Hindawi

International Journal of Reproductive Medicine

Volume 2018, Article ID 5945060, 7 pages
https://doi.org/10.1155/2018/5945060

Research Article
The Prevalence of Traditional Malpractice during
Pregnancy, Child Birth, and Postnatal Period among Women of
Childbearing Age in Meshenti Town, 2016

Haileyesus Gedamu , Adane Tsegaw, and Etsubdink Debebe

School of Nursing, Bahir Dar University, Bahir Dar, Ethiopia

Correspondence should be addressed to Etsubdink Debebe; [email protected]

Received 27 July 2017; Revised 18 November 2017; Accepted 14 January 2018; Published 7 February 2018

Academic Editor: Hind A. Beydoun

Copyright © 2018 Haileyesus Gedamu et al. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.

Background. Cultural practices, beliefs, and taboos are often implicated in determining the care received by mothers during
pregnancy and child birth which is an important determinant of maternal mortality. Objective. To assess prevalence of
cultural malpractice during pregnancy, child birth, and postnatal period among women of childbearing age in Meshenti town,
Amhara region, northwest Ethiopia, in 2016. Methods. Community based cross-sectional study was conducted among women of
reproductive age group interviewed during the study period from May 10 to June 17, 2016. Total sample size was 318 women of
reproductive age group. Systematic sampling technique was conducted. Result. Overall, 50.9% of the respondents had cultural
malpractices during their pregnancy. Out of 318 women, 62 (19.5%) practiced nutrition taboo, 78 (24.5%) practiced abdominal
massage, 87 (29.7%) delivered their babies at home, 96 (32.8%) avoided colostrums, 132 (45.2%) washed their baby before 24 hr
after delivery, and 6 (6.9%) cut the cord by unclean blade. Conclusion and Recommendation. The findings of this study show that
different traditional malpractice during perinatal period is still persisting in spite of modern developments in the world. Health
education and promoting formal female education are important to decrease or avoid these cultural malpractices.

1. Introduction It has been recognized that violence and trauma, mal-

practice during pregnancy and childbirth, low social status,
Tradition represents the sum total of all behaviors that are gender discrimination, and lack of awareness in ANC follow-
learned, shared by a group of people, and transmitted from up at nearby health facilities are direct and indirect medical
generation to generation. It includes language, religion, types causes of maternal mortality [5–7]. Harmful traditional
of food eaten and methods of their preparation, childrearing practices that affect children and women are female genital
practices, and all other values that hold people together and mutilation, milk teeth extraction, food taboo, uvula cutting,
give them a sense of identity and distinguish them from other forbidding food and fluids during diarrhea, keeping babies
groups [1, 2]. from exposure to sun, and feeding newborn babies with fresh
Women all over the world are confronted with many butter [8, 9]. In Ethiopia, the great majorities of women
difficult choices during pregnancy and child birth. Cultural deliver at home (90%) and follow the cultural birth customs.
practices, beliefs, and taboos are often implicated in deter- These create problems for several years associated with
mining the care received by mothers during pregnancy and harmful cultural practices at each individual community and
child birth which is an important determinant of maternal home during delivery [10, 11].
mortality. Every day, at least 800 women die worldwide from United Nations (UN) agencies and human right bodies
the complications of pregnancy and child birth. These deaths started addressing harmful traditional practice in the early
are mainly due to obstetric problem which easily could be 1990s but there was little progress. There are now a number of
prevented if the mothers get the appropriate care they deserve important international instruments endorsed by most of the
during their pregnancy, delivery, and postnatal period [3, 4]. governments and could serve as a basis for a struggle against
2 International Journal of Reproductive Medicine

harmful traditional practice [12, 13]. In addition to deep- 2.5. Inclusion and Exclusion Criteria
rooted beliefs, customs, and rational attitudes, lack of knowl-
edge and being unaware of the effects of the practices help to 2.5.1. Inclusion. All reproductive age women who experience
maintain these problems. Sometimes a harmful practice is so at least one pregnancy were included.
deeply rooted that it seems impossible to change [14, 15].
In the world, there are many traditional malpractices 2.5.2. Exclusion. Women who had severe medical and mental
during pregnancy, labor, and postnatal period. In Turkey and illness and could not communicate verbally during data
Iran, women use traditional practices to reduce engorgement collection were excluded.
of the breast and to increase the amount of breast milk [16–
18]. 2.6. Sample Size Determination and Sampling Technique
In Guatemala, Guatemalan women believe speedy deliv-
2.6.1. Sample Size Determination. The sample size was cal-
ery can be induced by drinking a liquid created by boiling a
culated by using the following single population proportion
purple onion in beer and in Niger, Muslim tradition allows
formula:
only a woman’s husband to touch her genitals, so midwives in
this African nation facilitate labor by offering the mom-to-be 𝑝 (1 − 𝑝)
herbal drinks and sprinkling herbs over her abdomen. Foods 𝑛 = (𝑧)2 × , (1)
𝑤2
that are good sources of energy and protein are not allowed to
be consumed by pregnant women for reasons such as difficult where 𝑧2 is the confidence limit of the study (95%), 𝑝 is the
and prolonged labor due to fears of a large baby. Similarly, proportion of study population (38.3%), 𝑤 is margin of error
sources of vitamins and minerals are restricted during preg- or desired precision (5% or 0.05), and 𝑛 is total sample size.
nancy mainly due to the fear of offensive discharges during Let us take 𝑝 = 38.3% which is prevalence rate for home
delivery and skin diseases on the body. Studies conducted in delivery which is most common traditional malpractice dur-
central, eastern, and southern parts of Ethiopia have reported ing delivery at Limmu Genet town, Oromia region, southwest
that food items that are white in color such as milk, fatty meat, Ethiopia [23].
porridge, potato, banana, clean vegetables, colostrums, and The required sample size for this study “𝑛” at confidence
fruits are prohibited to be consumed by pregnant/lactating interval of 95% and marginal error of 5% will be determined
women and children [10, 19–21]. by using population proportion formula: 𝑛 = (1.96)2 0.383(1−
Another research done in Bangladesh on usage of 0.383)/(0.05)2 = 364. With correction formula 𝑛/1 + 𝑛/𝑁
colostrum and duration to initiate breastfeeding revealed (where 𝑛 is the sample size we calculate as 364 and 𝑁 is
that 90% of the mothers reported feeding their newborn total population), our sample size becomes 289 and then, with
colostrum. 59% of mothers initiated breastfeeding within 4 10% nonresponse rate, a total of 318 study participants were
hours and 88% within 12 hours of parturition [22]. recruited.
2. Methods and Materials 2.6.2. Sampling Technique and Procedure. The sampling tech-
2.1. Study Area. The study was conducted in Meshenti nique was systematic random sampling which was conducted
town, west Gojjam zone, Amhara region, northwest Ethiopia. by considering list of households. The sampling interval was
Meshenti was one of the towns found around Bahir Dar calculated using 𝑘 = 𝑁/𝑛 (1397/318) = 4th, where 𝑘 is
which has a total population of 6006, among those 2697 sampling interval, 𝑁 is number of households in Meshenti
were males and 3309 were females. In addition, it has town, and 𝑛 is sampling size.
1397 households and a total of reproductive age women The first sample was selected by using lottery method
(15–49 years) of 1418. The town has one health center and it among the first four households and then assessed every 4th
has 1 Kebele; it is 555 km away from Addis Ababa and 12 km house. In households with no eligible person, we went to the
away from Bahir Dar. next house. But for households with more than one eligible
Many harmful traditional practices have been performed individual, one of the individuals was selected randomly.
in the study area. Therefore, this investigation revealed the
2.7. Data Collection. Data was collected by using struc-
evidence based occurrence of traditional malpractice during
tured questionnaire by face-to-face interview. The question-
pregnancy, child birth, and postnatal period among women
naire includes sociodemographic characteristics, reproduc-
of child bearing age.
tive health part, and traditional malpractice. Questionnaire
2.2. Study Design and Period. The community based cross- that addressed the objective of the study was gathered and
sectional study design was conducted from June 10 to June 17, adapted. The questionnaire was prepared in English and
2016. translated to Amharic version to facilitate the understanding.
Data collection was carried out by five data collectors from
2.3. Source Population. The source population was all women preparatory students trained on the study and data collection.
of reproductive age group (15–49 years).
2.8. Data Quality Assurance. Pretest of questionnaires was
2.4. Study Population. The study population was all women done one week before the actual survey and it was carried
in reproductive age (15–49 years) who experienced at least out with similar study population in Merawi town for 1 day
one pregnancy. on 5% of sample size and the necessary modification was
International Journal of Reproductive Medicine 3

made before being applied on study subjects. The data was Table 1: Sociodemographic characteristics of respondents among
collected carefully by the trained data collector and principal women of childbearing age in Meshenti town, Bahir Dar Zuria
investigators to get the reliable and necessary information woreda, Amhara region, June 2016.
according to the aim of the study. The principal investigator
Characteristics Category Frequency Percent (%)
made an ongoing checkup each day during the data collection
to ensure the quality of data by checking filled questionnaires 15–19 15 4.7
for their completeness and internal consistency. The quality 20–24 89 28.0
of data collection process was monitored by giving a clear 25–29 100 31.4
attention to the data. All the collected data was checked Age 30–34 50 15.7
and rechecked and we made the necessary correction each 35–39 34 10.7
day; when there were difficulties occurring during the data
40–44 14 4.4
collection, explanation and discussion with the respondents
were done and unclear questions were explained briefly by 45–49 16 5.0
using respondent native language. Total 318 100.0
Orthodox 252 79.2
2.9. Data Processing and Analysis. The collected data was Muslim 64 20.1
Religion
entered and analyzed by using SPSS version 20. Calculation Protestant 2 .6
was calculated by using a calculator and Microsoft Excel and
Total 318 100.0
statistical analysis was done by principal investigator. Finally
description, tables, graphs, and charts were used to present Amhara 314 98.7
the finding. Ethnicity Oromo 2 .6
Tigre 2 .6
3. Ethical Consideration Total 318 100.0
Have no formal 172 44.1
Ethical clearance was obtained from Bahir Dar University education
CMHS Ethical Review Board before data collection. Written
G 1–8 70 22.0
and oral consent were obtained from the study population Educational status
during data collection. The right was given for the study G 9–12 53 16.7
population to refuse or stop or withdraw at any time of 12+ 23 7.2
data collection. The confidentiality of the respondents was Total 318 100.0
ensured, where any person name did not appear on research Married 260 81.8
documents and respondents were informed about the aim of Single 18 5.7
the study. Marital status Divorced 24 7.5
Widowed 16 5.0
4. Result
Total 318 100.0
4.1. Sociodemographic Characteristics. A total of 318 partic- Housewife 211 66.4
ipants were included in the study and response rate was Employee 25 7.9
100%. Regarding the sociodemographic characteristics of the 45 14.2
Occupational status Merchant
respondents, 100 (31.4%) were in the age group of 25–29. The
Student 6 1.9
majority of them were orthodox (252) (79.2%) and Amhara
(314) (98.7%) by religion and ethnicity, respectively. Out of Other 31 9.7
318, 260 (81.8%) were married and 137 (41.1) were illiterate and Total 318 100.0
70 (22%) completed grades 1–8. Concerning occupation, 211
(66.4%) were housewives (Table 1).
Out of 87 (29.7%) mothers who delivered their last
4.2. Traditional Malpractices during Pregnancy. Generally child at home, most of them were assisted by their family
in Meshenti town, 50.9% of pregnant women are involved (37) (42.5%), untrained traditional birth attendant (UTTBA)
in traditional malpractice during their pregnancy. Out of (29) (33.3%), neighbors (12) (13.8%), and trained traditional
these, 62 (19.5%) had nutritional taboo, 139 (43.7%) used birth attendant (TTBA) (9) (10.3). Among 87 (29.7%) home
the mother’s drink “telba” during their pregnancy, and 48 deliveries, the cord was cut by using unboiled new blade (66)
(15.1%) and 43 (13.5%) practiced abdominal massage and (75.9%), boiled new blade (14) (16.1%), unboiled blade used
drank “kosso,” respectively (Table 2). before (6) (6.9%), and boiled blade used before (1) (1.1%).
From the 87 home deliveries, 84 of them had their umbilical
4.3. Traditional Malpractices during Child Birth. Generally in cord tied using boiled thread (71) (84.5%), unboiled thread
Meshenti town, 37.9% of mothers are involved in traditional (10) (11.9%), and other material (3) (3.6%) (Table 3).
malpractice during their child birth. From these, 6.3% of the For home-delivery mothers, the majority (43%) of them
mothers have traditional malpractice like abdominal massage were assisted by their family whereas 10% of them were
and uterine massage and the other 29.7% have home delivery. assisted by traditional trained birth attendants (Figure 1).
4 International Journal of Reproductive Medicine

Table 2: Traditional malpractice during pregnancy in Meshenti town, 2016.

Variables Frequency Percent (%)

Nutritional taboos 62 19.5
Abdominal massage 48 15.1
Drinking telba 139 43.7
Drinking kosso 43 13.5
Abdominal massage and drinking telba 20 6.3
Abdominal massage and drinking kosso 10 3.1
Drinking telba and drinking kosso 1 .3
Other 6 1.9
I don’t know 51 16

Table 3: Traditional malpractice during delivery in Meshenti town, 2016.

Variables Frequency Percent (%)

Traditional malpractice
Abdominal massage
Yes 8 2.73
No 0 0
Uterine massage
Yes 7 2.39
No 0 0
Abdominal and uterine massage
Yes 5 1.7
No 0 0
Total 20 6.82
Place of delivery
Home 87 29.7
Health facility 206 70.3
Total 293 100
Method used to expel placenta
Spontaneously 76 87.4
Uterine massage 11 12.6
Total 87 100
Instrument used to cut cord
Boiled new blade 14 16.1
Unboiled new blade 66 75.9
Unclean blade used before 6 6.9
Boiled blade used before 1 1.1
Total 87 100
Umbilical cord tied
Yes 84 96.6
No 3 3.4
Total 87 100
Material used to tie umbilical cord
Boiled thread 71 84.5
Unboiled thread 10 11.9
Other 3 3.6
Total 84 100
International Journal of Reproductive Medicine 5

Home-delivery attendants Table 4: Traditional malpractice during postnatal period in Mesh-

enti town, 2016.
10%
Variables Frequency Percent (%)
43%
What was applied on the
33% stump of umbilicus
Nothing 174 54.4
14% Cow dung 4 1.4
Butter 98 30.4
Other 17 5.8
Total 293 100
Family UTTBA
Neighbor TTBA What was given to the
child immediately after
Figure 1: Distribution of birth attendants for women who deliver at delivery
home in Meshenti town, northwest Ethiopia, Amhara region, June Butter 60 20.5
2016.
Cow milk 5 1.7
Water 7 2.4
Time to wash baby after delivery
Nothing 210 71.7
60.00
Other 11 3.8
50.00 54.90%
Total 293 100
40.00 Time to start
breastfeeding
(%)

30.00
27.60% Within 1 hour 219 74.7
20.00
17.40% Within 24 hours 51 17.4
10.00 23 7.8
After 24 hours
0.00 Total 293 100
Within 1 hour Within 24 hours After 24 hours
Avoiding colostrum
Figure 2: Time period of washing babies after delivery among
Yes 197 67.2
reproductive aged women in Meshenti town, west Gojjam, north-
west Ethiopia, June 2016. No 96 32.8
Total 293 100

4.4. Traditional Malpractices during Postnatal Period. Gener-

ally in Meshenti town, 76.1% of the mothers are involved in Our study reveals that the prevalence of nutritional
traditional malpractice during their postnatal period. From taboo was 19.5%. This result was slightly similar to a study
these 293 mothers, 96 (32.8%) mothers avoided colostrum conducted in Lemmu genet town with prevalence of 19.1%
and 98 (30.4%) of the mothers applied butter on their child [24]. The result was also lower than that of a study conducted
umbilicus after delivery. some of the respondents started in Shashemene with the prevalence of 49.8% [21]. The possible
breastfeeding within 24 hr and 23 (7.8%) after 24 hr. On reason for the variation of the results was different charac-
the other hand, 81 (27.6%) mothers washed their babies teristics in study population. The food items that are avoided
immediately after delivery (Table 4). during pregnancy, based on our research, are vegetables (6
The majority of babies delivered at Meshenti town had times), meat (2 times), paper (34 times), “genfo” (9 times),
their bodies washed after 24 hrs (Figure 2). sugar cane (16 times), and “ergo” (7 times); a research done in
Shashemene shows vegetables (17 times) and meat (63 times)
5. Discussion which is very high [21]. The major reasons for avoiding these
food items during pregnancy were that the food may plaster
This community based study has attempted to assess the the fetal head or make the baby fat and difficult to deliver.
prevalence of traditional malpractices during pregnancy, As Guatemala women believe that drinking liquid (which
delivery, and postnatal period in Meshenti town, west Gojjam is prepared by boiling purple onion in beer) is very helpful to
zone, Amhara region, northwest Ethiopia. The result of the induce labor, our research also shows that Meshenti women
study revealed that, from the total of 318 respondents, 100 drink telba to facilitate their labor [19].
(31.4%) of the women were of the age range of 25–29 years Our study revealed that the prevalence of home deliv-
and majority were married and illiterate: 260 (81.8%) and 137 ery was 29.7% which was lower than that of the study
(43.1%), respectively. This result was in line with a research conducted in Lemmu genet town, Oromia region, Jimma
done at north Arbaminch, south Ethiopia, where 36% of the zone, 38.3% [24]; however, our study was comparable with
women were aged 25–29 and 90.8% and 53.6% were married a study conducted in south Gondar zone, Debretabor town,
and illiterate, respectively [23]. where the prevalence was 29.6% [25]. Out of 29.7% of the
6 International Journal of Reproductive Medicine

home delivered babies, most of them were attended by work. Last but not least, they would like to express their
family (42.5%) and untrained traditional birth attendants heartfelt thanks to all data collectors and supervisor for their
(33.3%) which is higher and lower than the study conducted valuable contribution.
in Debretabor town, south Gondar zone, 13%, and south
Arbaminch, north Ethiopia, 79.4%, respectively [23, 25]. References
This investigation also revealed that prevalence of avoid-
ing colostrum was 32.8% which was lower than study con- [1] D. Asefa, E. Wassie, M. Getahun, M. Berehaneselassie, and
ducted in Bangladesh with the prevalence of 41% [22]; and A. Melaku, Harm Full Traditional Practices for the Ethiopian
the result was lower than the study conducted in Raya Kobo Health Center Team, Ethiopian public health training initiative
(EPHTI) manual, Awasa College, 2005, Harm full traditional
district, northeastern Ethiopia, with the prevalence of 13.5%
practices for the Ethiopian health center team. Ethiopian public
[26]. In this study, 132 (45%) of the mothers washed their health training initiative (EPHTI) manual, Awasa College.
babies before 24 hours after delivery that is higher than the
[2] CSA, Ethiopia Demographic and Health Survey, Central statisti-
research done at Lemmu genet town, Oromia region, Jimma
cal authority (CSA), Addis Ababa, Ethiopia, 2005.
zone, which was 28.4% [24]. This may cause negative impact
[3] UNCHR, Harmful Traditional Practices Affecting the Health of
on the newborn baby like hypothermia.
Women and Children, Fact Sheet No. 23, UN Office of the
About 6.9% of respondents used unsterile material to cut High Commissioner for Human Rights (UNCHR), Geneva,
the umbilical cord during home delivery which was higher Switzerland, 2006.
than the study conducted in South Gondar zone, Debretabor
[4] WHO, Maternal Mortality, World health organization (WHO)
town, which was 0.6% [25]. Fact sheet, Geneva, Switzerland, 2014.
A study conducted at Debretabor governmental health
[5] J. Raelori, “Cultural child birth practice’s, believes & tradition in
institution shows that 213 (60%) have started breastfeeding
Libya, 2009”.
within one hour, 109 (30.7%) within 24 hr, and 33 (9.3%) after
[6] Adolescent pregnancy cultural complex issue, 2008.
24 hours (d). But our study revealed that 219 (74.7%) have
started breastfeeding within one hour, 51 (17.4%) within 24 hr, [7] P. Otoo, H. Habib, and A. Ankomah, “Food prohibitions and
and 23 (7.8%) after 24 hours [25]. other traditional practices in pregnancy: a qualitative study in
western region of ghana,” Advances in Reproductive Sciences, vol.
Based on our study, 24.5% (78) of the mothers had
3, no. 3, pp. 41–49, 2015.
abdominal massage during pregnancy which was relatively
similar to a research done at Lemmu genet town, Oromia [8] MHRC, Cultural Practices and their impact on the enjoyment of
human rights, Particularly the Rights of Women and Children in
region, Jimma zone, with prevalence of 22% [24] and higher
Malawi, Malawi Human Rights Commission (MHRC), 2005.
when compared to a research done at Debretabor govern-
[9] A. Dawit, W. Eshetu, G. Masresha, B. Misganaw, and M.
mental health institution, south Gondar zone, Debretabor
Atsinaf, Harmful Traditional Practices: Module for Ethiopian
town, 12.1% [25]. The possible reason to do such a practice is Health Center Team, Ethiopian Public Health Training Institute,
to avoid striae and to relieve back pain that occurred during Awassa College, 2004, Harmful Traditional Practices: Module
pregnancy. for Ethiopian Health Center Team , Ethiopian Public Health
Training Institute, Awassa College.
6. Conclusion [10] M. Neguse, D. Hailemariam, and G. Metike, “Assessment of safe
delivery services utilization among WCBA North Gondar zone,
The prevalence of cultural malpractice in the study area was North West Ethiopia,” Ethio journal health, vol. 18, no. 3, pp. 145–
found to be high. Therefore, health education focusing on 152, 2004.
problems of cultural malpractice is recommended to reduce
[11] EGLDAM, Follow up National Survey on Harmful Traditional
or avoid the consequences of the malpractice. Practices in Ethiopia, 2008.
[12] M. Zuberi, ssessment of violence against children in the eastern
Conflicts of Interest and southern Africa region: Results of initial desk review for the
The authors declare that there are no conflicts of interest UN secretary general’s study on violence against children, 2006.
regarding the publication of this paper. [13] G. D. Alene and M. Edris, “Knowledge, attitudes and practices
involved in harmful health behavior in Dembia district, North-
west Ethiopia,” Ethiopian Journal of Health Development, vol. 16,
Authors’ Contributions no. 2, pp. 199–207, 2002.
All authors participated in proposal conception and design- [14] F. Worku and S. Gebresilassie, Reproductive Health for Health
ing the proposal, data collection, and analysis and wrote the Science Students, Ethiopian Public Health Training Institute,
manuscript. Finally, the paper was approved by all authors. University of Gondar, 2008, Reproductive Health for Health
Science Students , Ethiopian Public Health Training Institute,
University of Gondar.
Acknowledgments
[15] WHO, WHO Regional Health Forum South-East Asia Region,
The authors would like to express their deepest and heart- vol. 6, World health organization (WHO), 2008.
felt appreciation to Bahir Dar University for providing the [16] https://www.ncbi.nlm.nih.gov/pubmed/8693724.
chance of carrying out this project. They also thank the [17] A. Suheyla and V. Katabi, “Comparison of Cultural Practices
Meshenti town administration officer and community for Used in Pregnancy Postpartum Periods among Women in
their cooperativeness and their valuable information to this Turkey & Iran,” 2008.
International Journal of Reproductive Medicine 7

[18] A. McKinley, “Traditions from around the world; from con-

ception to birth and beyond, ancient traditions and cultural
beliefs have always shaped the art of motherhood,” 2010,
https://www.pnmag.com.
[19] Ethiopian public health training initiative (EPHTI), Pediatrics
& Child Health Lecture Note for Health Science Students, Jimma
University, 2003.
[20] N. Zepro, “Food taboos and misconceptions among pregnant
women of shashemene district, ethiopia,” Science Journal of
Public Health, vol. 3, no. 3, pp. 410–416, 2015.
[21] D. J. Holman and M. A. Grimes, “Colostrum feeding behaviour
and initiation of breast-feeding in rural Bangladesh,” Journal of
Biosocial Science, vol. 33, no. 1, pp. 139–154, 2001.
[22] G. Ayele, “Prevalence and associated factors of home delivery in
arbaminch zuria district, southern ethiopia: community based
cross sectional study,” Science Journal of Public Health, vol. 3, no.
1, p. 6, 2015.
[23] T. Tola and A. Tadesse, “Cultural malpractices during preg-
nancy, child birth and postnatal period among women of child
bearing age in limmu genet town, southwest Ethiopia,” Science
Journal of Public Health, vol. 3, no. 5, 2015.
[24] K. Zenebe, H. Alem, A. Merga, G. Abate, and H. Taha, “preva-
lence of cultural malpractice and associated factors among
women attending mch clinic at debretabor governmental health
institution south gondar, amhara region, north west Ethiopia,”
Gyneco and Obstet, vol. 6, no. 10, 2015.
[25] M. Legesse, M. Demena, F. Mesfin, and D. Haile, “Factors asso-
ciated with colostrum avoidance among mothers of children
aged less than 24 Months in Raya Kobo district, North-eastern
Ethiopia: Community-based cross-sectional study,” Journal of
Tropical Pediatrics, vol. 61, no. 5, Article ID fmv039, pp. 357–363,
2015.
[26] T. Rowen, N. Prata, and P. Passano, “Evaluation of a traditional
birth attendant training programme in Bangladesh,” Midwifery,
vol. 27, no. 2, pp. 229–236, 2011.
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