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☐ ☆ ✇ BMJ Open

Comparison of nutritional status and dietary intake among khat (Catha edulis) chewer and non-chewer women of reproductive age in Halaba Zone, South Ethiopia: a comparative cross-sectional study

Por: Wogayehu · B. · Demissie · T. · Wolka · E. · Alemayehu · M. — Septiembre 5th 2025 at 13:49
Objective

This study aimed to compare the nutritional status and dietary intake between khat chewer and non-chewer women of reproductive age in Halaba Zone, South Ethiopia.

Design

A comparative cross-sectional study was conducted.

Setting

The study was conducted in Halaba Zone, South Ethiopia.

Participants

A total of 792 (396 khat chewers and 396 non-chewers) women of reproductive age were selected by a simple random sampling technique from 20 June 2023 to 26 August 2023.

Outcome measures

Dietary intake was assessed by a single 24-hour recall method. The nutrient adequacy ratio and mean adequacy ratio were applied to estimate the adequacy of micronutrients. Standing height was measured using a wall-mounted stadiometer to the nearest 0.1 cm, and weight of the women was measured to the nearest 0.1 kg on a battery-powered digital scale (Seca Gmbh & Co. KG, Germany). A linear regression model was fitted to determine the relationship between nutritional status and khat chewing. Binary logistic regression analyses were used to estimate the odds of nutrient intake inadequacy among the two study groups. A p value of

Results

Women who chewed khat had a higher prevalence of underweight (36.6%) than those who did not (9.4%). The mean (SD) body mass index for khat chewer women was 48.66±5.39 kg, while that of non-chewer women was 55.29±6.75 kg. Women who chewed khat were significantly more likely to be underweight than those who had never chewed khat (β = –1.91, 95% CI –2.30 to –1.53; p12 (AOR=2.79 (95% CI 1.79 to 4.36), p

Conclusions

Women who chewed khat were significantly more likely to be underweight compared with those who had never chewed khat. Khat chewers were more likely than non-chewers to have inadequate carbohydrate, protein, thiamine, riboflavin, niacin, vitamin B12, zinc and calcium intake. Public health interventions aimed at improving the nutritional status of women of reproductive age should develop strategies to address the spread of khat-chewing habits.

☐ ☆ ✇ BMJ Open

Forecasting birth trends in Ethiopia using time-series and machine-learning models: a secondary data analysis of EDHS surveys (2000-2019)

Por: Alemayehu · M. A. · Ejigu · A. G. · Mekonen · H. · Teym · A. · Temesegen · A. · Bayeh · G. M. · Yeshiwas · A. G. · Anteneh · R. M. · Atikilit · G. · Shimels · T. · Yenew · C. · Ayele · W. M. · Ahmed · A. F. · Kassa · A. A. · Tsega · T. D. · Tsega · S. S. · Mekonnen · B. A. · Malkamu · B. — Julio 16th 2025 at 09:42
Objective

Ethiopia, the second most populous country in Africa, faces significant demographic transitions, with fertility rates playing a central role in shaping economic and healthcare policies. Family planning programmes face challenges due to funding limitations. The recent suspension of the US Agency for International Development funding exacerbates these issues, highlighting the need for accurate birth forecasting to guide policy and resource allocation. This study applied time-series and advanced machine-learning models to forecast future birth trends in Ethiopia.

Design

Secondary data from the Ethiopian Demographic and Health Survey from 2000 to 2019 were used. After data preprocessing steps, including data conversion, filtering, aggregation and transformation, stationarity was checked using the Augmented Dickey-Fuller (ADF) test. Time-series decomposition was then performed, followed by time-series splitting. Seven forecasting models, including Autoregressive Integrated Moving Average, Prophet, Generalised Linear Models with Elastic Net Regularisation (GLMNET), Random Forest and Prophet-XGBoost, were built and compared. The models’ performance was evaluated using key metrics such as root mean square error (RMSE), mean absolute error (MAE) and R-squared value.

Results

GLMNET emerged as the best model, explaining 77% of the variance with an RMSE of 119.01. Prophet-XGBoost performed reasonably well but struggled to capture the full complexity of the data, with a lower R-squared value of 0.32 and an RMSE of 146.87. Forecasts were made for both average monthly births and average births per woman over a 10-year horizon (2025–2034). The forecast for average monthly births indicated a gradual decline over the projection period. Meanwhile, the average births per woman showed an increasing trend but fluctuated over time, influenced by demographic shifts such as changes in fertility preferences, age structure and migration patterns.

Conclusions

This study demonstrates the effectiveness of combining time-series models and machine learning, with GLMNET and Prophet XGBoost emerging as the most effective. While average monthly births are expected to decline due to demographic transitions and migration, the average births per woman will remain high, reflecting persistent fertility preferences within certain subpopulations. These findings underscore the need for policies addressing both population trends and sociocultural factors.

☐ ☆ ✇ BMJ Open

Wealth-based inequality and dropout rate in the completion of the continuum of maternal healthcare in Ethiopia: a secondary data analysis of the Mini Demographic and Health Survey of 2019

Por: Alie · M. S. · Gichew · S. · Alemayehu · D. — Mayo 22nd 2025 at 09:59
Objective

To determine wealth-based inequality and the dropout rate in the completion of the maternal continuum of care (CoC) in Ethiopia.

Setting

Ethiopian Demographic and Health Survey-2019.

Participants

Reproductive-age women (15–49 years) in Ethiopia.

Primary outcome

Completion of the maternal CoC services is the primary outcome. Maternal CoC is defined as a situation where women have at least four antenatal care (ANC) visits, deliver their babies at a health facility and receive at least one postnatal care service for both mother and newborn baby.

Methods

We analysed the 2019 Mini demographic and health survey data using STATA V.17. Multilevel logistic regression analysis was employed for the factors associated with the maternal CoC. The concentration index was used to measure equity.

Result

Overall, 24% (95% CI: 21.6 to 26.5) of women completed the maternal CoC. There was wealth-based inequality in the completion of maternal CoC in Ethiopia (concentration index: 0.25 (95% CI: 0.18 to 0.31, p≤0.001)), rural residents (concentration index: 0.15 (95% CI: 0.09 to 0.21, p≤0.001)) and urban residents (concentration index: 0.15 (95% CI: 0.05 to 0.26, p≤0.01)). Being an urban resident (adjusted OR (AOR)=1.59, 95% CI: 1.09 to 2.33), attaining secondary (AOR=1.67, 95% CI: 1.19 to 2.33) or higher education (AOR=1.93, 95% CI: 1.30 to 2.87) and early initiation of ANC (AOR=1.97, 95% CI: 1.61 to 2.41) were positively associated with the completion of maternal CoC. However, belonging to a pastoral region (Afar or Somali) (AOR=0.46, 95% CI: 0.28 to 0.77), belonging to the poorest (AOR=0.58, 95% CI: 0.37 to 0.92) or middle (AOR=0.62, 95% CI: 0.40 to 0.96) wealth quintile, not being informed about obstetric danger signs (AOR=0.54, 95% CI: 0.43 to 0.66) and blood pressure not being measured (AOR=0.53, 95% CI: 0.32 to 0.85) were negatively associated with maternal CoC.

Conclusion

We concluded that completion of the maternal CoC was low in Ethiopia. There was significant inequality in the completion of maternal CoC across wealth status, place of residence and educational status. Strategies and interventions that target the disadvantaged group of women are needed to improve the utilisation of maternal healthcare services. Tailored and multisectoral intervention considering women with poor or middle wealth, women in pastoralist regions and women with no information on obstetric danger signs improves the CoC practice in the country.

☐ ☆ ✇ BMJ Open

Exit knowledge about dispensed medications and associated factors among outpatients served in public hospital pharmacies and private pharmacies in Ethiopia: a systematic review and meta-analysis

Por: Getachew · D. · Getachew · E. · Lakew · G. · Beyna · A. T. · Kebede · G. A. · Tadesse · G. · Ayele · H. S. · Alemayehu · T. T. · Lakew · A. A. · Yirsaw · A. N. — Mayo 2nd 2025 at 12:04
Objective

This study aims to synthesise evidence on the pooled level of exit knowledge among outpatients served in public hospital pharmacies and private pharmacies in Ethiopia and to identify the associated factors associated with medication knowledge by conducting a systematic review and meta-analysis of primary articles focused on this area.

Design

This systematic review and meta-analysis study employed the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.

Data sources

Three electronic databases—MEDLINE, Scopus and Google Scholar—were searched for all English-language articles published from 2010 until 18 December 2024.

Eligibility criteria of selected studies

The review exclusively included studies that reported original data, were freely accessible in full text and were written in English, as well as those investigating the level of knowledge among outpatients and associated factors, irrespective of study design. Studies lacking abstracts and full texts, reports, qualitative research, and conference summaries were excluded from the analysis.

Data extraction and synthesis

Data from selected studies were extracted by three independent reviewers using a standardised data extraction format created using Microsoft Excel. Their results were cross-checked by two additional reviewers for consistency.

Results

Of the 521 identified studies, 9 met the inclusion criteria. The overall pooled knowledge level was 45%. Factors associated with knowledge included residence (OR=0.67, 95% CI: 0.27 to 0.71), adequacy of information provided (OR=0.87, 95% CI: 0.24 to 0.90), education level (OR=0.70 CI: 0.39 to 0.89), clarity of instructions (OR=0.80 CI: 0.14 to 0.99) and pharmacist politeness (OR=0.72 CI: 0.46 to 0.77).

Conclusion

The systematic review and meta-analysis showed that pooled patient knowledge regarding their dispensed medications in Ethiopia is about 45%. Key determinant factors of knowledge included education level, quality of pharmacist communication, urban versus rural residence and pharmacist politeness. Recommendations for improvement include enhancing pharmacist training, developing educational materials in local languages, outreach programmes for rural areas and implementing patient-centred care policies.

PROSPERO number: CRD42024560816

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