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...S and three years preceding the surveyssof 20005 and 2011 EDHSssAs the review from DHS and WHO data showeds(Figure 2), the TFRs of several Sub SaharansAfrican (SSA) countries were in the higher ranges=-=(17, 18)-=-. When the TFR of Ethiopian women isscompared with that of other 34 selected SSAscountries, it was in the middle (4.8 children). Insshort, in Ethiopia, there has been an ongoingsprogress in fertility ...

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...le-income countries (thespopulation of Sub Saharan Africa and South Asiascarry a disproportionately large burden), to whichsdelay in health care seeking or delay insintervention are highly attributed =-=(2, 5, 6)-=-.sAlthough the major causes of maternalsdeaths, stillbirths and early neonatal deaths aresusually obstetric in origin (obstructed labor,shypertensive disorders, sepsis, and hemorrhage)s(7-9), several ...

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...contraceptive methods in Ethiopia (30, 31).sOn the other hand, as shown in Figure 5, thesunmet need for contraception among currentlysmarried women for family planning was amongsthe highest in Africa =-=(8, 9)-=-. The unmet need forscontraception in Ethiopia was 36% in the lates1995-2000 and 25% in the 2006-2011 (13, 15). Insgeneral, family planning is used as one of thesstrategies to reduce the risk of mater...

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... range because ofspartly socio-cultural norms, male dominance andslow status of women (10), and partly because ofslow supply of the preferred contraceptive methodsslike the other developing countries =-=(11, 12)-=-.sEthiopian demographic and health surveyss(EDHS) have shown that the TFR of women forsthe nation was about 5.9 in 1995-2000, 5.4 ins2002-2005 and 4.8 in 2006-2011 (13-15). In theslast decade, the TFR...

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...omen who were in theirsreproductive age had the awareness aboutscontraceptive methods. Other studies also showedsthe relatively high knowledge and low utilizationsof contraceptive methods in Ethiopia =-=(30, 31)-=-.sOn the other hand, as shown in Figure 5, thesunmet need for contraception among currentlysmarried women for family planning was amongsthe highest in Africa (8, 9). The unmet need forscontraception i...

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...According to the WHO estimates, insthis era about 140 million women and girlssglobally have been victims of FGC, and each yearsabout 3 million girls are subjected to this harmfulstraditional practice =-=(34)-=-. This harmful traditionalspractice is also widely practiced in Ethiopia (35).sThis is despite the fact that FGC is labeled as ashuman rights violation, and is condemned becausesof its immediate and l...

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...contraceptive methods in Ethiopia (30, 31).sOn the other hand, as shown in Figure 5, thesunmet need for contraception among currentlysmarried women for family planning was amongsthe highest in Africa =-=(8, 9)-=-. The unmet need forscontraception in Ethiopia was 36% in the lates1995-2000 and 25% in the 2006-2011 (13, 15). Insgeneral, family planning is used as one of thesstrategies to reduce the risk of mater...

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...eption in Ethiopia was 36% in the lates1995-2000 and 25% in the 2006-2011 (13, 15). Insgeneral, family planning is used as one of thesstrategies to reduce the risk of maternal andsperinatal mortality =-=(10, 12, 32)-=-.sAmong the low income countries, insBangladesh, it was possible to reduce the TFR tos2-3 by increasing the modern contraceptive use ofsReasons for Persistently High Maternal…Part II…sYifru B et als12...

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...natal mortalitysrate (r = -0.6; P < 0.0001) was more down-goingsthan for the stillbirth rate (r = -0.5; P < 0.0001),sprobably due to the relatively low attention givensto neonates than pregnant women =-=(54)-=-.sIn general, the positive correlation of nationalsadult literacy proportion with national ANC andsskilled person attended delivery proportion, and itssinverse correlation with MMR, stillbirth andsneo...

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... fertility rate and unwantedstotal fertility rate. The total fertility rate (TFR) ofsEthiopia remained in the high range because ofspartly socio-cultural norms, male dominance andslow status of women =-=(10)-=-, and partly because ofslow supply of the preferred contraceptive methodsslike the other developing countries (11, 12).sEthiopian demographic and health surveyss(EDHS) have shown that the TFR of women...

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...g HIV/HBVsduring breastfeeding.sOn the other hand, although thesrecommendation is the infant should not be givensanything per os other than the mother’s breastsmilk for the first 6 months after birth =-=(43)-=-, thestradition in the majority of Ethiopian family andsseveral other African countries (18) is to initiatesthe newborn feeding with something other thansbreast milk. The practice of prelacteal feeds ...

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...tiatesthe newborn feeding with something other thansbreast milk. The practice of prelacteal feeds is alsosquite common in the Arab world among thesMuslim community and in India among the Hindusfamily =-=(44, 45)-=-.sSpecific to Ethiopia, what is first given to thesnewborn varies from place to place. As ansunpublished study showed, the commonly used forsprelacteal feeding are butter, honey, cow milk,sbulla (prep...

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...le-income countries (thespopulation of Sub Saharan Africa and South Asiascarry a disproportionately large burden), to whichsdelay in health care seeking or delay insintervention are highly attributed =-=(2, 5, 6)-=-.sAlthough the major causes of maternalsdeaths, stillbirths and early neonatal deaths aresusually obstetric in origin (obstructed labor,shypertensive disorders, sepsis, and hemorrhage)s(7-9), several ...

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...tiatesthe newborn feeding with something other thansbreast milk. The practice of prelacteal feeds is alsosquite common in the Arab world among thesMuslim community and in India among the Hindusfamily =-=(44, 45)-=-.sSpecific to Ethiopia, what is first given to thesnewborn varies from place to place. As ansunpublished study showed, the commonly used forsprelacteal feeding are butter, honey, cow milk,sbulla (prep...

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...s ofshuman life. In African countries, it has beensshown that the incapacitated health infrastructuresand human resource for health were stronglyscorrelated with high maternal and perinatalsmortality =-=(55)-=-, which was in turn probablysbecause of the difference in the gross nationalsincome of the countries. A good indicator of thesimpact of income on health is the medical doctors’smigration from their bi...

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...le-income countries (thespopulation of Sub Saharan Africa and South Asiascarry a disproportionately large burden), to whichsdelay in health care seeking or delay insintervention are highly attributed =-=(2, 5, 6)-=-.sAlthough the major causes of maternalsdeaths, stillbirths and early neonatal deaths aresusually obstetric in origin (obstructed labor,shypertensive disorders, sepsis, and hemorrhage)s(7-9), several ...

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...risk of death increasedswith more genital tissue mutilation: 15% highersfor those whose mothers had Type I, 32% highersfor those with Type II and 55% higher for thoseswith Type III genital mutilation =-=(38, 39)-=-.sLate complications of FGC include:spsychological trauma, sexual disharmony andsdivorce due to severe dyspareunia, externalsgenitalia scarring and disfigurement, laborsabnormality, obstructed labor a...

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...ns increased with the severity ofsthe procedure (37-39).sIn Ethiopia, previous studies have shown thatsobstructed labor and uterine rupture were thesleading causes of maternal and perinatal mortalitys=-=(40, 41)-=-, and some other complication ofsobstructed labor (obstetric fistula, disability) aresalso rampant in this country (42). The authorsssurmise that the widely practiced FGC in severalsareas of Ethiopia ...

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... uterine rupture were thesleading causes of maternal and perinatal mortalitys(40, 41), and some other complication ofsobstructed labor (obstetric fistula, disability) aresalso rampant in this country =-=(42)-=-. The authorsssurmise that the widely practiced FGC in severalsareas of Ethiopia (14) has probably contributed tosthe high maternal and perinatal mortality due tosobstructed labor and uterine rupture....

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...eady demonstrated (13-15). Another article hassalso shown a high proportion of maternal andsperinatal mortality among rural and uneducatedswomen, specifically in Ethiopia and some othersSSA countries =-=(20)-=-. Furthermore, as shown insFigure 3, the Pearson correlation coefficient (r)shas demonstrated a positive and strong associationsof maternal mortality ratio (MMR)swith the TFRsin 45 African countries (...

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...isk of significant bleeding, localizedsand pelvic infection or abscess formation, sepsissand urinary retention may be inevitable, and inssome even death due to hemorrhage, sepsis orstetanus may occur =-=(36, 37)-=-. Another literaturesreview has also shown that the perinatal deathsrates were higher for those born to mothers whoshad undergone genital mutilation compared tosthose who had not and the risk of death...

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...nt for the other.sPrevious authors have shown the causalsrelationship of education and health-one more yearseducation raises earnings by about 10% andsincreases the life expectancy by about 0.2 yearss=-=(50)-=-. A number of studies have also firmlysestablished the intimate linkage between thesoverall general health (particularly women’sshealth) and the level of education of individuals insparticular and the...

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...lled person attendedsdelivery in African countries demonstrated aspositive correlation (r = 0.56; P = 0.001 for thesANC; r = 0.58; P < 0.0001 for the skilled personsattended delivery). Other articles =-=(53)-=- extractedsfrom this review have shown that Africanscountries with low ANC or low skilled personsattended delivery at the national level were foundsto have high maternal mortality. The increasingsregr...

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...0 years,smore than three-fourths of medical doctorssgraduated in the country migrated to developedscountries, and as a result, the physician tospopulation ratio remained among the lowest in thesworld =-=(56)-=-.sThe impact of low income on the public healths(specifically on maternal and perinatal health) issbeyond lack of health infrastructure and humansresource for health (low production, high attrition,sl...

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... range because ofspartly socio-cultural norms, male dominance andslow status of women (10), and partly because ofslow supply of the preferred contraceptive methodsslike the other developing countries =-=(11, 12)-=-.sEthiopian demographic and health surveyss(EDHS) have shown that the TFR of women forsthe nation was about 5.9 in 1995-2000, 5.4 ins2002-2005 and 4.8 in 2006-2011 (13-15). In theslast decade, the TFR...

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...fertility decline over the last twosdecades particularly in the urban and amongseducated women. According to Index Mundisestimation, the TFR of Ethiopia has declined froms7.08 in 1990 to 4.05 in 2011 =-=(19)-=-.sEthiop J Health Sci.sSpecial IssuesSeptember 2014s122sFigure 2: Total fertility rate per woman in 34 Sub Saharan African countriessThe high TFR among the rural and uneducatedswomen might have contri...

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...omen who were in theirsreproductive age had the awareness aboutscontraceptive methods. Other studies also showedsthe relatively high knowledge and low utilizationsof contraceptive methods in Ethiopia =-=(30, 31)-=-.sOn the other hand, as shown in Figure 5, thesunmet need for contraception among currentlysmarried women for family planning was amongsthe highest in Africa (8, 9). The unmet need forscontraception i...

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...countries, insBangladesh, it was possible to reduce the TFR tos2-3 by increasing the modern contraceptive use ofsReasons for Persistently High Maternal…Part II…sYifru B et als125smarried women to 56% =-=(33)-=-. The TFR and unmetsneed for contraception of the high incomescountries were reported to be about 1.8 and 6,srespectively, which might have contributed tostheir MMR to be about 14 per 100,000 live bir...

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...sglobally have been victims of FGC, and each yearsabout 3 million girls are subjected to this harmfulstraditional practice (34). This harmful traditionalspractice is also widely practiced in Ethiopia =-=(35)-=-.sThis is despite the fact that FGC is labeled as ashuman rights violation, and is condemned becausesof its immediate and long term complications tosthe victim (34).sFGC increases the risk of maternal...

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...isk of significant bleeding, localizedsand pelvic infection or abscess formation, sepsissand urinary retention may be inevitable, and inssome even death due to hemorrhage, sepsis orstetanus may occur =-=(36, 37)-=-. Another literaturesreview has also shown that the perinatal deathsrates were higher for those born to mothers whoshad undergone genital mutilation compared tosthose who had not and the risk of death...

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...risk of death increasedswith more genital tissue mutilation: 15% highersfor those whose mothers had Type I, 32% highersfor those with Type II and 55% higher for thoseswith Type III genital mutilation =-=(38, 39)-=-.sLate complications of FGC include:spsychological trauma, sexual disharmony andsdivorce due to severe dyspareunia, externalsgenitalia scarring and disfigurement, laborsabnormality, obstructed labor a...

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...ns increased with the severity ofsthe procedure (37-39).sIn Ethiopia, previous studies have shown thatsobstructed labor and uterine rupture were thesleading causes of maternal and perinatal mortalitys=-=(40, 41)-=-, and some other complication ofsobstructed labor (obstetric fistula, disability) aresalso rampant in this country (42). The authorsssurmise that the widely practiced FGC in severalsareas of Ethiopia ...

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... healthsservices, boosts professionals’ and patients’ssatisfaction and reduces health professionals’sattrition rate from public health facilities insparticular and the external brain drain in generals=-=(9, 57)-=-.s2) When the economic power of a countrysgrows well, there will be a capacity to build all-stime accessible roads, schools, and other facilitiessin the community. The construction of all thesesinfras...