Maternal mortality is noticeably high in sub-Saharan African countries including Ethiopia. Continuous nationwide systematic evaluation and assessment of the problem helps to design appropriate policy and strategy in Ethiopia. This study aimed to investigate the trends and causes of maternal mortality in Ethiopia between 1990 and 2013. We used the Global Burden of Diseases and Risk factors (GBD) Study 2013 data that was collected from multiple sources at national and subnational levels. Spatio-temporal Gaussian Process Regression (ST-GPR) was applied to generate best estimates of maternal mortality with 95% Uncertainty Intervals (UI). Causes of death were measured using Cause of Death Ensemble modelling (CODEm). The modified UNAIDS EPP/SPECTRUM suite model was used to estimate HIV related maternal deaths. In Ethiopia, a total of 16,740 (95% UI: 14,197, 19,271) maternal deaths occurred in 1990 whereas there were 15,234 (95% UI: 11,378, 19,871) maternal deaths occurred in 2013. This finding shows that Maternal Mortality Ratio (MMR) in Ethiopia was still high in the study period. There was a minimal but insignificant change of MMR over the last 23 years. The results revealed Ethiopia is below the target of Millennium Development Goals (MGDs) related to MMR. The top five causes of maternal mortality in 2013 were other direct maternal causes such as complications of anaesthesia, embolism (air, amniotic fluid, and blood clot), and the condition of peripartum cardiomyopathy (25.7%), complications of abortions (19.6%), maternal haemorrhage (12.2%), hypertensive disorders (10.3%), and maternal sepsis and other maternal infections such as influenza, malaria, tuberculosis, and hepatitis (9.6%). Most of the maternal mortality happened during the postpartum period and majority of the deaths occurred at the age group of 20–29 years. Overall trend showed that there was a decline from 708 per 100,000 live births in 1990 to 497 per 100,000 in 2013. The annual rate of change over these years was -1.6 (95% UI: -2.8 to -0.3). The findings of the study highlight the need for comprehensive efforts using multisectoral collaborations from stakeholders for reducing maternal mortality in Ethiopia. It is worthwhile for policies to focus on postpartum period.
Adverse birth outcomes are major public health problems in developing countries. Data, though scarce in developing countries including Ethiopia, on adverse birth outcomes and the risk factors are important for planning maternal and child health care services. Hence, this study aimed to determine the prevalence and associated factors of adverse birth outcomes among deliveries at Gondar University Hospital, Northwest Ethiopia. Institution based cross-sectional study was conducted in February 2013 at Gondar University Hospital. Data were collected by face-to-face interview of 490 women after verbal informed consent using a pretested and structured questionnaire. Gestational age was determined based on the last normal menstrual period. Birth weight was measured following standards. Multiple logistic regressions were fitted and odds ratios with their 95% confidence interval were computed to identify associated factors. The mean age of women was 26.2 (±5.2 SD) years. HIV infection among laboring women was 4.8%. About 23% of women had adverse birth outcomes (14.3% preterm, 11.2% low birth weight and 7.1% still births). Women having history of either preterm delivery or small baby (AOR: 3.1, 95% CI 1.1- 8.4) were more likely to have preterm births. Similarly, history of delivering preterm or small baby (AOR: 8.4, 95% CI 2.4- 29.4), preterm birth (AOR: 5.5, 95% CI 2.6- 11.6) and hypertension (AOR: 5.8, 95% CI 1.8- 19.6) were associated factors with low birth weight. Ante partum haemorrhage (AOR: 8.43, 95% CI 1.28- 55.34), hypertension (AOR: 9.5, 95% CI 2.1-44.3), history of perinatal death (AOR: 13.9, 95% CI 3.3- 58.5) and lack of antenatal care follow up (AOR: 9.7, 95% CI 2.7 - 35.8) were significantly associated with still birth. Prevalence of adverse birth outcomes (still birth, preterm birth and low birth weight) were high and still a major public health problem in the area. Histories of perinatal death, delivering preterm or small baby, ante partum hemorrhage, lack of ante natal care follow up and hypertension were associated factors with adverse birth outcomes. Thus, further enhancements of ante natal and maternal care and early screening for hypertension are recommended.
Hypertension is a growing public health problem in many developing countries including Ethiopia. However, its prevention and control has not yet received due attention. This study aimed to determine the prevalence and associated factors of hypertension among adults in Gondar city, North-West Ethiopia.
Ethiopia is the second most populous country in Africa with high fertility and fast population growth rate. It is also one of the countries with high maternal and child mortality rate in sub-Saharan Africa Family planning is a crucial strategy to halt the fast population growth, to reduce child mortality and improve maternal health (Millennium Development Goal 4 and 5). Therefore, this study aimed to assess the prevalence and determinants of modern contraceptive utilization among married women of reproductive age group.
Population studies on normal and dysfunctional characteristics of menstrual cycles are scarce in Ethiopia. In addition variability in menarcheal age and menstrual characteristics are common. Knowledge on this variability is necessary for patient education and to guide clinical evaluation.
Non-adherence to anti tuberculosis treatment is one of the crucial challenges in improving tuberculosis cure-rates and reducing further healthcare costs. The poor adherence to anti-tuberculosis treatment among patients with tuberculosis is a major problem in Ethiopia. Hence, this study assessed level of non-adherence to anti-tuberculosis therapy and associated factors among patients with tuberculosis in northwest Ethiopia. An institution based cross-sectional survey was conducted among tuberculosis patients who were following anti-tuberculosis treatment in North Gondar zone from February 20 – March 30, 2013. Data were collected by trained data collectors using a structured and pre-tested questionnaire. Data were entered to EPI INFO version 3.5.3 and analyzed using statistical package for social sciences (SPSS) version 20. Multiple logistic regressions were fitted to identify associations and to control potential confounding variables. Odds ratio (OR) with 95% confidence interval was calculated and p-values<0.05 were considered statistically significant. A total of 280 tuberculosis patients were interviewed; 55.7% were males and nearly three quarters (72.5%) were urban dwellers. The overall non-adherence for the last one month and the last four days before the survey were 10% and 13.6% respectively. Non-adherence was high if the patients had forgetfulness (AOR 7.04, 95% CI 1.40–35.13), is on the continuation phase of chemotherapy (AOR: 6.95, 95% CI 1.81–26.73), had symptoms of tuberculosis during the interview (AOR: 4.29, 95% CI 1.53–12.03), and had co-infection with HIV (AOR: 4.06, 95% CI 1.70–9.70). Non-adherence to anti-tuberculosis treatment was high. Forgetfulness, being in the continuation phases of chemotherapy, having symptoms of tuberculosis during the interview, and co-infected with HIV were significantly associated with non-adherence to anti-tuberculosis therapy. Special attention on adherence counseling should be given to symptomatic patients, TB/HIV co-infected patients, and those in the continuation phase of the tuberculosis therapy.