Papers by Wubegzier Mekonnen
MOJ women's health, Jan 25, 2022
Background: Cervical cancer diagnosis creates a stressful situation that influences women's life.... more Background: Cervical cancer diagnosis creates a stressful situation that influences women's life. Social support during a stressful experience may contribute to improved physical and mental well-being. Therefore, the objective of this study was to assess the social support experiences and needs of cervical cancer patients at
BMC health services research, May 10, 2024
Background Disparities in child healthcare service utilization are unacceptably high in Ethiopia.... more Background Disparities in child healthcare service utilization are unacceptably high in Ethiopia. Nevertheless, little is known about underlying barriers to accessing child health services, especially among low socioeconomic subgroups and in remote areas. This study aims to identify barriers to equity in the use of child healthcare services in Ethiopia. Methods Data were obtained from 20 key-informant interviews (KII) and 6 focus group discussions (FGD) with mothers and care givers. This study was conducted in Oromia Region, Arsi Zone, Zuway Dugda District from June 1-30, 2023. The study participants for this research were selected purposively. The information was collected based on the principle of saturation after sixteen consecutives interview were conducted. Both KII and FGD were audiorecorded and complementary notes were taken to record observations about the participants' comments and their interactions. Each interview and FGD data were transcribed word-for-word in the local Afaan Oromo and Amaharic languages and then translated to English language. Finally, the data were analyzed thematically using NVivo 14 software and narrated in the linked pattern of child health service utilization. Results This study identified six major themes which emerged as barriers to healthcare utilization equity for caregivers and their-under-five children. Barriers related to equity in low level of awareness regarding need, low socioeconomic status, geographical inaccessibility, barriers related to deficient healthcare system, community perception and cultural restrictions, and barriers of equity related to political instability and conflict. The most commonly recognized barriers of equity at the community level were political instability, conflict, and a tremendous distance to a health facility. Transportation challenges, poor functional services, closure of the health facility in working hours, and lack of proper planning to address the marginalized populations were identified barriers of equity at organizational or policy level. Conclusion This study showed that inequity in child healthcare utilization is an important challenge confronting Ethiopia. To achieve equity, policy makers and planners need to change health policy and structure to be pro-poor. It is also necessary to improve the healthcare system to increase service utilization and access for impoverished women, individuals with lower levels of education, and residents of isolated rural areas. Furthermore, context specific information pertaining to cultural barriers and political ecology are required.
Maternal mortality in sub-Saharan Africa (SSA) is higher than in any other region in the world. I... more Maternal mortality in sub-Saharan Africa (SSA) is higher than in any other region in the world. In countries such as Sierra Leone it is as high as 1 100 per 100 000 live births. [1] The National Committee for Confidential Enquiry into Maternal Deaths in South Africa (SA) reports the current maternal mortality rate at 147.7 deaths per 100 000 live births. [2] Avoidable factors, including patient-related non-compliance (49%) and healthcare and health worker factors (35%), are contributing to maternal mortality. [3] The National Department of Health (NDoH) has made attempts to reduce this, such as the implementation of a programme to reduce child and maternal mortality through strengthening primary healthcare in the country. While progress has been made-maternal mortality has decreased from 299 deaths per 100 000 live births in 2007 to 147.7 in 2013, SA still failed to meets its Millennium Development Goal of 38 deaths per 100 000 live births. [4] In SA, alarmingly high rates of adolescent fertility are a topical issue. [5] Despite teenage pregnancy rates decreasing from 116 per 1 000 women (aged 15-19 years) in the 1980s, an astonishing 30% of adolescent females still report 'ever being pregnant'. [6,7] While research has identified the levels and determinants of adolescent fertility, [8] the issue of adolescent maternal and pregnancy-related deaths has yet to be addressed. Pregnant adolescents face stigmatisation and are unable to afford healthcare, [9] which reduces healthcare accessibility and increases the risk of pregnancy complications and mortality. The extent of this is unknown. The objective of this article is to determine the level and assess the direct and indirect causes of adolescent maternal mortality in SA. The health and survival of adolescent females is an important development goal of the national government. Adolescents who transition into healthy and productive adults are a key social and labour resource for any country. For this reason, research addressing the levels and causes of adolescent mortality will contribute to reducing deaths and ensure the health and survival of adolescents in the country. Methods Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and Background. South Africa (SA)'s high adolescent fertility has been extensively studied. A pregnancy outcome that has not received sufficient attention in research is the causes of death among pregnant adolescents. Objectives. To examine levels and causes of adolescent maternal mortality in SA. Methods. A secondary data analysis of Death Notification Forms from 2006 to 2012 was carried out. SA General Household Surveys from 2006 to 2012 were used to ascertain the number of female adolescents in the population. Frequency distributions and life table techniques were employed. Results. An estimated 1 164 deaths have been recorded among pregnant adolescents between 2006 and 2012. Adolescent maternal and pregnancy-related mortality is lower than adult maternal and pregnancy-related mortality. The main causes of death among adolescents were hypertension (55.6% of all direct causes), abortion (17.6% of all indirect causes) and injuries (48.9% of all indirect causes). The probability of adolescents dying while pregnant without these causes is practically non-existent (range 0.002-0.150%). Conclusion. Policies and programmes should prioritise these pregnancy-related causes of death in order to further reduce such deaths among adolescents in SA.
Research Square (Research Square), Dec 4, 2020
Background: Vitamin D is essential for health and its shortage exacerbates overall mortality. Hea... more Background: Vitamin D is essential for health and its shortage exacerbates overall mortality. Health care workers (HCWs) need to educate on its uses and sources although studies indicate their low level of practice. The main aim of this study is therefore to assess the knowledge, attitude and practice of measuring adult vitamin D status, diagnosis of de ciency and managing health consequences among HCWs in Ethiopia. Methods: This study was conducted in three ecologies covering lowland, midland and highland districts. A total of 405 health care workers with different levels were interviewed. Tablets were used for data collection to archiving in a cloud server. Data were exported to Stata version 14 software for cleaning and analysis. Rates were computed and the Chi-square test was used to compare differences between the two groups. Binary logistic regression was used to measure the strength, direction and signi cance of the association between different covariates and the practice of HCWs. Result: The level of knowledge, positive attitude and good practice in measuring adult vitamin D status, diagnosis of de ciency and managing health consequences among HCWs was 210 (51.8%), 261(63.5%) and 195(47.4%) respectively. The odds of good practice in the provision of adult vitamin D service were AOR=6.87: 95% CI (3.57, 13.21) and AOR= 2.20: 95% CI (1.23, 3.92) times higher among HCWs in Addis Ababa and highlands compared with those working in lowlands. Good practice among clinicians was AOR=4.26: 95% CI (1.48, 12.25) times higher compared with those working in leadership positions. The likelihood was AOR=1.96: 95% CI (1.19, 3.23) times higher among those with good knowledge compared with those with poor knowledge. Besides, good practice in adult vitamin D service provision was AOR=2.30: 95% CI (1.40, 3.78) times higher among those with positive attitude compared with those who had negative attitude. Conclusions: A little over half of HCWs have good knowledge and close to two-thirds of them have positive attitude while less than half of them have good practice on adult vitamin D de ciency. Besides, HCWs' residential ecology, clinical position, knowledge and attitude is associated with good practice on adult vitamin D. It is essential to provide rigorous and continuous training for HCWs focusing on their deployment ecology.
European journal of public health, Apr 17, 2018
European journal of public health, Apr 17, 2018
PLOS global public health, Mar 13, 2023
Cause-and context-specific mortality data are imperative to understand the extent of health probl... more Cause-and context-specific mortality data are imperative to understand the extent of health problems in low-income settings, where national death registration and cause of death identification systems are at a rudimentary stage. Aiming to estimate cause-specific mortality fractions, adult (15+ years) deaths between January 2008 and April 2020 were extracted from the Butajira health and demographic surveillance system electronic database. The physician review and a computerized algorithm, InterVA (Interpreting Verbal Autopsy), methods were used to assign the likely causes of death from January 2008 to April 2017 (the first) and May 2017 to April 2020 (the second) phase of the surveillance period, respectively. Initially, adult mortality rates per 1000py across sex and age were summarized. A total of 1,625 deaths were captured in 280, 461 person-years, with an overall mortality rate of 5.8 (95%CI: 5.5, 6.0) per 1000py. Principally, mortality fractions for each specific cause of death were estimated, and for 1,571 deaths, specific causes were determined. During the first phase, the leading cause of death was tuberculosis (13.6%), followed by hypertension (6.6%) and chronic liver disease (5.9%). During the second phase, digestive neoplasms (17.3%), tuberculosis (12.1%), and stroke (9.4%) were the leading causes of death, respectively. Moreover, tuberculosis was higher among persons aged 50+ (15.0%), males (13.8%), and in rural areas (14.1%) during the first phase. Hypertensive diseases were higher among females (7.9%) and in urbanities. In the second phase, digestive neoplasms were higher in the age group of 50-64 years (25.4%) and females (19.0%), and stroke was higher in older adults (65+) (10%) and marginally higher among males (9.7%). Our results showed that tuberculosis and digestive neoplasms were the most common causes of death. Hence, prevention, early detection, and management of cases at all levels of the existing healthcare system should be prioritized to avert premature mortality.
Research Square (Research Square), Nov 10, 2020
Background: Vitamin D is essential for health and its shortage exacerbate overall mortality. Heal... more Background: Vitamin D is essential for health and its shortage exacerbate overall mortality. Health care workers (HCWs) need to educate on its uses and sources although studies indicate their low level of practice. The main aim of this study is therefore to assess the knowledge, attitude and practice of measuring adult vitamin D status, diagnosis of de ciency and managing health consequences among HCWs in Ethiopia. Methods: This study was conducted in three ecologies covering lowland, midland and highland districts. A total of 405 health care workers with different levels were interviewed. Tablets were used for data collection to archive in a cloud server. Data were exported to Stata version 14 software for cleaning and analysis. Rates were computed and Chi-square test was used to compare differences between the two groups. Binary logistic regression was used to measure the strength, direction and signi cance of association between different covariates and the practice of HCWs. Result: The level of knowledge, positive attitude and good practice in measuring adult vitamin D status, diagnosis of de ciency and managing health consequences among HCWs was 210(51.8%), 261(63.5%) and 195(47.4%) respectively. The odds of good practice in the provision of adult vitamin D service were AOR=6.87: 95% CI (3.57, 13.21) and AOR= 2.20: 95% CI (1.23, 3.92) times higher among HCWs in Addis Ababa and highlands compared with those working in lowlands. Good practice among clinicians was AOR=4.26: 95% CI (1.48, 12.25) times higher compared with those working in leadership positions. The likelihood was AOR=1.96: 95% CI (1.19, 3.23) times higher among those with good knowledge compared with those with poor knowledge. Besides, good practice in adult vitamin D service provision was AOR=2.30: 95% CI (1.40, 3.78) times higher among those with positive attitude compared with those who had negative attitude. Conclusions: A little over half of HCWs have good knowledge and close to two-third of them has positive attitude while less than half of them have good practice on adult vitamin D de ciency. Besides, HCWs residential ecology, clinical position, knowledge and attitude is associated with good practice on adult vitamin D. It is essential to provide rigorous and continues training for HCWs focusing on their deployment ecology.
British Dental Journal, Oct 1, 2015
The challenge for governments and the health development community... about the comparative effec... more The challenge for governments and the health development community... about the comparative effect of health risks...'
Frontiers in Public Health
BackgroundIntimate partner violence affects a significant portion of women worldwide throughout t... more BackgroundIntimate partner violence affects a significant portion of women worldwide throughout their lifetimes. Ethiopia lacks data that policymakers could utilize to develop context-specific policies for handling intimate partner violence during pregnancy.ObjectivesTo identify the determinants of spontaneous abortion among women survivors of intimate partner violence during pregnancy in Adigrat General Hospital, Northern Ethiopia, in 2020.MethodsA facility based, case–control study design was employed to recruit 371 women (124 cases and 247 controls) attending maternal health services in Adigrat General Hospital, Northern Ethiopia, from March 13 to June 12, 2020. Cases and controls were selected using a consecutive sampling technique. A multivariable binary logistic regression model was carried out to identify potential factors, and a p-value of <0.05 was used to declare statistical significance.ResultsThe proportion of any form of intimate partner violence during pregnancy amo...
Introduction: Despite Ethiopia’s policy intension to provide recommended vaccination services to ... more Introduction: Despite Ethiopia’s policy intension to provide recommended vaccination services to underprivileged populations, inequity in polio immunization persist. Objective: This study examined inequity and trends in polio immunization and determinant factors among children age 12–23 months in Ethiopia between 2000 and 2019. Methods: Cross-sectional data from 2000, 2005, 2011, 2016 and 2019 Ethiopian demographic and health surveys were analyzed with the updated version of the WHO’s Health Equity Assessment Toolkit (HEAT) software. Six standard equity measures: equity gaps, equity ratios, population attributable risk, population attributable fraction, slope index of inequality and relative index of inequality were used. Datasets were analyzed and disaggregated by the five equality stratifiers: economic status, education, place of residence, sex of the child and regions. And multilevel logistic regression analysis was used to identify determinant factors. Results: Polio immunizatio...
Cancer Management and Research
The purpose of the study was to explore the experiences among cervical cancer patients during fol... more The purpose of the study was to explore the experiences among cervical cancer patients during follow-up care. Patients and Methods: A qualitative study was conducted with purposively selected cervical cancer patients receiving follow-up treatment at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Data were collected using semi-structured interviews and analyzed via thematic analysis. Results: The results obtained in this study indicated that women experienced a variety of physical and psychosocial difficulties in the context of cervical cancer care. The data analysis resulted in five themes. Women have undergone difficulties indicated as lack of satisfaction with the health care experience, dealing with treatment side effects, struggle in work and daily life, having stress, disruption in social relationships, and financial difficulties incurred because of their illness and treatment. Conclusion: This study highlights that cervical cancer patient's experience is the outcome of a complex interplay by personal, clinical, psychological, and social spheres. Thus, interdisciplinary approach between health and psychosocial professionals is needed during follow-up care in order to help women experience better psychosocial adjustment.
Background: One challenge to achieving Millennium Development Goals was inequitable access to qua... more Background: One challenge to achieving Millennium Development Goals was inequitable access to quality health services. In order to achieve the Sustainable Development Goals, interventions need to reach underserved populations, it appears that the maternal, newborn and child health goals (MDG 4 and 5) will not be universally achieved. There was early recognition that it could be possible to achieve the health goals while decreasing health inequity, because most of the gains might go to the better-off rather than to the very poor.Methodology/Design: The current protocol adopts a strategy informed by the guidelines of The Cochrane Handbook for Systematic Reviews. Our systematic review will identify studies in English, provided inclusion of an English abstract - from 2010 onwards till 2020, by searching MEDLINE (PubMed interface), EMBASE (OVID interface), Cochrane Central (OVID interface) and the gray literature. Study selection criteria include research setting, study design, reported ...
Asian Pacific Journal of Cancer Care
Background: The diagnosis and treatment of cervical cancer could result in psychological distress... more Background: The diagnosis and treatment of cervical cancer could result in psychological distress. Greater understanding of patients’ coping strategies, and influencing factors, can aid in developing appropriate psychosocial support. The aim of this study was to assess the prevalence of coping strategies and associated factors among cervical cancer patients. Materials and methods: A cross-sectional study was conducted among 299 cervical cancer patients on follow-up treatment at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Data were collected through face-to-face interview to assess patients’ sociodemographic characteristics, self-efficacy, meaning in life, perceived social support, uncertainty, cognitive appraisal, and coping strategies. Pearson’s correlation coefficient and linear regression analysis was conducted. Results: Findings reveal that women utilized both problem-focused and emotion-focused coping strategies. However, emotion-focused coping strategies were mo...
Questionnaires. (DOCX 40Â kb)
Ethiopian Journal of Health Development, 2018
Background: Even though Ethiopia has achieved the Millennium Development Goal targets for child h... more Background: Even though Ethiopia has achieved the Millennium Development Goal targets for child health set for 2015 by the international community, it has failed to do so with regard to maternal health. Maternal deaths are still high, with an estimated maternal mortality ratio of 412 maternal deaths per 100,000 live births in 2016.The causes of maternal death and individual, environmental and health systems related gaps contributing to maternal death in Ethiopia remain unclear. Objectives: The main aim of this study was to document the causes of maternal deaths and risk factors contributing to deaths aggravated by pregnancy and its management in Ethiopia over the period 1990 to 2016, using a systematic review with meta-analysis. Methods: Manuscripts were reviewed on causes of maternal death that were published in scientific journals and grey literature, including the compendium of abstracts presented in the series of annual conferences of the Ethiopian Public Health Association, masters' theses in public health from different public universities in Ethiopia, and periodic reports of the Federal Ministry of Health of Ethiopia. A comprehensive and reproducible literature search was used, employing the Cochrane systematic literature review technique. Medical subject heading termsincluding maternal deaths, maternal mortality, causes of maternal mortality/death, maternal mortality/death in Ethiopia and etiology of maternal mortality/death in Ethiopiawere used to search the required articles. A total of 146 articles (134 from online sources and 12 hard copies) were identified on the basis of their titles and abstracts. Of these, 24 were found to be suitable for further analysis by applying the review criteria, which were then synthesized to identify the main causes of maternal death, as well as the risk factors affecting the patterns of deaths. Results: The main direct causes of maternal death in Ethiopia include obstetric complications such as hemorrhage (29.9%; 95% CI: 20.28%-39.56%), obstructed labor/ruptured uterus (22.34%; 95% CI: 15.26%-29.42%), pregnancy-induced hypertension (16.9%; 95% CI:11.2%-22.6%), puerperal sepsis (14.68%; 95% CI: 10.56%-18.8%), and unsafe abortion (8.6%; 95% CI: 5.0%-12.18%). In recent years, hemorrhage has been the leading cause of mortality, followed by hypertensive disorders of pregnancy and sepsis, while the contributions of obstructed labor and abortion have decreased over the period. The most reported indirect causes of maternal death were anemia (10.39%; 95% CI: 4.79%-15.98%) and malaria (3.55%; 95% CI: 1.50%-3.30%). Conclusions: The nationwide registration of causes of maternal death should be strengthened to understand the causes in detail, their attributes, as well as the patterns of causes of death. The health sector should sustain its current effort to tackle the diverse causes of maternal death in Ethiopia. [Ethiop.
Additional file 1. Study populations and data sources, definitions, Additional Tables S1–6 and Ad... more Additional file 1. Study populations and data sources, definitions, Additional Tables S1–6 and Additional Figures S1–16.
Health science journal, 2016
Introduction: Though women bear the physical, psychological and emotional strain of pregnancy and... more Introduction: Though women bear the physical, psychological and emotional strain of pregnancy and childbirth, it does not mean that fertility and contraception are based exclusively on the female population. The social roles of men who are dominant not only in decision making within the family, but also at community leadership have been overlooked. Most family planning programs give less emphasis to the understanding of men’s role in the effective and steadfast utilization of contraceptives. Objectives: the main aim was to assess the role of men in long acting and permanent contraceptive use among currently married men aged 20-64 years in Mizan-Aman District, South Western Ethiopia. Methods: A community based cross-sectional study with a mix of quantitative and qualitative methods was conducted. A total of 554 men were recruited for the study. Pre-tested and structured questionnaire was used to collect the data. Odds ratio along with 95 % Confidence interval in binary logistic regre...
Background: Under-five, infant and neonatal mortality rates for Ethiopia were 67, 48 and 29 per 1... more Background: Under-five, infant and neonatal mortality rates for Ethiopia were 67, 48 and 29 per 1,000 live births, respectively, based on the 2016 Ethiopia Demographic and Health Survey. Although under-five mortality is substantially improving in Ethiopia, about 190,000 deaths still occur every year. Although various studies have been conducted on the causes of neonatal and under-five deaths in different parts of the country, none of them document pooled analytic results for the causes of death. Objective: To identify neonatal, post-neonatal, infant and under-five causes of death in Ethiopia. Methods: A Cochrane systematic review and meta-analysis was carried out on published and grey literature relating to the causes of death for different categories of children under the age of five in Ethiopia between 1990 and 2016. Abstracts were initially reviewed using databases such as MEDLINE/PubMed, Embase, Google Scholar, Google and HINARI, as well as university databases, and conference c...
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Papers by Wubegzier Mekonnen