scholarly journals Effect of gender of new-born, antenatal care and postnatal care on breastfeeding practices in Ethiopia: Evidence from systematic review and meta-analysis of national studies

2018 ◽  
Author(s):  
Tesfa Dejenie Habtewold ◽  
Nigussie Tadesse Sharew ◽  
Sisay Mulugeta Alemu

AbstractObjectiveThe aim of this systematic review and meta-analysis was to investigate the association of gender of new-born, antenatal care (ANC) and postnatal care (PNC) with timely initiation of breastfeeding (TIBF) and exclusive breastfeeding (EBF) practice in Ethiopia.DesignSystematic review and meta-analysisMethodsPubMed, EMBASE, CINAHL, WHO Global Health Library, Web of Science and SCOPUS databases systematically searched and complemented by manual searches to retrieve all available literature. Newcastle-Ottawa Scale (NOS) was used for quality assessment of included studies. Egger’s regression test at p-value threshold ≤ 0.01 was used to examine publication bias. Cochran’s Q X2 test, τ2, and I2 statistics were used to test heterogeneity, estimate amount of total/residual heterogeneity and measure variability attributed to heterogeneity respectively. A meta-analysis using a weighted inverse variance random-effects model was performed. The trend of evidence over time was evaluated by performing a cumulative meta-analysis. Furthermore, mixed-effects meta-regression analysis was done to identify possible sources of heterogeneity.ResultsOf 523 articles retrieved, 17 studies (N = 26,146 mothers) on TIBF and 27 studies (N = 17,819 mothers) on EBF were included in the final analysis. ANC (OR = 2.24, 95% CI 1.65 -3.04, p <0.001, I2 = 90.9%), PNC (OR = 1.86, 95% CI 1.41 - 2.47, p <0.001, I2 = 63.4%) and gender of new-born (OR = 1.31, 95% CI 1.01 - 1.68, p = 0.04, I2 = 81.7%) significantly associated with EBF. In addition, ANC (OR = 1.70, 95% CI 1.10 - 2.65, p = 0.02, I2 = 93.1%) was significantly associated with TIBF but not gender of new-born (OR = 1.02, 95% CI 0.86 -1.21, p = 0.82, I2 = 66.2%).ConclusionsIn line with our hypothesis, gender of new-born, ANC and PNC significantly associated with EBF. Likewise, ANC significantly associated with TIBF. Optimal care during pregnancy and after birth is important to ensure adequate breastfeeding. This meta-analysis study provided evidence on breastfeeding practices and its associated factors in Ethiopian context, which can be useful for cross-country and cross-cultural comparison and for breastfeeding improvement initiative in Ethiopia.Protocol registration and publication:CRD42017056768 and 10.1136/BMJOPEN-2017-017437Strengths and limitations of this studyThis systematic review and meta-analysis was conducted based on the registered and published protocol.Since it is the first study in Ethiopia, the information could be helpful for future researchers, public health practitioners, and healthcare policymakers.Almost all included studies were observational which may hinder causality inference.Perhaps the results may not be nationally representative given that studies from some regions are lacking.Based on the conventional methods of the heterogeneity test, a few analyses suffer from high between-study variation.

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e023956 ◽  
Author(s):  
Tesfa Dejenie Habtewold ◽  
Nigussie Tadesse Sharew ◽  
Sisay Mulugeta Alemu

ObjectivesThe aim of this systematic review and meta-analysis was to investigate the association of gender of newborn, antenatal care (ANC) and postnatal care (PNC) with timely initiation of breast feeding (TIBF) and exclusive breastfeeding (EBF) practices in Ethiopia.DesignSystematic review and meta-analysis.Data sourcesTo retrieve all available literature, PubMed, EMBASE, CINAHL, WHO Global Health Library, Web of Science and SCOPUS databases were systematically searched and complemented by manual searches. The search was done from August 2017 to September 2018.Eligibility criteriaAll observational studies including cross-sectional, case-control, cohort studies conducted in Ethiopia from 2000 to 2018 were included. Newcastle-Ottawa Scale was used for quality assessment of included studies.Data extraction and synthesisStudy area, design, population, number of mothers (calculated sample size and participated in the study) and observed frequency data were extracted using Joanna Briggs Institute tool. To obtain the pooled effect size, a meta-analysis using weighted inverse variance random-effects model was performed. Cochran’s Q X2test, τ2and I2statistics were used to test heterogeneity, estimate amount of total/residual heterogeneity and measure variability attributed to heterogeneity, respectively. Mixed-effects meta-regression analysis was done to identify possible sources of heterogeneity. Egger’s regression test at p value threshold ≤0.01 was used to examine publication bias. Furthermore, the trend of evidence over time was examined by performing a cumulative meta-analysis.ResultsOf 523 articles retrieved, 17 studies (n=26 146 mothers) on TIBF and 24 studies (n=17 819 mothers) on EBF were included in the final analysis. ANC (OR=2.24, 95% CI 1.65 to 3.04, p<0.001, I2=90.9%), PNC (OR=1.86, 95% CI 1.41 to 2.47, p<0.001, I2=63.4%) and gender of newborn (OR=1.31, 95% CI 1.01 to 1.68, p=0.04, I2=81.7%) significantly associated with EBF. ANC (OR=1.70, 95% CI 1.10 to 2.65, p=0.02, I2=93.1%) was also significantly associated with TIBF but not with gender of newborn (OR=1.02, 95% CI 0.86 to 1.21, p=0.82, I2=66.2%).ConclusionsIn line with our hypothesis, gender of newborn, ANC and PNC were significantly associated with EBF. Likewise, ANC was significantly associated with TIBF. Optimal care during pregnancy and after birth is important to ensure adequate breast feeding. This meta-analysis study provided up-to-date evidence on breastfeeding practices and its associated factors, which could be useful for breastfeeding improvement initiative in Ethiopia and cross-country and cross-cultural comparison.Trial registration numberCRD42017056768


2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Gedefaw Abeje Fekadu ◽  
Getachew Mullu Kassa ◽  
Abadi Kidanemariam Berhe ◽  
Achenef Asmamaw Muche ◽  
Nuradin Abusha Katiso

2019 ◽  
Author(s):  
Bekalu Kassie ◽  
Melaku Desta ◽  
Habtamu Chanie ◽  
Bekele Tesfaye ◽  
Muluken Wubetu ◽  
...  

Abstract Background: In Ethiopia, literatures are not in agreement on magnitude of utilization of postnatal care service and factors are not well identified. Hence, this systematic review and meta-analysis aimed to engender pooled evidence of magnitude of postnatal care service utilization and associated factors. Methods: For this systematic review and meta-analysis international databases such as, HINARI, PubMed, Medline, EMBASE, Google scholar and Cochrane library were used for searching studies published from 2002 to 2018 in English language. The Modified Newcastle- Ottawa quality assessment scale was used to assess the quality of studies and meta-analysis was conducted using STATA version 14. Q statistics and I2 test were used to assess the heterogeneity. The random effect model was used to estimate the pooled utilization of postnatal care at 95%CI. Result: Total of 22 articles with total samples of 42,320 women were included to this review. The pooled prevalence of postnatal care service utilization in Ethiopia was 41.5% (95%CI: 28.51-54.52). Women who attended formal education (OR, 2.37, 95%CI: 1.13, 4.97), had middle level and above household’s wealth quintile (OR, 2.57, 95%CI: 1.31,5.05), had antenatal care visit (OR, 6.72, 95%CI: 4.16, 10.87), being multigravida (OR, 0.68, 95%CI: 0.53, 0.88) and gave birth in health institutions (OR, 3.86, 95%CI: 2.89, 5.16) were high likely to utilize postnatal care services while rural resident women (OR, 0.17, 95%CI: 0.05, 0.60) were less likely to utilize postnatal care services. Conclusion: Postnatal care service utilization in Ethiopia is low (41.5%). It is affected by educational status, residence, wealth quintile, gravidity, antenatal care follow up and place of delivery. Scale up the service and awareness for rural people, improving economic status of the household, improve antenatal care follow up, and promote institutional delivery are having paramount importance. Key words: Health care service utilization, Ethiopia, systematic review, Meta-analysis


2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Tsegaye Mehare ◽  
Birhanie Mekuriaw ◽  
Zelalem Belayneh ◽  
Yewbmirt Sharew

Background. Postpartum contraceptive use is defined as the avoidance of short spaced pregnancies and unintended pregnancy through the first 12 months after delivery. In Ethiopia, different studies have been conducted to assess the prevalence of postpartum contraceptive use and associated factors. The findings of these studies were inconsistent and characterized by great variability. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of postpartum contraceptive use and determinants in Ethiopia using the accessible studies. Methods. The articles were identified through electronic search of reputable databases (MEDLINE through PubMed, EMBASE, HINARI, Science Direct, and Cochrane Library) and the hand search of reference listed in previous prevalence studies to retrieve more. 18 articles are included based on a comprehensive list of inclusion and exclusion criteria. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 14 statistical software was used to analyze the data. The Cochrane Q and I2 test were used to assess the heterogeneity between the studies. A random effects model was calculated to estimate the pooled prevalence of postpartum contraceptive use. Moreover, the determinants for family planning use were reviewed. Results. The pooled prevalence of family planning use among mothers during the postpartum period in Ethiopia was 48.11% (95% CI: 36.96, 59.27). Besides, subgroup analysis revealed that the highest family planning use prevalence among postpartum mothers was observed in Addis Ababa, 65.41 (95% CI: 48.71, 82.11). Resumed sexual activity: 7.91 (95% CI: 4.62, 13.55), antenatal care: 4.98 (95% CI: 2.34, 10.21), secondary school and above level of maternal education: 3.53 (95% CI: 1.67, 7.45), postnatal care: 3.16 (95% CI: 1.7, 5.88), menses resumption: 3.12 (95% CI: 1.52, 6.39), and ≥6 months of postpartum period: 2.78 (95% CI: 1.97, 3.93) have shown a positive association with the use of family planning among mothers in the postpartum epoch. Conclusions. In this study, family planning use among mothers of the postpartum period in Ethiopia was significantly low compared to the existing global commendation on postpartum contraceptive use. Resumed sexual activity, antenatal care, secondary and above level of maternal education, postnatal care, menses resumption, and postpartum period≥6 months were found to be significantly associated with postpartum contraceptive use.


2020 ◽  
Author(s):  
Ravi Kant ◽  
Poonam Yadav ◽  
Surekha Kishore ◽  
Shruti Barnwal ◽  
Rajesh Kumar ◽  
...  

ABSTRACTObjectiveTo evaluate the effectiveness of mHealth interventions on antenatal and postnatal care utilization in low and middle-income countries.DesignSystematic review and meta-analysisSettingStudies from low and middle-income countries were included for analysis.ParticipantsWe searched the literature through major electronic databases such as PubMed, MEDLINE, Embase, Cochrane, Scopus, CINAHL, Clinical key, Google Scholar, Ovid databases with selected keywords, and explored the reference list of articles. Meta-analysis was performed in RevMan 5.4 software; p-value < 0.05 was considered statistically significant. The effect of variables was measured in the Odds ratio with a fixed-effect model. Six published interventional studies were selected as per the eligibility and PICO framed for the systematic review and meta-analysis. Search restricted to articles in the English language, online published, and preprint articles till September 2020.Primary and secondary outcome measuresWe evaluated the effectiveness of mHealth intervention on antenatal care utilization, including four antenatal check-ups, iron-folic acid supplementation, two tetanus toxoid immunizations, and postnatal care utilization, which includes postnatal check-ups of delivered mothers.ResultsResults have been presented in the form of a forest plot. Findings of this meta-analysis depicted the significant increase in four or more antenatal care attendance (OR=1.89, 95% CI-1.49-2.19), TT immunization (OR=1.63 (95% CI-1.17-2.27), compliance to iron supplementation (OR=1.88, 95% CI-1.18-3.00) and postnatal care attendance (OR=2.54 (95% CI-2.15-2.99) among those pregnant mothers who received mHealth intervention compared to control group.ConclusionThis meta-analysis concluded that m-health has the potential to increase the utilization of full antenatal care and postnatal care compared to standard care, although the level of evidence is moderate.Trial registrationCRD42020204618, PROSPERO, International prospective register of systematic reviewsArticle SummaryStrengths and limitations of this studyThis meta-analysis creates an evidence for the effectiveness of mHealth with pooled data of interventional studies with limited sample sizes.Technology is changing, but even with limited support like SMS, there was an improvement in antenatal and postnatal service utilization.Sensitivity analysis identified possible reasons for heterogeneity among studies.Studies included from LMICs so results can be generalized for the respective population.mHealth as an intervention is a broad term that created heterogeneity also.


Author(s):  
Manuel Chavarrias ◽  
Santos Villafaina ◽  
Ana Myriam Lavín-Pérez ◽  
Jorge Carlos-Vivas ◽  
Eugenio Merellano-Navarro ◽  
...  

Background and objectives: Obesity or overweight is associated with many health risk factors and preventable mortality. Even people with normal weight and without history of obesity or overweight should avoid weight gain to reduce health risks factors. In this regard Latin aerobic dances involved in Zumba® practice make this modality motivating for people. Apart from weight loss and VO2peak benefits, Zumba practice is also interesting by the increase in adherence which can also avoid weight regain. The aim was to systematically review the scientific literature about the effects of any randomized intervention of Zumba® practice on total fat mass (%) and maximum oxygen consumption (VO2peak), besides establishing directions for the clinical practice. Evidence acquisition: Two systematic searches were conducted in two electronic databases following the PRISMA guidelines. The eligibility criteria were (a) outcomes: body mass or VO2peak data including mean and standard deviation (SD) before and after Zumba® intervention, (b) study design: randomized controlled trial (RCT) and (c) language: English. GRADE guidelines were used to assess the quality of evidence. A meta-analysis was performed to determine mean differences. Nine and four studies were selected for fat mass percentage and VO2peak in the systematic review, respectively. However, only eight studies for fat mass percentage and three for VO2peak could be included in the meta-analysis. Evidence synthesis: The overall standardized mean difference for fat mass was −0.25 with a 95% CI from −0.67 to 0.16 with a p-value of 0.69, with large heterogeneity. On the other hand, the overall effect size for VO2peak was 0.53 (95% CI from 0.04 to 1.02 with a p-value of 0.03) with large heterogeneity. Conclusions: Based on the evidence, we cannot conclude that Zumba® is effective at reducing body mass but it may improve VO2peak. However, the limited number of studies that met the inclusion criteria makes it too early to reach a definite conclusion, so more research is needed.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Alemu Degu Ayele ◽  
Habtamu Gebrehana Belay ◽  
Bekalu Getnet Kassa ◽  
Mulugeta Dile Worke

Abstract Background Preconception care is the provision of biomedical, behavioural, and social health interventions provided to women and couples before conception. However, in Ethiopia, little is known and practised to support preconception care. Therefore, this study aimed to assess women’s knowledge and utilisation of preconception care and its associated factors in Ethiopia using systematic review and meta-analysis. Method In the current meta-analysis, variables were searched from different electronic database systems, which included PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature. Data were extracted using a standardised data collection measurement tool. The data were analysed by using STATA 14 statistical software. I2 tests assessed heterogeneity between the studies. A random-effect model was used to forecast the pooled knowledge and utilisation of preconception care. Results Thirteen full-text studies were included. The pooled prevalence of knowledge and utilisation of preconception care among women in Ethiopia was 30.95% and 16.27% respectivelly. Secondary education (OR = 2.78, 95% CI,2.01–3.85), college and above (OR = 5.05, 95% CI,2.70–9.44), and antenatal care (OR = 3.89, 95% CI, 1.69–8.98) were significantly associated with knowledge level whereas; age (OR = 2.43, 95% CI, 1.30–4.53) and knowledge on preconception care (OR = 3.95, 95% CI,2.35–6.62) were positively associated with utilisation of preconception. Conclusions Women’s level of knowledge and utilisation of preconception care was significantly low. Educational status and antenatal care follow-up were factors shown to affect knowledge of preconception care. Age and having a sound knowledge of preconception care indicated a significant association towards utilisation of preconception care. Thus, integrating preconception care strategies and policies that can address all the components of preconception care services with other maternal and child health services will be essential when designing effective implementation strategies to improve preconception care uptake. Besides this, advocating for better education for women, awareness creation, and increasing antenatal care services are essential. Prospero registration: CRD42020218062


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