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Cervical cancer is a leading cause of cancer-related mortality in Ethiopia, despite being preventable. Screening programs remain underutilized despite multiple initiatives. This systematic review and meta-analysis aimed to assess the pooled prevalence of intention to undergo cervical cancer screening and its associated factors among Ethiopian women, addressing a significant gap in national data. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases such as PubMed, EMBASE, CINAHL, Web of Science, Cochrane Library, HINARI, Google Scholar, and African Journals online were searched using specific keywords and Medical Subject Headings (MeSH). Studies were assessed using a standardized appraisal format adapted from the Newcastle-Ottawa Scale (NOS). Data extraction and analysis were performed using Microsoft Excel-10 and STATA 17 software, respectively. Heterogeneity was evaluated with the I2 statistic and publication bias was examined using Egger's test. Meta-analysis employed a random-effects model. Out of the 750 articles retrieved, nine were included in this systematic review and meta-analysis. The pooled prevalence of intention to screen for cervical cancer in Ethiopia was 33% (95% CI: 9%-56%). Factors significantly associated with intention to undergo cervical cancer screening included favorable attitude (POR = 2.15, 95% CI: 1.29, 4.26), good knowledge about cervical cancer screening (POR: 3.49; 95% CI: 2.04, 6.93), and direct subjective norm (POR: 1.54; 95% CI: 1.32, 3.54). Based on the findings of this meta-analysis, it was observed that women's intention toward cervical cancer screening was low. Determinants identified included favorable attitude, direct subjective norm, and good knowledge of cervical cancer screening. To enhance women's intention for cervical cancer screening, strategies, and activities should be developed to positively influence perceptions among women and those who influence their decisions. Additionally, efforts to enhance public awareness about cervical cancer and its prevention are crucial.

Pregnancy complications can’t always be predicted. However, pregnant women must be aware of these pregnancy complications to avoid serious complications and begin treatment as soon as possible. Maternal mortality can be decreased by offering high-quality maternity services and educating women about the early warning signs of pregnancy. Therefore, the current study aimed to assess individual and community-level factors associated with women’s knowledge about pregnancy complications in Ethiopia based on the 2019 Ethiopian mini-demographic health survey data (EMDHS). The study analyzed data from the 2019 EMDHS, including a weighted sample of 1,655 reproductive-age women. Multilevel binary logistic regression analysis was used to fit the associated variables. Using the interclass correlation (ICC), deviance, proportional change variance (PVC), and median odds ratio (MOR), the comparison and fit of the models were evaluated. The significant variables associated with knowledge about complications during pregnancy were identified using an adjusted odds ratio (AOR) and a 95% confidence interval (CI). The proportion of mothers with good knowledge of pregnancy complications was 44.8% (CI 42.4%–47.2%). The multi-level analysis revealed that secondary education (AOR = 1.54, 95% CI = 1.04–2.29), a higher education level (AOR = 1.74, 95% CI = 1.11–2.72), four and above ANC Visits (AOR = 0.74, 95% CI = 0.49–0.98), women who lived in Amhara (AOR = 2.10, 95% CI = 1.24–3.55), and SNNPR (AOR = 3.92, 95% CI = 2.10–7.31) were positively associated with knowledge about pregnancy complications while, women residing in Harari (AOR = 0.20, 95% CI = 0.98–0.44) and Dire-Dawa (AOR = 0.48, 95% CI = 0.24–0.95) were negatively associated with knowledge about pregnancy complications. This study found that nearly half (44.8%) of the study participants demonstrated knowledge about pregnancy complications. This suggests a significant gap in awareness that could potentially impact access to obstetric care for women experiencing complications during pregnancy. Therefore, prioritizing enhancements in antenatal counseling services and community health education regarding pregnancy complications is crucial.

Despite continued global and local initiatives to address nutritional problems, low- and middle-income countries are facing both malnutrition and non-communicable diseases, with about 80% of non-communicable disease-related deaths. There is a dearth of recent evidence on the extent and determinants of underweight, overweight, and obesity in this region, which is essential for guiding intervention programs. Thus, this study intended to provide insights into the current level of malnutrition among women of reproductive age in low- and middle-income countries. A secondary analysis of Demographic and Health Survey data from 40 low- and middle-income countries was performed using a weighted sample of 1,044,340 women of reproductive age. Forest plots and line graph were used to present the pooled and regional estimates of underweight and overweight and obesity. A multilevel multinomial logistic regression models were fitted to identify determinants of malnutrition and models were compared based on the deviance and log-likelihood values. In the final model, statistical significance was determined using an adjusted relative risk ratio with the corresponding 95% confidence interval. The overall prevalence of obesity and overweight was 26.8% (95% CI: 26.7%-26.9%), with the highest rate in Jordan (67.2%) and lowest in Burundi (9.5%). Additionally, the level of underweight was found to be 15.6% [95% CI: 15.5%-15.7%], ranging from 1.3% in Jordan to 25.4% in Timor-Leste. Women of families with middle and rich wealth indexes, those aged 25-34 and 35-49, contraceptive users, those with primary and higher education, and urban residents were more likely to be overweight or obese. In contrast, the results showed a lower likelihood of undernutrition among women in the households with middle [ARRR (95% CI): 0.83 (0.80-0.86)] and rich wealth indexes [ARRR (95% CI): 0.73 (0.71-0.76)], those with primary [ARRR (95% CI): 0.70 (0.68-0.73)], secondary [ARRR (95% CI): 0.71 (0.69-0.74)], and higher education [ARRR (95% CI): 0.57 (0.53-0.61))], and women with media access [ARRR (95% CI): 0.79 (0.77-0.82)]. Over a quarter of women of reproductive age in LMICs were overweight or obese, with underweight affecting 15.6%. It was also found that the levels of overweight and obesity were higher than the rate for underweight, with wide variations across the countries. Thus, efforts to improve the modifiable risks can have a positive impact on reducing undernutrition and over-nutrition. Given the considerable variations between countries and survey periods, nutrition programs should also be tailored to the specific needs and cultural contexts of different regions within the study settings. Furthermore, the findings suggest the need for regular monitoring and evaluation of the existing nutritional interventions to assess their effectiveness.

BackgroundDespite global efforts to improve nutrition, young women aged 15–24 years in low-income and middle-income countries (LMICs) face persistent dual burdens of malnutrition, marked by high rates of underweight and emerging issues of overnutrition, such as overweight and obesity. Current research often emphasises individual-level factors, potentially overlooking broader regional influences.ObjectiveTo examine the burden of abnormal nutritional indices among women aged 15–24 years in 40 LMICs using the most recent Demographic and Health Survey conducted between 2015 and 2023.DesignCross-sectional study design.Setting40 LMICs.Participants357 587 young women aged 15–24 years.Primary and secondary outcome measuresA multilevel mixed-effect multinomial analysis was conducted to identify determinants of underweight, overweight and obesity. The adjusted relative risk ratio with 95% CI was used to declare the statistical significance of the association.ResultsOur analysis found that among young women aged 15–24 years in LMICs, the pooled prevalence of underweight was 25.7% (95% CI 25.6% to 25.8%), with substantial country-level variation. The highest prevalence was in Timor-Leste (35.4%) and India (31.6%), while Jordan (2.9%) and Zambia (5.5%) had the lowest rates. Overweight and obesity prevalence was 17.7% (95% CI 15.7% to 19.7%), with the highest rates in Jordan (48.9%) and Zambia (40.9%) and the lowest in Timor-Leste (3.9%) and Ethiopia (4.5%). Furthermore, factors such as household wealth, age at marriage, age, education status, access to media, employment status, parity, contraceptive use, toilet facility, region and place of residence were statistically associated with being underweight, overweight and obese.ConclusionsOur study highlights significant variations in nutritional status among young women aged 15–24 years in LMICs, with a notable prevalence of underweight and emerging challenges of overweight and obesity. Country-specific strategies addressing socioeconomic disparities and regional differences are crucial for effective public health interventions to improve nutritional outcomes among this vulnerable population.

Background Cervical cancer is a preventable disease. However, it remains the commonest and deadly cancer in women worldwide. Health care seeking behaviour is not well studied in Ethiopia even though it is crucial in averting cervical cancer by maximizing cervical cancer screening utilization. Therefore, this study amid to assess health care seeking behaviour towards cervical cancer screening and its associated factors among women aged 30–49 years in Arba Minch town, Southern Ethiopia, 2023. Methods A community-based cross-sectional study design was conducted on 414 women who are in the age range of 30–49 in Arba Minch town from January 2-February20, 2023. Study participants were selected by a simple random sampling technique from all kebeles and data were collected using pretested interviewer administered questionnaires. SPSS version 27 was used to conduct binary and multivariable logistic regression analysis. Socio-demographic characteristics of the respondents were described using descriptive statistics. Furthermore, binary and multivariable logistic regression analyses were made to find the factors associated with health care seeking behaviour. Variables with a p -value less than 0.25 on binary logistic regression were selected for multivariable logistic regression. Variables with a p -value < 0.05 were considered statistically significant. The reliability and internal consistency of the constructs of health belief model were calculated independently using Cronbach’s alpha. Result The prevalence of health care seeking behaviour towards cervical cancer screening was 197(47.6%) [95%CI: 42.7-52.5%]. Respondents’ good knowledge [AOR = 1.55, 95%CI: 1.01–2.39], positive perceived susceptibility [AOR = 3.63, 95%CI: 2.06–6.42], positive perceived severity [AOR = 2.65, 95%CI: 1.71–4.09], positive perceived benefits [AOR = 4.85, 95%CI: 2.92–7.87] were significantly associated with health seeking behaviour. Conclusion The prevalence of health care seeking behaviour towards cervical cancer screening is low in this study. To maximize the health care seeking behavior of women, further acting on perceived susceptibility, respondents’ knowledge, perceived severity, and perceived benefit of the woman are crucial.

Introduction Due to data gaps in most countries, the factors that affect the prevalence of abortion among women from a variety of social and economic backgrounds, especially in Africa, are little understood. We investigated abortion and its determinants among women of reproductive age in this study with the aim of providing policymakers in Ghana specific information. Methods After obtaining authorization to analyze data on abortion among women of reproductive age, we looked at the data from the Ghana demographic health survey 2022 that we obtained from the DHS website. We used binary logistic regression, both bivariate and multilevel. A three-level binary logistic regression analysis was performed on community and individual-level abortion predictors, using p -values less than 0.05 and adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results In the current study, the prevalence of abortion was 39.84%. Factors associated with abortion were age group 20–24 (AOR = 1.65, 95%CI = 1.05–2.61), 25–29 (AOR = 2.55, 95%CI = 1.60–4.08), 30–34 (AOR = 2.97, 95%CI = 1.54–4.81), 35–39 (AOR = 2.54, 95%CI = 1.54–4.17), 40–44 (AOR = 4.73, 95%CI = 2.74–8.15), 45–49 (AOR = 4.73, 95%CI = 2.21–9.45), married women (AOR = 1.48, 95%CI = 1.07–2.04), women living with their partner (AOR = 1.42, 95%CI = 1.02–1.98), intention to use contraceptives (AOR = 0.73, 95%CI = 0.61–0.88), smokers (AOR = 0.05, 95%CI = 0.06–0.43), Northern region (AOR = 0.50, 95%CI = 0.26–0.96), North East region (AOR = 0.26, 95%CI = 0.11–0.59), Upper East region (AOR = 0.33, 95%CI = 0.16–0.71), and Upper West region (AOR = 0.29, 95%CI = 0.12–0.67). Conclusion The magnitude of abortion was relatively higher than that of other African countries including Mozambique, Ghana, Côte d’Ivoire and Ethiopia. Education status, age, intention of using contraceptives, smoking, and region were determinants of abortion in Ghana. Therefore, comprehensive and culturally acceptable sexual and reproductive health services for women must be provided by those in charge. It is important to establish programs that support women’s livelihood and education so that they can make educated decisions about things like using contraception and avoiding unintended pregnancies.

ObjectiveTo assess the pooled prevalence of self-reported sexually transmitted infections (STIs) and their associated factors among adults in South and Southeast Asia, using the Demographic and Health Survey data collected between 2015 and 2023.DesignA community-based cross-sectional study design was conducted using a multistage cluster sampling approach. Multilevel multivariable logistic regression analysis was employed to identify predictors of self-reported sexually transmitted infections (STIs). Model selection was guided by Akaike’s information criterion, and adjusted odds ratios (AORs) with 95% CIs were estimated to determine statistically significant associations.SettingSouth and Southeast Asia.ParticipantsThis analysis included a weighted sample of 791 019 adults aged 15–49 who reported ever having had sexual intercourse. The majority of the participants were female (n=6 87 880; 87%), and most were from Southeast Asia (n=7 00 539; 89%).ResultsThe pooled prevalence of self-reported STIs among adults in South and Southeast Asia was 12.94% (95% CI 7.73% to 18.14%). At the individual level, higher odds of reporting STIs were associated with being female (AOR 1.84; 95% CI1.68 to 2.02), having middle (AOR 1.11; 95% CI 1.04 to 1.19) or high wealth status (AOR 1.15; 95% CI 1.07 to 1.24]), being employed (AOR 1.14; 95% CI 1.07 to 1.22), having multiple sexual partners (AOR 2.79; 95% CI 2.22 to 3.52) and having undergone HIV testing (AOR 1.10; 95% CI: 1.02 to 1.20). Conversely, lower odds of self-reported STIs were observed among individuals aged 35–39 years (AOR 0.78; 95% CI 0.66 to 0.92), 40–44 years (AOR 0.68; 95% CI 0.58 to 0.82) and 45–49 years (AOR 0.61; 95% CI 0.52 to 0.73); those who had ever been in a union (AOR 0.71; 95% CI 0.62 to 0.83); individuals with higher education (AOR 0.84; 95% CI 0.76 to 0.93); and those with comprehensive HIV knowledge (AOR 0.82; 95% CI 0.77 to 0.87). At the community level, high illiteracy rates (AOR 1.25; 95% CI 1.15 to 1.35) and high media non-exposure (AOR 1.11; 95% CI 1.02 to 1.20) were positively associated with STIs, while rural residence (AOR 0.81; 95% CI 0.74 to 0.89) and living in Southeast Asia (AOR: 0.47; 95% CI 0.42 to 0.53) were linked to lower odds of self-reported STIs.ConclusionsA substantial prevalence of self-reported STIs was observed among adults in South and Southeast Asia. Both individual- and community-level factors influence STI risk. The individual-level determinants include socio-demographic characteristics, sexual behaviours, HIV-related knowledge and testing history, while community-level factors reflect disparities in geographic location, educational attainment and media exposure.

Background. Childbirth self-efficacy is a pregnant women’s perception of their ability to cope with labor stress. Low childbirth self-efficacy is linked to pain intolerance and poor labor progression, which increase the possibility of operative delivery. However, Ethiopia has limited data. So, the aim of this study was to assess childbirth self-efficacy and its factors among pregnant women attending antenatal care in public health facilities in Arba Minch town, Southern Ethiopia, in 2023. Objective. To assess childbirth self-efficacy and associated factors among pregnant women attending antenatal care in public health facilities in Arba Minch town, Southern Ethiopia, in 2023. Methods. An institution-based cross-sectional study was carried out among 416 women from January 1 to January 30, 2023. A systematic random sampling technique was employed. Data were collected by KoboToolbox through face-to-face interviews using a structured and pretested questionnaire. Modified short-form childbirth self-efficacy inventory was used to score self-efficacy. The Statistical Package for Social Sciences, version 27, was used for data management and analysis. Descriptive statistics were calculated for each variable, and a logistic model was used. Statistical significance was determined at a p value of less than 0.05 and 95% confidence level. Results. A total of 416 pregnant women participated in the study. Two hundred twenty-eight (54.8%) of the pregnant women had low childbirth self-efficacy. Age group in ≤24 years (AOR=3.80, 95% CI: 1.82-8), primigravida (AOR=1.51, 95% CI: 1.10-2.86), unplanned pregnancy (AOR=1.67, 95% CI: 1.02-2.70), poor social support (AOR=2.17, 95% CI: 1.09-4.30), having anxiety (AOR=1.30, 95% CI: 1.10-3.64), having poor knowledge of childbirth (AOR=2.21, 95% CI: 2.09-5.39), and severe fear of childbirth (AOR=6.40, 95% CI: 2.60-9.80) were statistically significant with low childbirth self-efficacy. Conclusions. The magnitude of low childbirth self-efficacy was high in the study area. Being primigravida, unplanned pregnancy, age≤24 years, severe fear of childbirth, anxiety, poor social support, and poor knowledge were significantly associated with low childbirth self-efficacy. Therefore, giving special attention to these factors during antenatal care would be important.

Background Worldwide, sexual and reproductive health remains a prominent public health concern for women of reproductive age. Modern contraceptive methods play a crucial role in enabling individuals and families to regulate fertility, thereby reducing unintended pregnancies, abortions, pregnancy-related complications, and mortality. Due to the scarcity of reliable and current data regarding the factors affecting the adoption of modern contraceptives among women of reproductive age at the national level in Ghana, this research aimed to explore the determinants of modern contraceptive usage among reproductive age women. Methods The study analyzed data from the 2022 Ghana Demographic and Health Survey, including a weighted sample of 6,839 reproductive-age women. By employing a multilevel logistic regression model, the study sought to determine factors associated with the utilization of modern contraceptives. Associations between explanatory variables and the outcome were evaluated using adjusted odds ratios (AORs) along with 95% confidence intervals (CIs). Statistical significance was established using a p -value threshold of less than 0.05. All statistical analyses were conducted using STATA version 17 software. Results The study found that 26.36% (95% CI: 25.33-27.34%) of women of reproductive age in Ghana used modern contraceptives. Secondary education (AOR = 1.26, 95% CI = 1.03–1.53), poorer household (AOR = 1.30, 95% CI = 1.05–1.61), women’s marital status, i.e. married (AOR = 1.46, 95% CI = 1.16–1.83), living with a partner (AOR = 1.65, 95% CI = 1.32–2.06), divorced (AOR = 2.53, 95% CI = 1.48–4.31), and separated (AOR = 1.70, 95% CI = 1.21–2.37), multipara (AOR = 1.39, 95% CI = 1.04–1.87), were the factors that promote modern contraceptive utilization. Women’s age in years, i.e. 35–39 (AOR = 0.71, 95% CI = 0.52–0.97), 40–44 (AOR = 0.63, 95% CI = 0.44–0.90), and 45–49 (AOR = 0.45, 95% CI = 0.25–0.79), history of pregnancy loss (AOR = 0.86, 95% CI = 0.76–0.98), region, i.e. Greater Accra (95% CI = 0.42–0.92), Bono East (95% CI = 0.32–0.81), Northern (95% CI = 0.28–0.67), Savannah (95% CI = 0.28–0.81), and North East (95% CI = 0.20–0.63), were all associated with a lower use of modern contraceptives. Conclusions Modern contraceptive utilization was low in this study. Factors such as women’s education, socioeconomic status, and marital status were associated with increased modern contraceptive utilization, whereas women’s age and regional disparities were linked to lower usage rates. These findings emphasize the need for targeted interventions to address socioeconomic barriers and regional disparities in access to family planning services across Ghana.

Although late initiation of antenatal care has been linked with adverse pregnancy outcomes, a significant number of pregnant women in resource-limited regions are seeking this care late. There has been a lack of information on the extent and factors influencing late initiation of antenatal care in the African context following the implementation of the new antenatal care model in 2016. Thus, we aimed to determine the pooled prevalence of late antenatal care visit and its determinants among women in Sub-Saharan Africa (SSA) using national surveys conducted after the implementation of new guidelines. We analyzed data from the recent demographic and health survey (DHS) conducted in 16 SSA between 2018 and 2022 using a weighted sample of 101,983 women who had antenatal care follow-up during their index pregnancy. A multilevel logistic regression models were fitted and likelihood and deviance values were used for model selection. In the regression model, we used adjusted odds ratios along with their corresponding 95% confidence intervals to determine the factors associated with late antenatal care visit. The pooled prevalence of late antenatal care visit among pregnant women in SSA was 53.8% [95% CI: 46.2% - 61.3%], ranging from 27.8% in Liberia to 75.8% in Nigeria. Women's age and education, working status, partner's education, health insurance coverage, birth order, household wealth, age at marriage, decision on health care, residence, and community-level women's illiteracy were the factors associated with late antenatal care visit. More than half of pregnant women in SSA initiated attending antenatal care during late pregnancy, with significant differences seen among countries. These results underscore the necessity for focused interventions to tackle these issues and enhance prompt access to antenatal services for better maternal and child health outcomes in the area. Moreover, creating tailored interventions for younger women, those with multiple previous births, employed women, and those who experienced early marriage to address their specific challenges and obstacles in seeking care is crucial.