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Background: For every neonate who dies, many others experience a near miss event that could have but did not result in death. Neonatal near miss is three to eight times more frequent than neonatal deaths and, therefore, is more useful for assessing the determinants of adverse neonatal outcomes. The aim of this study was to assess the incidence and determinants of neonatal near miss in south Ethiopia.Methods: A facility-based prospective study was conducted among 2704 neonates between 12 July to 26 November 2018. The neonates were followed from the time of admission to hospital discharge or seven postpartum days if the newborn stayed in the hospital. The data were collected by interviewer-administered questionnaire and medical record review. Logistic regression was employed to identify the distant, intermediate and proximal factors associated with neonatal near miss. The independent variables were analysed in three hierarchical blocks. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were used to determine the strength of the associations.Results: The incidences of neonatal near miss and neonatal death were 45.1 (95% CI = 37.7-53.8) and 17.4 (95% CI = 13.0-23.3) per 1000 live births, respectively. Of those newborns who experienced neonatal near miss, more than half (59.8%) of their mothers were referred from other health facilities. After adjusting for potential confounders, the odds of neonatal near miss were significantly higher among neonates with a low monthly income (< 79 USD monthly), a birth interval of less than 24 months and where severe maternal complications had occurred.Conclusion: Strategies to improve neonatal survival need a multifaceted approach that includes socio-economic and health-related factors. The findings of this study highlight important implications for policymakers with regard to neonatal near miss. In particular, addressing inequalities by increasing women's income, promoting an optimal birth interval of 24 months or above through postpartum family planning, and preventing maternal complications may improve newborn survival. [ABSTRACT FROM AUTHOR]

Background: Birth Preparedness and Complication Readiness interventions have a significant role in the reduction of maternal and neonatal mortality risk. Inadequacy of birth and emergency preparedness were depicted as one of the major reasons for high maternal deaths in sub-Saharan Africa. The main objective of this study was to assess birth preparedness, complication readiness and associated factors among pregnant women.Methods: A community based comparative cross-sectional study design was conducted among 411 urban and 209 rural respondents who were selected using multi-stage stratified random sampling technique. Quantitative data were collected by interviewer administered questionnaire while qualitative data were collected from purposely selected 54 members of the community by using guiding checklist and analyzed by thematic areas. Birth preparedness and complication readiness was measured using five birth preparedness and complication readiness items then women who scored at least three were considered as well prepared. Bivariate and multivariable logistic regressions were used to examine the association between independent variables and birth preparedness and complication readiness. The result were presented as Odds Ratio at 95% CI. P < 0.05 ware used to dictate statistical significance.Results: A total response rate of the study was 97.3%. The prevalence of birth preparedness and complication readiness was significantly higher among urban respondents (P = 25.8%; p < 0.05). Factors such as history of obstetric complication, knowledge of key danger signs, having favourable attitude towards birth preparedness and complication readiness, starting antenatal care visit within 3 months age of pregnancy, completing at least four antenatal care visits, urban residence, having occupation of government employee or merchant and being in the higher wealth quintile were variables positively associated with birth preparedness and complication readiness.Conclusions: Prevalence of birth preparedness and complication readiness was low in this study, though significantly higher in urban area. Three-fourth of women planned to attend 4+ antenatal care visits indicating opportunity to counsel them on birth preparedness and complication readiness which increases its prevalence. Health workers should counsel every woman on birth preparedness and complication readiness components during her first antenatal care visit and subsequent visits. [ABSTRACT FROM AUTHOR]

Objective: To identify perinatal mortality risk factors in the Southern Zone of Tigray, northern Ethiopia.Methods: The present unmatched case-control study included data from 20 health facilities; stillbirths and neonatal deaths were included as a case group and patients with neonates who survived until discharge or day 7 postpartum were included as a control group. Perinatal mortality risk factors were investigated using bivariate and multivariate logistic regression analyses.Results: There were 126 and 252 patients included in the case and control groups, respectively. Prematurity (adjusted odds ratio [AOR] 12.2; 95% confidence interval [CI] 3.46-43.17; P<0.001), delivery weight below 2500 g (AOR 11.5, 95% CI 3.16-42.36; P<0.001), and fewer prenatal visits (AOR 5.4; 95% CI 0.80-36.63; P=0.028) were determinants of perinatal mortality. Partograph use (AOR 0.2; 95% CI 0.08-0.48; P<0.001) and seeking labor care at the start of labor (AOR 0.1; 95% CI 0.01-0.96; P=0.010) were protective. Short childbirth interval (<2 years) (AOR 2.2; 95% CI 1.03-5.09; P=0.013), distance to facility (AOR 3.7; 95% CI 1.56-9.02; P=0.007), and lack of iron supplementation (AOR 3.3; 95% CI 1.16-9.76; P=0.021) were also predictors of perinatal mortality.Conclusion: Perinatal mortality was linked to prematurity and low delivery weight. Interventions including partograph and auscultation, as well as subsidizing transport and iron supplementation, could help in this region. [ABSTRACT FROM AUTHOR]

Background: Knowledge of danger signs of obstetric complications is first step in the appropriate and timely referral to essential obstetric care. Although women's knowledge about the obstetric danger signs is important for improving maternal and child health, little is known about the current knowledge and influencing factors in pastoral community of Ethiopia. This study, therefore, aims to fill this gap by assessing the current level of knowledge and associated factors of pregnant women living in Erer district of Somali region, Ethiopia.Methods: A community based, cross-sectional study was conducted from April 7 to 21, 2014. The study involved 666 pregnant women residing in the district. Two-stage sampling technique was used to select the study subjects. Data about women's socio-demographic information, reproductive history, knowledge of the danger signs, exposure to media and interventions were collected by interviewer administered questionnaires. A respondent who spontaneously mentioned at least two of the danger signs during each of the three periods was considered knowledgeable; otherwise not. Descriptive, bivariate, then multivariable logistic regression were done.Results: Six hundred thirty two pregnant women were interviewed with a response rate of 94.9 %. Only 98 (15.5 %) respondents were knowledgeable about obstetric danger signs. Urban residence [AOR = 2.43; 95 % CI (1.40, 4.21)], women who had been pregnant five or more times [AOR = 6.65; 95 % CI (2.48, 17.89)] and antenatal care utilization [AOR = 5.44; 95 % CI (3.26, 9.09)] were associated with being knowledgeable about obstetric danger signs during pregnancy, childbirth and postpartum.Conclusion: A significant proportion of pregnant women in Erer district do not have knowledge of obstetric danger signs. The implication is that lack of recognition may lead to delay in seeking care. Area of residence, gravidity and antenatal care service utilization are independently associated with the knowledge of women on obstetric danger signs in Erer district, a pastoralist community. Thus, intervention programs aiming to improve women's knowledge about obstetric danger signs and symptoms should consider the factors independently associated. [ABSTRACT FROM AUTHOR]

Purpose: Women with diabetes and hypertension are at increased risk of pregnancy complications, including those from surgical delivery and their offspring are at risk for congenital anomalies. Thus, diabetic and hypertensive women of reproductive age are advised to use valid contraceptive methods for reducing unwanted pregnancy and its complications. However, contraceptive use among these segments of the population had not been previously assessed in Ethiopia. Hence, the aim of this study was to assess contraceptive use and associated factors among diabetic and hypertensive women of reproductive age on chronic follow-up care at University of Gondar and Felege Hiwot Hospitals. Methods: Hospital-based cross-sectional study was conducted from April to May 2012 among diabetic and hypertensive women on follow-up at the chronic illness care center. The sample size calculated was 403. Structured and pretested questionnaire was used for data collection. Data were collected using interview supplemented by chart review. The data were entered using EPI info Version 2000 and analyzed using SPSS Version 16. Frequencies, proportion, and summary statistics were used to describe the study population in relation to relevant variables. Both bivariate and multivariate analyses were run to see the association of each independent variable with contraceptive practice. Results: A total of 392 married women on chronic follow-up care were interviewed making the response rate of 93.3%. The contraceptive prevalence rate was found to be 53.8%. Factors such as age 25-34 years (adjusted odds ratio, AOR [95% confidence interval, CI] =3.60 [1.05-12.36]), (AOR [95% CI] =2.29 [1.15-4.53]), having middle- and high-level incomes (AOR [95% CI] = 2.12 [1.19-3.77]), (AOR [95% CI] =5.03 [2.19-11.54]), receiving provider counseling (AOR [95% CI] =9.02 [4.40-18.49]), and controlled disease condition (AOR [95% CI] =4.13 [2.35- 7.28]) were significantly associated with contraceptive practice. Conclusion: The contraceptive utilization of women on diabetes and hypertension follow-up care was found to be low. Hence, strengthening counseling and education about family planning and controlling their medical conditions would help increase the contraceptive uptake of women on chronic follow-up. [ABSTRACT FROM AUTHOR]