Background: Non-communicable diseases (NCDs) are the dominant cause of global morbidity and mortality, especially in developing countries. Tackling NCDs is central to advancing women’s and child health, and future generations. Many NCDs can be prevented with appropriate approaches across the maternal and child health life-cycle, throughout the years of reproductive age especially before conception and continuing through pregnancy. However, women’s awareness of NCDs screening during the preconception period was not well known in many countries including Ethiopia. Therefore, this study aimed to assess women’s awareness of common NCDs screening during the preconception period and associated factors in Manna District, Jimma Zone, Oromia Region, Ethiopia, 2019. Methods: A community-based cross-sectional study was conducted from March 02 to April 10, 2019. The sample size was 636 pregnant women from eight randomly selected rural kebeles and a purposively taken urban kebele. The data were collected using a pre-tested structured questionnaire and entered into Epi data manager version 4.0.2 and exported to SPSS version 21. Descriptive, binary, and multivariable logistic regression analyses were carried out. Results: Of the total of 623 respondents, 459 (73.7%) of them had good awareness of common NCDs screening during the preconception period. Women who had formal education [AOR = 1.95, 95% CI: (1.31–2.89)], those who had planned pregnancy [AOR = 2.17, 95% CI: (1.47–3.19)], on ANC follow up [AOR = 1.79, 95% CI: (1.16–2.74], and those who had media (radio and/or television) in their house [AOR = 1.55, 95% CI: (1.05–2.29)] had good awareness on common NCDs screening during the preconception period compared to their counterparts. Conclusions: In this study, nearly three-quarters of respondents had a good awareness of common NCDs screening during the preconception period. Women’s educational status, pregnancy planning status, ANC visit, and having radio and/or television in the house were predictors of women’s good awareness of common NCDs screening during the preconception period. Therefore, all concerned bodies are recommended to work toward increasing women’s awareness using different approaches like awareness creation campaigns and counseling clients attending health facilities.
A community-based cross-sectional study was conducted from March 02/2019 to April 10/2019 in the Manna district among pregnant women. The Manna district is one of the 21 districts found in Jimma zone, Oromia Region. It is located 368 km southwest far from Addis Ababa (the capital city of Ethiopia) and 22 km from Jimma town. According to the 2019 report obtained from the Manna District Health Office, the district has a total population of 197,911, of which 26,451 were urban and 171,460 were rural. Women of reproductive age groups of the district were 43,738, and pregnant women were 6868. The district has a total of 26 kebeles: 1 urban and 25 rural kebeles. It has 7 health centers, 26 health posts, 11 private clinics, and 3 private pharmacies. It has also 68 health extension workers and 121 health care providers of different professions. The source populations were all pregnant women found in the district during the study period, and the study populations were randomly selected pregnant women who fulfilled the inclusion criteria. All pregnant women (regardless of the gestational age) who lived in the district for at least 6 months prior to the study period were included in the study. Pregnant women who were critically ill and unable to communicate were excluded. In this study, pregnant women were recruited instead of women in preconception period due to issues related to feasibility, as list of pregnant women were easily obtained from the family folder of the community health information system. The sample size was determined by using a single population proportion formula, considering the following assumptions: 50% proportion of women’s awareness of NCDs screening during the preconception period since there was no prior study in Ethiopia specifically to address the study objectives, 95% level of confidence, 5% margin of tolerable sampling error, 10% non-response, and 1.5 design effects. Based on these, the final sample size of the study was 636. To select the study participants, first, the 26 kebeles were stratified into rural and urban. Then, the urban kebele was included in the study purposively for representation. Eight kebeles among the 25 rural kebeles were selected using a simple random sampling technique. Then, the sample size was proportionally allocated to the selected 9 kebeles. Accordingly, a total of 566 pregnant women (Haro = 89, Gudeta Bula = 42, Buxure = 54, Somodo = 83, Gube Muleta = 65, Bilida = 86, Kenteri = 72, and Sombo Manna = 75) were allocated to the eight selected rural kebeles. For the urban kebele (Yabbu town), 70 pregnant women were allocated. The lists of the total number of pregnant women found in the selected rural kebeles were obtained from the family folder of the community health information system, which is available at the health post. The rural health extension workers identify pregnant women, women on family planning and women who had under-five children and register them on the family folder. They update the family folder every month. For the urban kebele, since the family folder did not exist, a census was conducted by two urban health extension workers to construct the sampling frame. The two health extension workers conducted home to home visit and asked every woman of reproductive age whether they are on family planning or not, the absence of their menstrual period, its duration, early pregnancy symptoms and visits women’s abdomen to identify the pregnant women. The human chorionic gonadotropin (HCG) test was not done due to a lack of resources. Finally, computer-generated simple random sampling was used to identify the study participants. Their usual place of residence was identified in collaboration with kebele leaders. Data were collected using an interviewer-administered structured questionnaire developed after reviewing different relevant literatures. It was first prepared in English and then translated to Afan Oromo and Amharic by experts. Then, it was translated back to English by another person to ensure its consistency and accuracy. A pretest was conducted among 5% of pregnant women in the Saka district, which is located 20 km away from the study area. A total of 6 data collectors (4 clinical nurses and 2 BSc nurses) and 2 public health officers as supervisors were recruited based on their previous experience in data collection and fluency in the languages of the community. In addition, the authors also closely supervised the data collection processes. The data collectors and supervisors were trained for 1 day on the objective of the study, data collection tool, approach to the interviewees, details of interviewing techniques, respect and maintaining privacy and confidentiality of the respondents. Cronbach’s α coefficient was computed to test the internal consistency of the tool, which was 0.88. The data collectors asked pregnant women about their awareness of NCDs screening specifically before they became pregnant. Awareness of Common non-communicable diseases screening during the preconception period was the dependent variable. Socio-economic and demographic factors (age, residence, educational level, occupation, marital status, family size, and wealth of the household), gynecologic and obstetric factors (history of family planning use prior to conception, pregnancy planning status, parity, gravidity, and antenatal care visit), preexisting medical illnesses, health facility-related factor (distance from health facility), and media-related factors (access of radio and/or television in the household) were independent variables. Kebele: The lowest government administrative hierarchy that exists next to district. Common non-communicable diseases: In this study, the common non-communicable diseases are anemia, diabetes mellitus and hypertension. Good awareness of common non-communicable diseases screening during preconception period: defined as having ever “heard” or “read” about screening for at least one of the three common non-communicable diseases (anemia, diabetes mellitus and hypertension) for the sake of becoming pregnant. That means, in this study, women who answered “Yes” to at least one of the following three questions were considered as “women with good awareness of common non-communicable diseases screening during preconception period”. Questions: After checking the completeness of the data manually, the collected data were entered, cleaned, and checked using Epi data manager version 4.0.2. Then, the data were exported to SPSS version 21 for analyses. Bivariable and multivariable logistic regression analyses were carried out to identify an association between the predictors and outcome variables. Binary logistic regression analysis was performed to select variables for multivariable logistic regression analysis. Variables with a p-value < 0.25 in the binary logistic regression analysis were taken as candidates for multivariable logistic regression analysis. Finally, multivariable logistic regression analysis was performed to control for the possible confounding effects of the selected variables. Variables with a p-value < 0.05 were recognized as statistically significant associations with women’s good awareness of NCDs screening during the preconception period. Odds ratio with its 95% CI was used to show the degree of association between the outcome and independent variables. Descriptive analyses like frequencies and proportions were also conducted for different variables as necessary. A letter of ethical approval was received from the Institutional Review Board of Jimma University Institute of Health. The necessary permission was obtained from the Manna district health office and kebele administrative offices. All the study participants were informed about the purpose of the study, their right to refuse and assured about the confidentiality of the information they provided. Written informed consent was obtained from all the study participants. For participants under 18 years old, written consent was obtained from their parents.
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