Department of Reproductive Health
Permanent URI for this collectionhttps://repository.mu.edu.et/handle/123456789/190
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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 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 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 FISHABackground: 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.Item 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 TESFAMICHAELBackground: 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.Item 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 ZEREABRUKBackground: 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.Item 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 ASHEBThe 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.