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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.

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. Vitamin D deficiency (VDD) is a global health concern affecting people of all ages. The Ethiopian guidelines recommend sun exposure for neonates starting from 2 weeks old, with 15 to 20 minutes per day. However, evidence suggests that the implementation of this recommendation is inconsistent. Most studies conducted in Ethiopia regarding infant sunlight exposure have been limited to health facilities and towns. Objective. this study aimed to assess mothers’ practice, and factors affecting the sunlight exposure of their infants in Adami Tulu Jido Kombolcha district, East Shoa Zone, Oromia Region, Ethiopia, 2022. Method. A community based cross-sectional study design was conducted among 575 mothers with their infant’s from March 11 to 25, 2022. A lottery method sampling technique was employed to select local administrative units and systematic random sampling employed to select study participants. Practices and knowledge were assessed by categorizing mothers based on their responses to practice and knowledge questions, respectively. Mothers who scored above the mean value of 4.5 were classified as having good practice, while those who scored 6.9 or below on the knowledge questions were classified as having poor knowledge. Data were collected through face-to-face interviews using both semi-structured and structured questionnaires. The data were then entered into EPI Data version 3.1 and exported to SPSS version 25 for analysis. The association between variables was analyzed using bivariate and multivariable binary logistic regression and level of significant determined with adjusted odd ratio at 95% CI and P-value less than <.05. Result. All 575 mothers were interviewed and responded 100%. Out of 567 mothers, 55.2% had good practice of infant sunlight exposure. Lack of advice at health facility (AOR = 3.05, 95% CI: 1.08, 8.60), absence of postnatal care follow up (AOR = 2.38, 95% CI: 1.15, 4.94) and poor knowledge about sunlight exposure (AOR = 1.70, 95% CI: 1.15, 2.50) were factors associated with practice of infant sunlight exposure. Conclusions. In this study, more than half of the mothers had good practice of infants’ sunlight exposure. This study highlights the importance of improving maternal knowledge and healthcare practices related to infant sunlight exposure. Key factors affecting these practices include lack of advice at health facilities, absence of postnatal care follow-up, and poor maternal knowledge. To address these issues, healthcare providers, local health offices, and mass media should focus on educational programs and strengthening advice during health visits. Future research should use validated tools and mixed-method approaches to better understand the social and cultural factors at play. Establishing national guidelines and studying infant serum vitamin D levels can further enhance community awareness and promote the benefits of sunlight exposure.

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.

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.

Introduction Enhancing clinical outcomes and patient satisfaction can be achieved through interprofessional collaboration between physicians and nurses. Conversely, a lack of nurse-physician interprofessional collaboration compromises patient safety, care, and improvement, and creates moral discomfort for healthcare professionals. Studies indicate that failures in interprofessional collaboration between nurses and physicians lead to adverse medical events, including hospital-acquired infections, medication administration errors, and unnecessary health-related costs. Objective This systematic review and meta-analysis aimed to investigate the pooled proportions of the interprofessional collaborations towards patient care and associated factors among nurses and physicians in Ethiopia, 2024. Methods A comprehensive search was conducted to find articles on interprofessional collaboration towards patient care and associated factors among nurses and physicians in Ethiopia. The study included cross-sectional studies conducted in Ethiopia and published in English from inception up to August 20, 2024. Excluded were conference proceedings, qualitative research, commentaries, editorial letters, case reports, case series, and monthly and annual police reports. The search encompassed full-text publications written in English and databases such as PubMed/MEDLINE, African Journals Online (AJOL), Semantic Scholar, Google Scholar, and Google. A checklist from the Joanna Briggs Institute (JBI) was used to evaluate the quality of the studies. Two independent reviewers performed data extraction, critical appraisal, and article screening. Statistical analysis was performed using STATA-17 software. A random-effects model was employed to estimate pooled proportions, and effect sizes with 95% confidence intervals were used to analyze determinants of interprofessional collaboration in patient care among nurses and physicians. Funnel plots and Egger’s test were used to examine the possibility of publication bias (p-value < 0.10), and the trim-and-fill method by Duval and Tweedie was applied to adjust for publication bias. Results Five studies with a total of 1686 study participants that are conducted in three Ethiopian regions and meet the inclusion criteria were reviewed and pooled for this evaluation. The pooled proportions of the interprofessional collaboration towards patient care in Ethiopia is 52.73% (95% CI = 44.66, 60.79%, I 2  = 91.5%). Factors such as attitude (favorable attitude towards collaboration) (OR = 1.13, 95% CI: 0.13, 9.89, I 2  = 97.7%) and organizational support (satisfaction towards organizational support) (OR = 0.38, 95% CI: 0.07, 2.10, I 2  = 97.5%) were not significantly associated with interprofessional collaboration towards patient care. Conclusion In summary, this systematic review and meta-analysis reveal that interprofessional collaboration between nurses and physicians in Ethiopia is moderately common, with a pooled proportion of 52.73%. This finding underscores the need for ongoing efforts to enhance collaborative practices to further improve patient care outcomes. Additionally, the review identified two potential contributors to interprofessional collaboration: satisfaction with organizational support and favorable attitudes towards collaboration. However, the pooled effects of these factors did not show a significant association with interprofessional collaboration. This highlights the necessity for further primary research to identify additional factors that may influence interprofessional collaboration and enhance patient care outcomes. Notable limitations of this study include significant variation among studies, a small number of studies, a focus solely on public hospitals, restriction to English-language publications, only observational studies, and limited access to databases such as EMBASE, CINAHL, and Web of Science. Registration This systematic review and meta-analysis was registered in Prospero with the registration ID and link as follows: CRD42024579370; https://www.crd.york.ac.uk/prospero/#recordDetails .

Background Low birth weight continues to be a significant cause of perinatal morbidity and mortality, contributing to 80% of neonatal deaths in low and middle-income countries. To the authors’ knowledge, no prior study has estimated the regional and sub-regional prevalence of low birth weight and its determinants in these settings. Therefore, this study aimed to examine the pooled and regional estimates of low birth weight in low and middle-income countries. Methods We used a weighted sample of 343,898 birth records, taken from the pooled demographic and health surveys conducted from 2015 to 2022 in 44 low and middle-income countries. Overall and sub-regional trends in low birth weight estimates were presented using a line graph. A multilevel mixed-effect analysis was done to identify determinants of low birth weight. Model comparison was performed using deviance and log-likelihood values, and statistical significance was determined at a P-value of less than 0.05. Results The overall prevalence of low birth weight births was 13.7% [95% CI: 13.5%—13.8%], showing significant variations among countries and regions. Asia region had the highest prevalence at 16%, followed by Latin America, the Caribbean, and Europe at 11.5%, and Africa at 9.5%. Our study also indicated a decline in low birth weight from 11.4% to 9.5% over eight-year periods, with no consistent trend observed. Furthermore, factors such as health insurance, household wealth, maternal age, access to healthcare facilities, maternal education, neonate’s sex, prenatal care, and antenatal iron supplementation were found to be statistically associated with low birth weight. Conclusion Our findings highlight the significant burden of low birth weight births, with notable variations in rates among countries and regions. The study also reveals a slight decline in low birth weight over time, although no consistent trend was observed. Importantly, maternal and household factors play significant roles in influencing low birth weight. Thus, addressing these factors through targeted interventions and policies could help reduce the incidence of low birth weight births in LMICs.

Background Although excessive birth weight is associated with short-term and long-term effects for both neonates and mothers, there is a gap in our understanding of its prevalence and contributing factors in low- and middle-income countries. Moreover, previous studies primarily focused on low birth weight and were limited to a specific geographic area. Therefore, this study aimed to estimate the prevalence of macrosomia and identify its determinants using data from 44 countries. Methods Data were obtained from demographic and health surveys conducted between 2015 and 2022 across 44 LMICs and a weighted total of 343,898 birth records was included in the analysis. Mixed-effect logistic regression models were fitted to identify determinants of excessive birth weight and the models were compared based on log-likelihood and deviance values. A p-value less than 0.05 and an adjusted odds ratio with the corresponding 95% confidence interval were used to identify determinants of macrosomia. Results The overall prevalence of excessive birth weight among neonates in LMCs was 7.1% [95% CI: 6.1%-8.1%], varying from 1.3% in India to 27% in Chad. The odds of excessive birth weight were higher in neonates born to mothers from households without health insurance [AOR (95% CI): 1.50 (1.36–1.65)], mothers with primary education [AOR (95% CI): 1.19 (1.09–1.31)], those born to multipara [AOR (95% CI): 1.13 (1.04–1.24), grand multipara [AOR (95% CI): 1.36 (1.20–1.54)], and overweight or obese mother [AOR (95% CI): 1.54 (1.44–1.66)]. Moreover, maternal age, number of antenatal care visits, sex of neonate, place of residence, and region were the other determinants of macrosomia. Conclusion About 7% of neonates in low- and middle-income countries had excessive weight at birth, with a significant variation across the countries. Therefore, strengthening programs aimed at improving maternal literacy and promoting healthy weight management before and during pregnancy is crucial. Moreover, improving access to antenatal care and health insurance and developing programs that address the specific needs of at-risk populations, such as older, multiparous, and rural women could help reduce the incidence of macrosomia.