: 4.221-19.193), history of STIs, (AOR=3.433, 95% CI: 1.600-7.364) and ever use of hormonal contraceptives (AOR=2.340, 95% CI: 1.220-4.487) were found to be determinates of precancerous cervical lesions. Conclusion and Recommendation: Having two or more lifetime sexual partners, education status of women secondary, diploma, and above, ever use of hormonal contraceptives, and having history of sexual transmission infections were identified as determinants of precancerous cervical lesions. Therefore, efforts should be made to reduce the risk of sexual transmission infections, provide health education and strengthening education for those no formal education women, educate about faithful, one to one relationship, and promote early screening for cervical cancer in women who have ever use hormonal contraceptives.
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 DERBEW
Background: 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.
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 TEKLU
Background: 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.
MAGNITUDE AND ASSOCIATED FACTORS OF COMMON CHILDHOOD ILLNESS AMONG UNDER FIVE CHILDREN IN ENDAMOHONI DISTRICT, TIGRAY, ETHIOPIA. COMMUNITY BASED CROSS - SECTIONAL STUDY 2023/24.
(Mekelle University, 2024-05-28) HINTSA GEBREMEDHIN
Background: Common childhood illness includes acute respiratory infections, diarrheal diseases, and febrile illnesses. Thus illnesses remain a significant cause of morbidity and mortality among children under five children in developing country. Thus identification of associated factors of childhood illness would help to guide strategic planning and prioritize interventions. Objectives: To assess the magnitude and associated factors of common childhood illness among under five children in Endamohoni district, Tigray, Ethiopia. 2024. Methods: A community based cross sectional study design was employed. The study population were all children aged below 59 months and residents in the randomly selected Kebeles of Endamohoni District. A total of 552 study participants were selected using systematic random sampling technique and the sample size was determined using single and double proportion formula. Interviewer administered structured questionnaire was used to collect data. The data was entered in to Epi-data 4.4.2.1 and exported to SPSS version 25 for analysis. Binary Logistic regression analysis was used to assess the influence of independent variables to the outcome variable. Variables with p-value of ≤ 0.25 in the bivariate analysis were transferred to multivariable analysis. In the multivariable analysis, variables with P-value of P < 0.05 were considered statistically significant. Hosmer and Lemeshow was used to indicate goodness of fit. Result: One hundred eighty seven 33.9% (95% CI:30.0%-38.4%) under five children had common childhood illness. according to specific symptoms presence of cough ,diarrhea and fever were 15.2 % ( 95% CI:12.1%-18.3%) ,13 % ( 95% CI:10.1%-15.8%) and 12.3 % ( 95% CI:9.6%-15.4%). the factors affecting common childhood illness were place of residence (AOR= 2.3 (95% CI: (1.15, 4.59)), mother met minimum meal frequency while she was pregnant or lactating (AOR= 1.6 (95% CI: (1.05, 2.54)) and hand washing at critical times by family members (AOR= 4.00 (95% CI: (2.19, 7.56)). Conclusion and recommendation:. The findings of this study shows a concerning prevalence of common childhood illness ,affecting 33.9% of children in the surveyed population. in our community.by fostering better dietary practices and hygiene education ,we can create a healthier future for our children.
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 Yihun
Background: 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. .
Magnitude and Determinants of Maternal Complications during Pregnancy and Post-Partum in Ethiopia: A Survey Study using PMA Data
(Mekelle University, 2025-06-17) MAEDOT FISHA
Background: A maternal complication is a physical or mental issue that affects the mother's health, the fetus's health, or both. Even women who were healthy before getting pregnant can experience complications. These complications may make the pregnancy a high-risk pregnancy. All pregnancies are at risk. According WHO (world health organization) most of the complications develop during pregnancy and most are preventable or treatable. Other complications may exist before pregnancy but are worsened during pregnancy. In Ethiopia the these complications were the major direct obstetric complications Objective: To determine the magnitude and determinant factors during pregnancy and postpartum complications data from PMA Ethiopia Methods: Performance Monitoring for action (PMA) surveys are a prospective cohort survey based on a multistage stratified cluster sampling design with urban-rural stratification. The sample size of this study is 1678 and the study population was women’s who have pregnant or women 0-4 weeks of postpartum. The magnitude of complications during pregnancy and postpartum period will be computed by using STATA 17 software. Multivariable logistic regression analysis was used to control confounding variables at the p-value < 0.05 and the strength of the statistical association with maternal complication during pregnancy and post partum was measured by using adjusted odds ratios and ` 95% confidence intervals. Result: magnitude of maternal complication during pregnancy and postpartum is 37.31% and38.74% respectively. Women who have develop a complication both during pregnancy and post partum were 18.3%. Women who have completed the higher education [AOR =0.191, 95% CI: (0.093, 0.392)]. A woman who has a grand multi Para [(AOR = 0.662, 95 % CI: (0.442, 0.993)]. Women’s who have obtain ANC follow up[AOR =0.758, 95% CI: (0.573, 1.004)]. Women with twin pregnancies [(AOR = 1.97, 95 % CI: (0.974, 3.963)] these factors associated with maternal complication during pregnancy. Living with a man [AOR = 2.453, 95% CI: (1.214, 4.957)]. Women who attended greater than 4 ANC follow up [AOR = 0.727, 95% CI: (0.526, 1.006)]. Women with twin pregnancy [AOR = 3.596, 95% CI: (1.225, 10.556)]. Postpartum visit [AOR = 0.682, 95% CI: (0.482, 0.965)] these factors associated with postpartum complication. Conclusion: Maternal complication during pregnancy and postpartum in Ethiopia was found to be major maternal health issue. Being living with a man, uneducated mother and their life partners, twin pregnancy, absence of post natal visit and low ANC visit were important predictors of maternal complications during pregnancy and postpartum period. By implementing targeted interventions to address the identified maternal complications, focusing on high - risk areas and populations to improve maternal health outcomes.
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 BERIHUN
Back 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.
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 TEWELEBIRHAN
Background- 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.
POSTPARTUM CONTRACEPTIVE UTILIZATION AND ASSOCIATED FACTORS AMONG WOMEN WHO GAVE BIRTH IN THE PAST 12 MONTHS IN ENDAMOKONI DISTRICT, TIGRAY, NORTH ETHIOPIA. A MIXED CROSS-SECTIONAL STUDY
(Mekelle University, 2025-03-28) ASEFU KIROS
Background The first year after a woman has given birth is crucial period for uptake of contraceptives to prevent pregnancy. However, in Ethiopia contraception use in postpartum period is only 8% while unmet need is 81%. There is limited research that provided detail information regarding barriers of modern contraceptive utilization during postpartum period in the study area. In addition, earlier study also suggested that to conduct using mixed quantitative and qualitative design for additional investigations to answer these “why”questions and narrow these gaps. Objective. This study aimed to assess postpartum contraceptive utilization and associated factors among women who gave birth in the past 12 months Endamokoni district, Tigray, northern Ethiopia 2024. Method: A mixed type community based cross-sectional study design was conducted among 396 women in Endamokoni district, from April, 2–30/2024 Systematic random sampling technique was used to select study participant and data was collected using semi-structured pretested questionnaire and entered in to Epi data version 3.1 and then exported to SPSS version 25.0 for analysis for quantitative. The association between variables was analyzed using bivariate and multivariable binary logistic regression and level of significant determined with adjusted odd ratio at 95% CI and P-value less than < 0.05. After translation and transcription, manual thematic analysis was applied to the qualitative data Results: The prevalence of postpartum contraceptive use in Endamekoni wereda found 33.6% (95% CI: 28.6– 38.7) with a response rate of 98%. The most frequently used method was implant (17.9%). Knowledge on modern contraceptive (AOR=3.23,95% CI=2.11-3.9) and ever use of family planning, (AOR=2.58, 95% CI: 1.57-4.22) were predictors for postpartum contraceptive use. Partner opposes, myths and, need for excess family size, fear of side effect, menses not resumed were barriers to modern postpartum contraceptive utilizationn. Conclusion and recommendation: utilization of Postpartum family planning use in the study area was low. Uptake of postpartum family planning was influenced with knowledge on FP and prior family planning use. All study area stakeholders should promote knowledge of post-partum family planning. Menses’ resumed, family planning counseling during antenatal care visit, linked to family planning unit during child immunization and good knowledge were factors associated to modern postpartum contraceptive utilization.
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 GITET
Background 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.
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 NIGUSE
Introduction: 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.
QUALITY AND SPATIAL DISTRIBUTION OF IMMEDIATE POSTPARTUM CARE IN ETHIOPIA: A MULTILEVEL ANALYSIS USING PERFORMANCE MONITORING FOR ACTION ETHIOPIA 2023 DATA
(Mekelle University, 2024-11-28) HAFTAAB ASHEB
The immediate postpartum period is associated with a significantly increased risk of morbidity and mortality for both the mothers and newborns. Providing quality immediate postpartum care helps reduce negative outcomes. Most studies conducted in Ethiopia have identified factors associated with postnatal care utilization. However, no evidence links household and community data to service delivery points and their geographic distribution, which are necessary to assess the quality of immediate postpartum care. To assess the quality and spatial distribution of immediate postpartum care in Ethiopia, 2024. We used a cohort of household and facility data from the National Performance Monitoring for Action Ethiopia study, which was conducted in 2023 across four major regions (Amhara, Oromia, South Ethiopia, and Addis Ababa). A total of 1,351 postpartum women and their newborns were linked to the nearest 264 health facilities. A multilevel binary logistic regression analysis was employed to assess contextual factors. The adjusted odds ratio with a 95% confidence interval (CI) was used to measure the associations between variables, with statistical significance set at P<0.05. The SaTScan V.10.2.5 and ArcGIS V.10.8 geostatistical software were used to explore the spatial distribution and interpolation of the quality of immediate postpartum care. The quality of immediate postpartum care among women and their newborns was 29.8% (95% CI 27%- 32%), ranging from 14.1% in Southern Ethiopia to 40.9% in Addis Ababa. In the multivariable multilevel analysis, religion (AOR=0.51; 95% CI 0.31-0.83), antenatal care visits (AOR=1.78; 95% CI 1.08-2.95), cesarean delivery (AOR=0.45; 95% CI 0.27-0.76), being attended by a nurse/midwife (AOR=1.96; 95% CI 1.26-3.03), urban residence (AOR=1.85; 95% CI 1.05-3.25), birth at private hospitals/clinics (AOR=4.12; 95% CI 2.07-8.51), and higher community media exposure (AOR=2.99; 95% CI 1.76-5.06) were significant predictors of the quality of immediate postpartum care. The spatial distribution of the quality of care varied significantly across regions, with a global Moran’s I = 0.99, P=0.001. Significant hotspots of good-quality care were detected in Addis Ababa. The quality of immediate postpartum care was low in Ethiopia, with significant spatial variation across the country. Therefore, public health interventions should be designed for areas where the quality is low to reduce maternal and newborn mortality by increasing antenatal care visits, increasing community media exposure, and strengthening health systems in rural areas.
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 HADDIS
Background: 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.
WOMEN’S AUTONOMY ON MATERNAL HEALTH SERVICES UTILIZATION AND ASSOCIATED FACTORS AMONG REPRODUCTIVE AGE GROUP WOMEN IN CENTRAL TIGRAY, ETHIOPIA, 2025, A CROSS-SECTIONAL STUDY.
(Mekelle University, 2025-04-21) FITHANEGES ZEREABRUK
Background: The ability of a woman to make decisions pertaining to herself and the closest members of her family are all considered aspects of women's autonomy. Many studies revealed women’s decision-making autonomy of maternal services utilization is low in many parts of the world, particularly in developing countries. The absence of previously studied research and the presence of a protracted and complex crisis in the Tigray region create a need to assess women's autonomy in maternal health service utilization and associated factors among the reproductive age group in Ethiopia. Objective: To assess women's autonomy on maternal health service utilization and associated factors among reproductive-age group women in the Central Zone, Tigray, Ethiopia, 2025. Methodology: A community-based cross-sectional study design was carried out from January to April 2025. Multi-stage sampling technique was used, and design effect was considered. The total sample size was 836, which was proportionally allocated for each randomly selected 21 kebeles of 07 woredas in the central zone of Tigray and the study participants were chosen using a systematic random sampling technique. Data were collected using Kobo Toolbox and analyzed using SPSS version 26. A pretest was done on 5% of the sample size. In the Bivariate analysis, variables with p-value < 0.25 were a candidate for the multivariable logistic regression analysis and statistical significance was declared at a p-value of <0.05. Results: Women who had autonomy in deciding whether to utilize maternal health services was 70.3% [95% CI: 67.2-73.4]. women who attend secondary education or above (AOR=18.9, 95% CI: 8.8-40.9) over no formal education, increased household annual capital by 1000 Ethiopian birrs (AOR=1.02, 95% CI: 1.01-1.03), women who get married by their choice (AOR = 6.6, 95% CI: 3.5-12.7) over their counter parts were positively associated with women’s autonomy. Conversely, increased age difference between spouses by 01 year (AOR=0.7, 95% CI: 0.6-0.8), increased women’s family size by one family member (AOR=0.4, 95% CI: 0.34-0.52) were negatively associated with women’s autonomy. Conclusion and recommendation: Women’s ability to utilize maternal health care services depends on women’s autonomy in making decisions for their health care. Accordingly, this study shows three-fourths (70.3%) of the participants were autonomous in deciding whether to use maternal health services or not. Factors significantly related to women’s autonomy in maternal health services utilization were women’s educational status, women’s annual capital, how they got married (willingness/choice), age difference between spouse, family size, and type of family. A great emphasis should be given to empowering women in terms of education, job opportunities, protecting their rights and choices during marriage, and the use of contraceptive methods to limit their family size and burden.