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To determine the level and predictors of micronutrient intake inadequacy among pregnant women attending antenatal public health facilities in Bahir Dar City, Northwest Ethiopia.
A multicentre, cross-sectional study.
The study was conducted in public health facilities in Bahir Dar City, Northwest Ethiopia from January to March 2024.
About 420 pregnant women aged 18 years and older attending antenatal care at public health facilities in Bahir Dar. Pregnant women diagnosed with chronic diseases, sick and unable to communicate, and who had attended weddings, birthday celebrations or religious festivals within the past 24 hours were excluded.
Micronutrient intake inadequacy among pregnant women was measured using a single multiphasic 24-hour dietary recall. The Nutria-Survey Food Processor software, the Ethiopian food composition table and the World food composition table were used for the calculation of the nutrient value of micronutrients. The nutrient intakes were assessed by nutrient adequacy ratio and mean adequacy ratio. Data were analysed using SPSS V.26. Multivariable logistic regression analysis was done to identify the predictors of micronutrient intake inadequacy.
A total of 411 pregnant women were recruited in the study, yielding a 97.8% response rate. The overall prevalence of micronutrient intake inadequacy was 76.4% (95% CI 72.0% to 80.3%). The proportions of zinc, vitamin A, iron and calcium intake inadequacies were 48.2%, 66.7%, 14.8% and 74%, respectively. Having nutrition counselling (adjusted ORs (AOR)=3.5; 95% CI 2.00 to 6.48), having
Micronutrient intake among pregnant women was lower than the recommended levels. Therefore, strengthening community efforts to promote the consumption of a diversified diet for pregnant women, encourage nutrient-dense food production and enhance food security is essential.
by Ayelign Mengesha Kassie, Solomon Woldeyohannes, Anteneh Zewdie, Eskinder Wolka, Yibeltal Assefa
BackgroundEffective coverage (EC) has emerged as a better measure of service coverage, in the past decades, compared to the simple crude coverage measures. It represents the proportion of a population in need of a service that successfully receives it with sufficient quality to achieve the intended health benefits. Nevertheless, EC in maternal and newborn health (MNH) services are significantly variable across and within countries. Therefore, this study aimed to identify the societal and health system factors that can explain why some countries are having higher EC of MNH services than others in Sub-Saharan Africa (SSA).
MethodsA mixed-method case study design was employed with inclusion of document review. Effective coverage rates were estimated using countries demographic and health survey (DHS) datasets. Two countries were then selected for each MNH service domain from each performance category, high, medium, and low, for further analysis of explanatory factors. Data sources included DHS and health facility survey summary reports, the Global Health Expenditure Database, and TheGlobalEconomy.com.
ResultsWe found huge variation in EC of MNH services across countries in SSA. The scores range from 7% in Ethiopia to 64% in Liberia for 4+ ANC visits, 9% in Ethiopia and Nigeria to 81% in Rwanda for institutional delivery, 3% in Ethiopia to 77% in Gambia for PNC mothers, and 1% in Ethiopia to 68% in South Africa for PNC newborns. These discrepancies are highly likely influenced by multilevel health system and societal factors. High-performing countries in EC of MNH services have higher service availability and readiness scores than medium- and low-performing ones. For instance, Ghana and Liberia scored 83% and 84%, respectively, for tracer indicators of ANC service availability, compared to 43% in Ethiopia and 64% in Malawi. Similar pattern is observed between the selected countries EC estimates of MNH services and their health service specific readiness index scores. In addition, they also have favourable societal factors including high proportion of women attending primary and/or more school levels, better mass media and internet access, and relatively lower political instability indexes. Low-performing countries like Ethiopia and Nigeria had complex futures including having low health service availability and readiness scores and unfavourable societal factors including in women’s education, and internet and mass media access. Furthermore, the two countries had weakest average political stability index that hinders the utilization and delivery of MNH services.
ConclusionsThe findings revealed that better health service availability and readiness, strong healthcare financing, favourable societal factors and having a relatively stable political index are critical in determining countries performance in EC of MNH services. Therefore, countries, particularly low performers in EC of MNH services need to learn from positive outliers in improving EC of MNH services. Strengthening existing health facilities with better staffing, training, and resources is crucial beyond merely expanding new ones.
by Berihun Agegn Mengistie, Getie Mihret Aragaw, Tazeb Alemu Anteneh, Kindu Yinges Wondie, Alemneh Tadesse Kassie, Alemken Eyayu Abuhay, Wondimnew Mersha Biset, Gebrye Gizaw Mulatu, Nuhamin Tesfa Tsega
BackgroundPrecancerous cervical lesions, or cervical intraepithelial neoplasia (CIN), represent a significant precursor to cervical cancer, posing a considerable threat to women’s health globally, particularly in developing countries. In Africa, the burden of premalignant cervical lesions is not well studied. Therefore, the main purpose of this systematic review and meta-analysis was to determine the overall prevalence of precancerous cervical lesions and identifying determinants among women who underwent cervical cancer screening in Africa.
MethodsThis study followed the Preferred Reporting Item Review and Meta-analysis (PRISMA) guidelines. The protocol for this systematic review and meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42025645427). We carried out a systematic and comprehensive search on electronic databases such as PubMed and Hinari. In addition, Google Scholar and ScienceDirect were utilized to find relevant studies related to precancerous cervical lesions. Data from the included studies were extracted using an Excel spreadsheet and analyzed using STATA version 17. The methodological quality of the eligible studies was examined using the Joanna Briggs Institute (JBI) assessment tool. Publication bias was checked by using the funnel plot and Egger’s tests. A random-effects model using the Der Simonian Laird method was used to estimate the pooled prevalence of pre-cancerous cervical lesions in Africa. The I-squared and Cochrane Q statistics were used to assess the level of statistical heterogeneity among the included studies.
ResultsA total of 112 eligible articles conducted in Africa, encompassing 212,984 study participants, were included in the quantitative meta-analysis. Thus, the pooled prevalence of pre-cancerous cervical lesions in Africa was 17.06% (95% confidence interval: 15.47%−18.68%). In this review, having no formal education (AOR = 4.07, 95% CI: 1.74, 9.53), being rural dweller(AOR = 2.38, 95% CI: 1.64, 3.46), history of STIs (AOR = 3.94, 95% CI: 2.97, 5.23), history of having multiple partners (AOR = 2.73, 95% CI: 2.28, 3.28), early initiation of coitus (AOR = 2.77, 95% CI: 2.11, 3.62), being HIV-seropositive women (AOR = 3.33, 95% CI: 2.32, 4.78), a CD4 count Conclusions
In Africa, the overall prevalence of pre-cancerous cervical lesions is high (17%). The findings of this review highlight that health professionals, health administrators, and all other concerned bodies need to work in collaboration to expand comprehensive cervical cancer screening methods in healthcare facilities for early detection and treatment of cervical lesions. In addition, increasing community awareness and health education, expanding visual inspection of the cervix with acetic acid in rural areas, offering special attention to high-risk groups (HIV-positive women), encouraging adherence to antiretroviral therapy for HIV-positive women, overcoming risky sexual behaviors and practices, and advocating early detection and treatment of precancerous cervical lesions.
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