Background: Despite the enormous benefit of exclusive breastfeeding (EBF) to mothers and infants,... more Background: Despite the enormous benefit of exclusive breastfeeding (EBF) to mothers and infants, the practice of exclusive breastfeeding is globally low. In sub-Saharan Africa and Ethiopia, the prevalence of EBF stands at 35% and 59%, respectively. The low EBF practice in Ethiopia as well as in the studied region calls for further study and thus we studied the EBF practice in the study area since little is known about its current magnitude and factors influencing its practice for some programmatic improvements. Methods: A facility based cross-sectional study linked to a community was conducted from June-July 2019 among 412 mothers who had antenatal follow-up and delivered in health facilities of Asosa town over a period of one year prior to the study. Data on socio demographic characteristics and other important variables were collected through face to face interview while gestational age in weeks was recorded from their medical chart by trained health extension workers in accordance with relevant ethical guidelines and regulations. The collected data were then cleaned and entered into Epi-data software version 3.02. Analysis was done by SPSS version 20. Binary and multivariate logistic regression were performed to identify the contributing factors. P-value of less than 0.05 and 95% confidence interval was considered to determine statistical significance. Results: Of the 412 respondents, the majority (88.1%) were multi-gravida and above. Slightly higher than a quarter (26.0%) and over half (55.4%) had neither received antenatal nor postnatal care. The proportion of mothers who exclusively breastfed their children was 76.0% and the overall aggregated good practice of EBF score was 64.1%. Mothers who completed primary school [AOR = 4.5; 95% CI = 1.1,18.2], had four or more ANC [AOR = 1.8;95CI = 0.79-0.98], and postnatal follow-up [AOR = 0.21;95% CI = 0.07-0.67], and had male infants [AOR = 2.3; 95% CI = 1.0-4.95] were among the factors influencing the exclusive breastfeeding practice score. Conclusion: While three in four mothers exclusively breastfed their newborns and about two-thirds had good EBF score, the observed women's retention on the continuum of the maternal care pathway is low with one in four had no antenatal and over half had no postnatal care which are important derivers for EBF practice. To improve the EBF score and narrow the observed maternal and child health disparities, it is essential to promote maternal education and increase the recomended coverage of antenatal and postnatal care for mothers.
Understanding clerics and healers' knowledge, attitude, and practice towards epilepsy are crucial... more Understanding clerics and healers' knowledge, attitude, and practice towards epilepsy are crucial to identify the mechanisms of epilepsy stigma in Ethiopia. The objective of this study is to characterize the social and demographic determinants of knowledge, attitude, and practices of clerics and healers towards people with epilepsy in Addis Ababa, Ethiopia. Methods: A total of 440 clerics and healers were interviewed by trained data collectors using a pretested structured questionnaire. The count sum of outcome variables was grouped into "biological and cultural" knowledge attitude and practice scores. Ordinal regression analysis was performed for each outcome variable against socio-demographic variables of interest. Results: The percentage of responses matching cultural causes (58%) surpassed biological causes. The most frequently mentioned cultural cause was an evil spirit (22.5%). While the most frequently mentioned biological cause was a head injury (12%). Consistent with the above findings, cultural treatment responses (77%) exceeded biological treatment responses. The most commonly referred cultural treatment response was Church healing session (12%). The type of faith followed by the study participants positively correlated with higher cultural knowledge, attitude, and practice score. Conclusions: Clerics and traditional healers in Ethiopia have a partiality to the cultural epilepsy explanation model. Cultural metaphors attached to an evil spirit, curse of God, and witchcraft have formed and fostered existing 'epilepsy societal norms' in Ethiopia. The findings of this study contribute to the understanding of epilepsy stigma and treatment gap. Besides, it provided direction to design and implement epilepsy stigma intervention programs in Ethiopia.
Objective: To evaluate the impact of daily and weekly iron supplementation on serum zinc status a... more Objective: To evaluate the impact of daily and weekly iron supplementation on serum zinc status among anaemic lactating mothers. Design: A randomised iron intervention controlled trial. Setting: Seven urban slum communities of Addis Ababa. Subjects: Phase one of the study involved 207 anaemic lactating women assigned into two intervention groups; the daily (N=71) and weekly (N=71) Iron supplemented and the control group (N=68). Supplementation with 60 mg tablet containing 300 microg ferrous sulphate and 400 microg folic acid was done for three months while the control group was n otsupplemented. Phase two involved 53 participants systematically drawn from phase one. Main outcome measures: Haemoglobin from all subjects and serum zinc and ferittin levels following three months supplementation. Zinc status based on serum zinc value of less than 10.7% micromole/L. Results: The mean baseline characteristics and serum zinc of the women at baseline were similar, overall marginal zinc deficiency prevalence was 11.3% and no zinc deficiency was detected. Following supplementation, zinc deficiency was detected in the supplemented groups but not in the control group. The mean serum zinc significantly changed in both supplemented groups while no change was observed in the control group. The reduction in the mean serum zinc was significantly higher in the daily than in the weekly supplemented group. Conclusion: Iron supplementation impacts negatively on serum zinc status (exacerbates zinc deficiency) and hence, its contribution to zinc deficiency deserves further investigation especially in the context of the on-going promotion of double fortification strategies that involve iron.
Background: In countries like Ethiopia where the spread of HIV infection is extensive, health ser... more Background: In countries like Ethiopia where the spread of HIV infection is extensive, health services are faced with an increased demand for care. The most obvious reflection of this increased demand is through patient load, longer bed occupancy perhaps to the exclusion of patients with other ailments. Objective: The purpose of this study was to describe the bed occupancy rate and the average length of stay of HIV/AIDS inpatients of three major public hospitals. Methods: A Retrospective Cross-sectional study was conducted in three major hospitals of Addis Ababa namely Zewditu Memorial Hospital, Tikure Anbessa Hospital and Saint Paul's Hospital from February to March 2004. Results: Of the total 453 sampled inpatients, 293 (65 %) were HIV positives. Over half (55.0%) were Males. The most affected age group was between 24 and 56 years. The majority (85.8%) were from Addis Ababa and over half (57.7%) was married. Housewives constituted about a quarter (26.3%) of all the admitted cases. The most common co-morbidities resulted in admission to the medical wards among the HIV-positive cases were Tuberculosis (73.0%) and jirovicii pneumonia (70.3%), and their occurrence was significantly higher among HIV+ than their counter parts (p=0.001). Although numbers of patients admitted in Tikur Anbesa hospital was more than Saint Paul's and Zewditu Memorial hospitals (ZMH), the proportion of HIV positive cases admitted to ZMH however was higher (49.0%) than Tikur Anbessa (14.0%) and Saint Paul's hospitals (18.0%). Likewise the number of inpatient days was also higher in ZMH (n=7765) than the other hospitals. The bed occupancy rate was however, higher in ZMH (53.0%) than Tikur Anbessa (12.0%) and Saint Paul's (12.0%) hospitals. Conclusion: One of the most obvious consequences of HIV/AIDS patients are the increased occupancy of hospitals beds suggesting that only 81.1 % of the beds are for all other afflictions in the hospitals. It appears that there is a lot of concern that patients with HIV are competing with the non-HIV infected patients in a resource limited areas. Home based care with community involvement and greater use made of existing community resources might be a response to the limitations of curative hospital-based care and treatment needs of many HIV/AIDS patients.
Objective: To determine the level of malnutrition and xerophthalmia in pre-school children. Desig... more Objective: To determine the level of malnutrition and xerophthalmia in pre-school children. Designs: Non-randomised community based study. Settings: Four different administrative regions: Harari, Tigray, Southern Nation Nationalities and people region (SNNPR) and Oromiya, with different eco-zones, were studied from May to June 1996. Subjects: Fifteen thousand and eighty seven children, aged between six and 71 months, examined for clinical symptoms and signs of xerophthalmia. Anthropometry and blood samples were taken from every 20 children (n = 634) of same age, for serum retinol and nutritional determination. INTERVENTION MEASURES: Disease targeted approach of vitamin A supplementation was employed in the regions. Results: The overall prevalence rates of night blindness and Bitot's spots exceeded WHO cut-off point for xerophthalmia as a public health problem, with higher prevalence rates in males (53%) than females (26%). The proportion of children with deficient serum retinol concentrations (SRC), and Bitot's spot were observed to be higher in Oromiya and Harari regions followed by Tigray, than SNNPR administrative regions. Most of the affected children were aged between 36 and 72 months. The greatest low SRC was also observed in the same age group of children in all regions. There was higher prevalence rate of stunting (60.1%) than wasting (12.2%) with an additional (8.8%) of children both stunted and wasted. The proportion of stunted children was high in Tigray followed by Oromiya, SNNPR and Harari regions. Conclusion: The high level of stunting and Bitot's spot, together with the low level of serum retinol concentrations found in these regions, indicates the need to strengthen this intervention strategy further with universal vitamin A capsule distribution, nutrition education and promotion of horticulture activities.
Iron deficiency anemia (IDA) is the most common disorder among pregnant women and is associated w... more Iron deficiency anemia (IDA) is the most common disorder among pregnant women and is associated with nutritional deficiency. This cross-sectional study determined IDA status in pregnant and lactating mothers from various staple diet areas in Ethiopia. A total of 13 randomly selected sites representing six main staple diet areas were stratified with reference to the amount of their dietary iron consumption and prevalence of parasitic diseases between 1990 and 1994. The study subjects comprised 1449 pregnant and lactating mothers aged 15-49 years. Findings showed that the proportion of women with IDA was higher among illiterates women aged 20-29 years multiparous women and in areas where the prevalence of intestinal parasites was high and dietary intake of iron was low. When the iron content of the staple diet consumed was considered against the prevalence of anemia by hemoglobin level low iron intake areas (milk and maize staple areas) were seen to be affected more significantly (p < 0.05) by anemia than the high iron intake areas. In conclusion a mild to moderate degree of IDA exists with milk- and maize-dependent staple diets; therefore iron supplementation targeted to pregnant and lactating mothers is recommended.
Background: Body mass index (BMI) is a commonly used anthropometric measurement to estimate the l... more Background: Body mass index (BMI) is a commonly used anthropometric measurement to estimate the level of nutritional indices (underweight/overweight) of adolescents and adults. Knowledge of the factors affecting BMI is essential for developing intervention programs. This study was conducted to measure BMI and determine the socioeconomic and demographic factors affecting the relative weight of adolescents living in rural districts in Ethiopia. Methods: A randomized cross-sectional study of 425 adolescent students living in the Ambo region of Ethiopia was conducted. A pre-tested questionnaire was used to collect the socioeconomic and demographic status of the participants. BMI (weight/height(2), kg/m(2)) was measured and used as index of relative weight. Data were analyzed using SPSS version 15. A stepwise backward logistic regression analysis was applied to identify the major determinant abnormal weight of the adolescents while controlling for co-linearity. Results: The prevalence of underweight was 27.2% with male preponderance. The proportion of normal weight females was higher than that of males. There was no significant difference in the proportion of overweight males and females. Age, number of meals, parental education level, source of food, and number of cattle owned were correlated with being underweight. After adjusting for confounding variables only being a member of the younger age group (AOR=1.99; 95% CI=1.01 to 3.57), source of food (AOR=2.4; 95% CI=1.24 to 4.74), and a greater number of cattle owned (AOR=4.9; 95% CI=1.27 to 19.28 were positively correlated with being underweight. Conclusion: Younger age adolescents, those who come from homes with no or few cattle, and their parents purchased food were likely to be underweight. This study will help local governments, educators and community groups develop programs to assist underweight adolescents attending schools.
East African journal of public health, Oct 7, 2014
Background : Pregnancy among HIV positive individuals is an issue of public health importance bec... more Background : Pregnancy among HIV positive individuals is an issue of public health importance because of poor maternal outcomes and pediatric HIV infections. Hence meeting contraceptive needs of people with HIV help avoiding unintended pregnancy and could reduce maternal death and pediatric HIV infection. Objective : To assess contraceptive utilization and factors affecting its use among HIV positive women taking anti-retroviral therapy. Methods : A cross sectional facility based quantitative study supplemented by qualitative in-depth interview (IDI) was conducted from January 2013 to June 2013 on a sample of 353 HIV positive women who had regular ART follow up in five major hospitals with large client flows in the capital city, Addis Ababa. A pretested structured questionnaire was used to collect the quantitative data and semi- structured (open ended) question was used to collect the qualitative data. The cleaned quantitative data were entered and analyzed using SPSS version 16 while the qualitative data were transcribed and analyzed into thematic areas. Result : One hundred forty four (40.8%) of the respondents used at least one method of contraceptive method and condom was the most highly utilized contraception. The major determinant factors identified to augment contraceptive user were, having alive children (AOR=5.95; 95%CI= 3 to11), being married or cohabitated (AOR=0.15; 95%CI= 0 .08 to 0.27), age between 20-29 years (AOR=0.26; 95%CI=0.1 to 0.7); heard of contraceptive method (AOR=5.91; 95%CI=1.7 to20), counseling on unintended pregnancy (AOR=1.87; 95% CI=1to3.4). According to the IDI responses, refusal of spouses and dislike of condom were the reasons mentioned for inconsistent condoms use while from the service provider views, fear of drug side effect was attributed to inconsistent contraceptive use. Conclusion : In this study 40.8% of people living with HIV used at least one method of contraceptive method and condom being the leading contraceptive methods. The major predictor identified for some program improvements need to target on women having alive child, in marital union, heard of contraceptive method, counseled on unintended pregnancy and age group between 20 and 29 years and ultimately avoid unintended pregnancy among HIV positive women.
Consumption of food pattern refers to any edible or drinks taken during A specified period which ... more Consumption of food pattern refers to any edible or drinks taken during A specified period which could vary across different seasons, geographic locations, economic situations, physiological status and culture [1-6]. During pregnancy, women are advised to take more diversified food to get adequate energy and multiple nutrients to satisfy their demand as well as the growing fetus [7-9]. Such advice, however, in most developing countries including Ethiopia are not practiced and consequently results in multiple micronutrient deficiencies Background: Maternal undernutrition during pregnancy is likely to face a wide range of poor pregnancy outcomes in most developing countries including Ethiopia. Recent evidence in Ethiopia showed some reduction in the trend though the problem is still prevalent and underlines the need for uncovering the attributes for plausible intervention particularly among pregnant which this study has addressed. Objective: To assess the maternal attributes for optimal nutrient intake among pregnant women that they are antenatal follow-up. Method: Data from 380 of women of reproductive age was extracted from a large data set collected for partial fulfillment for master's in public health which is titled as Food consumption pattern, nutrient intake and associated maternal attributes of antenatal care attendees in Bishoftu town, eastern Ethiopia. A facility-based cross-sectional study. Dietary intake was assessed using a semiquantitative food frequency questionnaire composed of 70 food items. Data were cleaned and analyzed using STATA version 12.1. Consumption patterns were identified using factor analysis and each pattern was further analyzed using a multivariate regression model adjusted for age and calorie intake. A P-value<0.05 was considered statistically significant. Result: All women had low intake of calorie, fat, vitamin A, folic acid and calcium throughout their pregnancy period. Interestingly, inadequate intake of zinc was found only during third trimester. Older maternal age, being married, increased maternal and husband education, being employed, higher socioeconomic status, and snack habits were positively correlated while increasing household size and gravidity, fasting, food restriction and chronic diseases were negatively associated with adequacy of intake. Conclusion: Except for zinc otherwise all the necessary nutrients taken by the participants were inadequate underscores the need for supplementary feeding targeting the most at risk groups. 02
Background: Iron deficiency anaemia (IDA) is one of the most common causes of nutritional problem... more Background: Iron deficiency anaemia (IDA) is one of the most common causes of nutritional problem, and is of great public health significance affecting children, adolescents and women of reproductive age world wide. The magnitude of IDA in the general population of Ethiopia has not yet been well documented. Objective: To estimate the magnitude of IDA among women of reproductive age in nine administrative regions. Methods: A cross-sectional study of analytical nature was conducted in 270 clustered villages drawn from 9 administrative regions of the country between June and July 2005. A total of 22,861 women of reproductive age (15-49 years) were examined clinically for pallor and 5% of these subjects were systematically selected and assessed further for their haemoglobin (Hgb) and serum ferritin (SF) status. Results: The prevalence rate of clinical anaemia, anaemia, ID (iron deficiency) and IDA were 11.3%, 30.4%, 49.7% and 17.0% respectively. The majority of anaemic women were in the category of mild (19.3%) to moderate (10.3%) and severe anaemia was 0.9%. A significantly higher proportion of clinical anaemia [26.7% (95% CI: 24 to 28%)], anaemia (Hgb) [79.4% (95% CI: 72 to 86%)], ID [65.1% (95% CI: 72 to 86%)] and IDA [58.0% (95% CI: 55 to 76%)] was observed in Afar signifying distinct regional variation. The most affected age groups were those between 36-49 years and the difference noted was statistically significant. Conclusion: This study substantiates the existence of mild to moderate form of IDA among women of reproductive age and underlines the need for iron supplementation to all reproductive women during the antenatal period with more attention to the most affected regions.
Ethiopian Journal of Health Development, Dec 16, 2010
Background: The predictive validity and applicability of Theory of Planned Behavior (TPB) may be ... more Background: The predictive validity and applicability of Theory of Planned Behavior (TPB) may be a promising model for understanding and predicting intended behaviors to use VCT services. The need for theory based study would thus be essential in designing evidence based HIV-related interventions in the future. Objectives: To examine the applicability of the Theory of Planned Behavior and the additional predictive role of perceived risk in predicting intended use of Voluntary HIV Counseling and Testing (VCT) services. Methods: A cross sectional study design was conducted among 20 randomly selected schools in Harari Region between March and April 2009. Four hundred ninety seven randomly selected teachers consented to participate in the study giving a response rate of 87.8%. Self administered questionnaire, adopted from the TPB was used for data collection. Multiple linear regression models were used to predict the role of important variables that can influence the intention to use VCT among teachers using SPSS version 15. Result: More than half (53.7%) who had never used VCT service were considered in the analysis for the intended VCT service use. All the modal variables correlated significantly with behavioral intention. Subjective norm (r=0.45, p<0.001), perceived behavioral control (r=0.42, p<0.001) attitude (r=0.33, p<0.001) and perceived susceptibility(r=0.25, p<0.001), were significantly and positively correlated while perceived severity to the illness (r=-0.14, P<0.001) was significantly but negatively correlated with behavioral intention. Perceived severity of the illness, normative belief and having high level of self control were the major predictors for intended use of VCT. Conclusion: The study demonstrated that the TBP is a useful model for evidence based educational programs focusing mainly on creating supportive social system and strengthens their self efficacy for positive VCT uptake. [Ethiop.
The South African journal of clinical nutrition, 2010
Objective: To investigate the country-wide extent of folate deficiency and risk factors in Ethiop... more Objective: To investigate the country-wide extent of folate deficiency and risk factors in Ethiopian women. Design: Cross-sectional study. Methods: Multistage cluster sampling and systematic sampling were used to select 970 women aged 15 to 49 years from nine accessible regions of Ethiopia. Demographic and health information was collected via questionnaire. Biological samples were collected by medical technologists. Outcome measures: demographic and health variables, food frequency, haemoglobin status, ferritin status and folate status. Results: Mean ± SD plasma folate was 5.57 ± 3.84 ng/mL. Forty-six per cent of women had severe folate deficiency (≤ 4 ng/mL) and 21.2% had marginal folate deficiency (> 4-6.6 ng/mL) with unequal prevalence across the country. Severe folate deficiency was higher in women who were unmarried (p = 0.002), had parity of 4-6 (p = 0.001), used oral contraceptives (p = 0.01), had no illnesses (p = 0.001), had intestinal parasites (0.001), followed lower plant food diets (0.001), followed lower animal product diets (0.001), had no anaemia (0.001) and had no iron deficiency (0.001). In logistic regression analysis, only low plant food diets (p = 0.001) and iron deficiency (p < 0.001) retained their significance with regard to folate deficiency. The odds for developing folate deficiency was 0.9 times less likely among those with higher plant food intake (AOR-0.9;95%CI-0.72-1.2) and 0.2 times less likely among those with adequate iron (AOR-0.2;95%CI-0.17-0.34). Conclusions: Folate deficiency is widespread in Ethiopian women, emphasising the need for sustainable folate intake through dietary diversification and appropriate public health measures.
Background: The Ethiopian Demographic and Health Survey 2019 shows that 59% of children are exclu... more Background: The Ethiopian Demographic and Health Survey 2019 shows that 59% of children are exclusively breastfed for the first 6 months of life, then the rate decreases sharply with age. Nearly half of the Ethiopian labor force (46%) is comprised of women. This is encouraging since women's employment is one way of ensuring women's empowerment. However, various factors related to employment make it one of the commonly mentioned factors contributing for the low prevalence of breastfeeding. Hence, there needs to be a conducive work environment that accommodates maternal needs to not fall back from empowerment and to improve breastfeeding practice. There are not many studies in Ethiopia that focus on work environment in relation with employers' experience and their perception of breastfeeding of employed mothers. Therefore, this study aims to explore employers' experience and perception of employed mothers' breastfeeding experience in different working environments in Addis Ababa, Ethiopia. Methods: A qualitative study design using a descriptive phenomenology strategy was employed in this study and purposive sampling technique was used to recruit study participants. Data was collected between December 2016 and May 2017 in Addis Ababa city from 10 employers from private, governmental and non-governmental institutions through an in-depth interview. Thematic data analysis was performed where collected data was organized, coded and categorized into themes to give meaningful contributions to answering the research questions. Results: Understanding breastfeeding, current maternity leave, perception of breastfeeding supporting the conditions and mother-friendly work environment were the themes generated after analysis. Almost all employers in this study recognized the importance of breastfeeding despite their different work environments and they also acknowledged the importance of making the working environment mother-friendly for stability and motivation of employed mothers. Conclusions: Providing mothers with a friendly environment is understood as a positive thing by employers. The current maternity leave of 3 months has low acceptance and both onsite childcare center and six-month maternity leave are believed to help in creating a mother-friendly work environment despite their pros and cons.
Background: Maternal underweight is a challenging public health issues globally affecting women i... more Background: Maternal underweight is a challenging public health issues globally affecting women in most developing countries and consequently affect their newborns. Such information however is scantly in the study area and thus we examined the contribution of low dietary diversity score towards underweight among expectant mothers from rural Ethiopia. Methods: This study was based on data extracted from a large data set gathered from three rural villages from September 2017 to June 2018 in a district of North-Shewa Zone of Amhara Regional State which is 220 km north of Addis Ababa, the capital city of Ethiopia. Data on socio demographic characteristics food groups consumed and Mid-Upper Arm Circumference (MUAC) measurement were taken for all expectant mothers by trained health extension workers in accordance with relevant ethical guidelines and regulations. The collected data were entered into Epi-data software version 3.02 and analyzed using SPSS version 20. Statistical signi cance was a rmed at a p-value ≤ 0.05. Result: Of the 400 consented participants, 380 of them had adequate information and thus analyzed for their variety of food groups consumption and their MUAC measurement outcomes. The magnitude of underweight was 18.2% and the mean (±SD) dietary diversity score was 4.45(±1.32). interestingly, the relationship between poor dietary diversity score and underweight of the participants was signi cant (AOR= 2.4; 95% CI=1.05 to 5.3). Conclusion: Our study revealed a signi cant relationship between low dietary diversity score and
There is nothing worse than leaving home country. Instability in many parts of the world has led ... more There is nothing worse than leaving home country. Instability in many parts of the world has led to massive displacement of civilian population with associated shortage of basic services such as food, water, shelter and health services often leading to higher incidence of morbidity and mortality. Malnutrition and anaemia remain one of the most common causes of morbidity and mortality among displaced population throughout the world. The most vulnerable to suffer from the consequences of malnutrition and anaemia are refugee children due to their living condition. Although the burden of malnutrition and anaemia is expected to be high in protracted refugee areas, the magnitude of malnutrition and anaemia and their determinants among refugee children are not well identified and documented. The objective of this work is to assess the magnitude and determinants of under nutrition and anaemia among refugee preschool children in Kebribeyah refugee camp, Ethiopia.
Background : Patient satisfaction questionnaires are the commonly used patient satisfaction measu... more Background : Patient satisfaction questionnaires are the commonly used patient satisfaction measure, and may be global or multidimensional in focus. Global patient satisfaction consists of overall patient satisfaction while multidimensional patient satisfaction has multiple items focusing on different dimensions of the healthcare. Objective : To develop reliable and valid patient satisfaction questionnaire for an outpatient neurology services in Ethiopia. Methods : A facility based cross-sectional study was employed to assess patient satisfaction from Outpatient Neurology Clinic (ONC) of Zewditu Memorial Hospital in Addis Ababa, Ethiopia from August to October, 2009. A total of 193 consecutive patients that had a follow up in the ONC during the ten weeks period were invited and included in the study. Data were entered and analyzed using SPSS version 15. Factor analysis was used to describe the structure of the multidimensional patient satisfaction questionnaire for reliability (Cronbach’s alpha) and validity. Results : Of the 193 patients enrolled, 176 of them completed the study making the response rate 91.2%. Exploratory factor analysis identified three distinct subscales (waiting time, accessibility and physician services) in the patient satisfaction questionnaire which accounted for 84.1% of the total variance. All subscale Cronbach’s alpha values were more than 0.80. Analyses of the content, criterion and construct validity yielded complimentary evidences for the overall validity of the patient satisfaction questionnaire. Conclusion : The instrument used in the study is psychometrically good for the measurement of patient satisfaction in the Outpatient Neurology Clinic. Keywords : Questionnaire validation; patient satisfaction; outpatient neurology services, Ethiopia.
East African journal of public health, Oct 23, 2014
Background: Malnutrition remains one of the most common causes of morbidity and mortality among c... more Background: Malnutrition remains one of the most common causes of morbidity and mortality among children throughout the world, and is an important public health problem affecting preschool children. Refugee children, due to their living condition, are the most vulnerable to suffer from this problem. The magnitude of malnutrition and its determinant factors among refugee children are not clearly identified and documented. Objective: To assess the magnitude of malnutrition and its determinants among refugee preschool children Methodology: A cross -sectional study with analytic component was conducted in Kebribayah refugee camp during March 2010. A total of 671 refugee children aged between 6 and 59 months were randomly selected using simple random sampling and assessed for their nutrition status based on weight and height measurements. Data were entered into the computer using EPI-INFO software version 3.5.1. (has Epi – Nut) to compute the nutritional using the NCHS/WHO reference population and then exported to SPSS version16.0 statistical software package program for data cleaning and analysis. Results: The prevalence of stunting, underweight and wasting were 27.6%, 26.1% and 8.9% respectively. The main determinant factors of stunting were child age, maternal illiteracy, paternal lack of education, and family size (p< 0.05). Child sex, age, maternal lack of education, childhood illness such as diarrhea and ARI, and lack availability of toilet facility were associated with underweight (p< 0.05). Age of child, sharing and selling of food ration, duration of ration lasting, presence of ARI and poor personal hygiene (number of baths took) were the most important determinants of wasting (p< 0.05). Conclusion: The present study delineated the factors associated with stunting, underweight and wasting among refugee children. Underweight is serious in the area and chronic malnutrition (stunting) was also of particular concern. To achieve success in nutritional status of refugee children provision of adequate food ration, sufficient provision of micronutrients, early child illness treatment, and educating parents should be respected and pressure from the food aid donors/concerned bodies to reduce families sharing and selling their food ration should be encouraged. Furthermore, provision of non-food items should be strengthened to improve the hygienic practice of the beneficiaries.
Background. Antenatal care (ANC) is an entry point for the prevention of mother-to-child transmis... more Background. Antenatal care (ANC) is an entry point for the prevention of mother-to-child transmission (PMTCT), particularly when a man accompanies his spouse for voluntary counselling and testing (VCT), even though this seldom happens in Ethiopia. Objective. To study the role of male partners in improving PMTCT/ANC, which is essential to prevent HIV/AIDS transmission in this country. Our study focused on identifying barriers for the low involvement in PMTCT/ANC among male partners whose spouses received ANC. Methods. A total of 422 male partners in Goba town, Oromia regional state, Ethiopia, were recruited in September-October 2014 and enrolled by a systematic sampling method. A facility-based cross-sectional study and two focus group discussions (FGDs) were conducted. Binary logistic regression and odds ratios were calculated to ascertain sociodemographic and other important information compared with the outcome variable and PMTCT/ANC, while the findings of the FGDs were grouped according to the emerging themes and analysed manually by means of a thematic approach. Results. The percentage of male partners (22.7%) accompanying their spouses for HIV testing and counselling at antenatal clinics improved threefold when an invitation letter was introduced as a new initiative to increase male participation. Individuals in the age group 15-29 years (adjusted odds ratio (AOR) 5.4, 95% confidence interval (CI) 1.66-17.85), and whose duration of marriage was ˂5 years (AOR 5.6, 95% CI 1.83-17.30), were more likely to be tested than their referent groups. Men without a higher education (AOR 0.1, 95% CI 0.02-0.50), who disagreed with legal enforcement (AOR 0.1, 95% CI 0.07-0.32), were less likely to be tested, while those who did not notify their partners (AOR 8.4, 95% CI 1.92-37.12) were more likely to use the service. Being busy, proxy testing, fears of testing HIV-positive, neglecting the importance of VCT, and inadequate knowledge about the PMTCT/ANC programme were other barriers that came to the fore in the FGDs. Conclusion. Identified barriers have to be addressed, and helpful practices, such as using invitation letters to increase the uptake of the service by male partners, have to be instituted.
Background: Despite the enormous benefit of exclusive breastfeeding (EBF) to mothers and infants,... more Background: Despite the enormous benefit of exclusive breastfeeding (EBF) to mothers and infants, the practice of exclusive breastfeeding is globally low. In sub-Saharan Africa and Ethiopia, the prevalence of EBF stands at 35% and 59%, respectively. The low EBF practice in Ethiopia as well as in the studied region calls for further study and thus we studied the EBF practice in the study area since little is known about its current magnitude and factors influencing its practice for some programmatic improvements. Methods: A facility based cross-sectional study linked to a community was conducted from June-July 2019 among 412 mothers who had antenatal follow-up and delivered in health facilities of Asosa town over a period of one year prior to the study. Data on socio demographic characteristics and other important variables were collected through face to face interview while gestational age in weeks was recorded from their medical chart by trained health extension workers in accordance with relevant ethical guidelines and regulations. The collected data were then cleaned and entered into Epi-data software version 3.02. Analysis was done by SPSS version 20. Binary and multivariate logistic regression were performed to identify the contributing factors. P-value of less than 0.05 and 95% confidence interval was considered to determine statistical significance. Results: Of the 412 respondents, the majority (88.1%) were multi-gravida and above. Slightly higher than a quarter (26.0%) and over half (55.4%) had neither received antenatal nor postnatal care. The proportion of mothers who exclusively breastfed their children was 76.0% and the overall aggregated good practice of EBF score was 64.1%. Mothers who completed primary school [AOR = 4.5; 95% CI = 1.1,18.2], had four or more ANC [AOR = 1.8;95CI = 0.79-0.98], and postnatal follow-up [AOR = 0.21;95% CI = 0.07-0.67], and had male infants [AOR = 2.3; 95% CI = 1.0-4.95] were among the factors influencing the exclusive breastfeeding practice score. Conclusion: While three in four mothers exclusively breastfed their newborns and about two-thirds had good EBF score, the observed women's retention on the continuum of the maternal care pathway is low with one in four had no antenatal and over half had no postnatal care which are important derivers for EBF practice. To improve the EBF score and narrow the observed maternal and child health disparities, it is essential to promote maternal education and increase the recomended coverage of antenatal and postnatal care for mothers.
Understanding clerics and healers' knowledge, attitude, and practice towards epilepsy are crucial... more Understanding clerics and healers' knowledge, attitude, and practice towards epilepsy are crucial to identify the mechanisms of epilepsy stigma in Ethiopia. The objective of this study is to characterize the social and demographic determinants of knowledge, attitude, and practices of clerics and healers towards people with epilepsy in Addis Ababa, Ethiopia. Methods: A total of 440 clerics and healers were interviewed by trained data collectors using a pretested structured questionnaire. The count sum of outcome variables was grouped into "biological and cultural" knowledge attitude and practice scores. Ordinal regression analysis was performed for each outcome variable against socio-demographic variables of interest. Results: The percentage of responses matching cultural causes (58%) surpassed biological causes. The most frequently mentioned cultural cause was an evil spirit (22.5%). While the most frequently mentioned biological cause was a head injury (12%). Consistent with the above findings, cultural treatment responses (77%) exceeded biological treatment responses. The most commonly referred cultural treatment response was Church healing session (12%). The type of faith followed by the study participants positively correlated with higher cultural knowledge, attitude, and practice score. Conclusions: Clerics and traditional healers in Ethiopia have a partiality to the cultural epilepsy explanation model. Cultural metaphors attached to an evil spirit, curse of God, and witchcraft have formed and fostered existing 'epilepsy societal norms' in Ethiopia. The findings of this study contribute to the understanding of epilepsy stigma and treatment gap. Besides, it provided direction to design and implement epilepsy stigma intervention programs in Ethiopia.
Objective: To evaluate the impact of daily and weekly iron supplementation on serum zinc status a... more Objective: To evaluate the impact of daily and weekly iron supplementation on serum zinc status among anaemic lactating mothers. Design: A randomised iron intervention controlled trial. Setting: Seven urban slum communities of Addis Ababa. Subjects: Phase one of the study involved 207 anaemic lactating women assigned into two intervention groups; the daily (N=71) and weekly (N=71) Iron supplemented and the control group (N=68). Supplementation with 60 mg tablet containing 300 microg ferrous sulphate and 400 microg folic acid was done for three months while the control group was n otsupplemented. Phase two involved 53 participants systematically drawn from phase one. Main outcome measures: Haemoglobin from all subjects and serum zinc and ferittin levels following three months supplementation. Zinc status based on serum zinc value of less than 10.7% micromole/L. Results: The mean baseline characteristics and serum zinc of the women at baseline were similar, overall marginal zinc deficiency prevalence was 11.3% and no zinc deficiency was detected. Following supplementation, zinc deficiency was detected in the supplemented groups but not in the control group. The mean serum zinc significantly changed in both supplemented groups while no change was observed in the control group. The reduction in the mean serum zinc was significantly higher in the daily than in the weekly supplemented group. Conclusion: Iron supplementation impacts negatively on serum zinc status (exacerbates zinc deficiency) and hence, its contribution to zinc deficiency deserves further investigation especially in the context of the on-going promotion of double fortification strategies that involve iron.
Background: In countries like Ethiopia where the spread of HIV infection is extensive, health ser... more Background: In countries like Ethiopia where the spread of HIV infection is extensive, health services are faced with an increased demand for care. The most obvious reflection of this increased demand is through patient load, longer bed occupancy perhaps to the exclusion of patients with other ailments. Objective: The purpose of this study was to describe the bed occupancy rate and the average length of stay of HIV/AIDS inpatients of three major public hospitals. Methods: A Retrospective Cross-sectional study was conducted in three major hospitals of Addis Ababa namely Zewditu Memorial Hospital, Tikure Anbessa Hospital and Saint Paul's Hospital from February to March 2004. Results: Of the total 453 sampled inpatients, 293 (65 %) were HIV positives. Over half (55.0%) were Males. The most affected age group was between 24 and 56 years. The majority (85.8%) were from Addis Ababa and over half (57.7%) was married. Housewives constituted about a quarter (26.3%) of all the admitted cases. The most common co-morbidities resulted in admission to the medical wards among the HIV-positive cases were Tuberculosis (73.0%) and jirovicii pneumonia (70.3%), and their occurrence was significantly higher among HIV+ than their counter parts (p=0.001). Although numbers of patients admitted in Tikur Anbesa hospital was more than Saint Paul's and Zewditu Memorial hospitals (ZMH), the proportion of HIV positive cases admitted to ZMH however was higher (49.0%) than Tikur Anbessa (14.0%) and Saint Paul's hospitals (18.0%). Likewise the number of inpatient days was also higher in ZMH (n=7765) than the other hospitals. The bed occupancy rate was however, higher in ZMH (53.0%) than Tikur Anbessa (12.0%) and Saint Paul's (12.0%) hospitals. Conclusion: One of the most obvious consequences of HIV/AIDS patients are the increased occupancy of hospitals beds suggesting that only 81.1 % of the beds are for all other afflictions in the hospitals. It appears that there is a lot of concern that patients with HIV are competing with the non-HIV infected patients in a resource limited areas. Home based care with community involvement and greater use made of existing community resources might be a response to the limitations of curative hospital-based care and treatment needs of many HIV/AIDS patients.
Objective: To determine the level of malnutrition and xerophthalmia in pre-school children. Desig... more Objective: To determine the level of malnutrition and xerophthalmia in pre-school children. Designs: Non-randomised community based study. Settings: Four different administrative regions: Harari, Tigray, Southern Nation Nationalities and people region (SNNPR) and Oromiya, with different eco-zones, were studied from May to June 1996. Subjects: Fifteen thousand and eighty seven children, aged between six and 71 months, examined for clinical symptoms and signs of xerophthalmia. Anthropometry and blood samples were taken from every 20 children (n = 634) of same age, for serum retinol and nutritional determination. INTERVENTION MEASURES: Disease targeted approach of vitamin A supplementation was employed in the regions. Results: The overall prevalence rates of night blindness and Bitot's spots exceeded WHO cut-off point for xerophthalmia as a public health problem, with higher prevalence rates in males (53%) than females (26%). The proportion of children with deficient serum retinol concentrations (SRC), and Bitot's spot were observed to be higher in Oromiya and Harari regions followed by Tigray, than SNNPR administrative regions. Most of the affected children were aged between 36 and 72 months. The greatest low SRC was also observed in the same age group of children in all regions. There was higher prevalence rate of stunting (60.1%) than wasting (12.2%) with an additional (8.8%) of children both stunted and wasted. The proportion of stunted children was high in Tigray followed by Oromiya, SNNPR and Harari regions. Conclusion: The high level of stunting and Bitot's spot, together with the low level of serum retinol concentrations found in these regions, indicates the need to strengthen this intervention strategy further with universal vitamin A capsule distribution, nutrition education and promotion of horticulture activities.
Iron deficiency anemia (IDA) is the most common disorder among pregnant women and is associated w... more Iron deficiency anemia (IDA) is the most common disorder among pregnant women and is associated with nutritional deficiency. This cross-sectional study determined IDA status in pregnant and lactating mothers from various staple diet areas in Ethiopia. A total of 13 randomly selected sites representing six main staple diet areas were stratified with reference to the amount of their dietary iron consumption and prevalence of parasitic diseases between 1990 and 1994. The study subjects comprised 1449 pregnant and lactating mothers aged 15-49 years. Findings showed that the proportion of women with IDA was higher among illiterates women aged 20-29 years multiparous women and in areas where the prevalence of intestinal parasites was high and dietary intake of iron was low. When the iron content of the staple diet consumed was considered against the prevalence of anemia by hemoglobin level low iron intake areas (milk and maize staple areas) were seen to be affected more significantly (p < 0.05) by anemia than the high iron intake areas. In conclusion a mild to moderate degree of IDA exists with milk- and maize-dependent staple diets; therefore iron supplementation targeted to pregnant and lactating mothers is recommended.
Background: Body mass index (BMI) is a commonly used anthropometric measurement to estimate the l... more Background: Body mass index (BMI) is a commonly used anthropometric measurement to estimate the level of nutritional indices (underweight/overweight) of adolescents and adults. Knowledge of the factors affecting BMI is essential for developing intervention programs. This study was conducted to measure BMI and determine the socioeconomic and demographic factors affecting the relative weight of adolescents living in rural districts in Ethiopia. Methods: A randomized cross-sectional study of 425 adolescent students living in the Ambo region of Ethiopia was conducted. A pre-tested questionnaire was used to collect the socioeconomic and demographic status of the participants. BMI (weight/height(2), kg/m(2)) was measured and used as index of relative weight. Data were analyzed using SPSS version 15. A stepwise backward logistic regression analysis was applied to identify the major determinant abnormal weight of the adolescents while controlling for co-linearity. Results: The prevalence of underweight was 27.2% with male preponderance. The proportion of normal weight females was higher than that of males. There was no significant difference in the proportion of overweight males and females. Age, number of meals, parental education level, source of food, and number of cattle owned were correlated with being underweight. After adjusting for confounding variables only being a member of the younger age group (AOR=1.99; 95% CI=1.01 to 3.57), source of food (AOR=2.4; 95% CI=1.24 to 4.74), and a greater number of cattle owned (AOR=4.9; 95% CI=1.27 to 19.28 were positively correlated with being underweight. Conclusion: Younger age adolescents, those who come from homes with no or few cattle, and their parents purchased food were likely to be underweight. This study will help local governments, educators and community groups develop programs to assist underweight adolescents attending schools.
East African journal of public health, Oct 7, 2014
Background : Pregnancy among HIV positive individuals is an issue of public health importance bec... more Background : Pregnancy among HIV positive individuals is an issue of public health importance because of poor maternal outcomes and pediatric HIV infections. Hence meeting contraceptive needs of people with HIV help avoiding unintended pregnancy and could reduce maternal death and pediatric HIV infection. Objective : To assess contraceptive utilization and factors affecting its use among HIV positive women taking anti-retroviral therapy. Methods : A cross sectional facility based quantitative study supplemented by qualitative in-depth interview (IDI) was conducted from January 2013 to June 2013 on a sample of 353 HIV positive women who had regular ART follow up in five major hospitals with large client flows in the capital city, Addis Ababa. A pretested structured questionnaire was used to collect the quantitative data and semi- structured (open ended) question was used to collect the qualitative data. The cleaned quantitative data were entered and analyzed using SPSS version 16 while the qualitative data were transcribed and analyzed into thematic areas. Result : One hundred forty four (40.8%) of the respondents used at least one method of contraceptive method and condom was the most highly utilized contraception. The major determinant factors identified to augment contraceptive user were, having alive children (AOR=5.95; 95%CI= 3 to11), being married or cohabitated (AOR=0.15; 95%CI= 0 .08 to 0.27), age between 20-29 years (AOR=0.26; 95%CI=0.1 to 0.7); heard of contraceptive method (AOR=5.91; 95%CI=1.7 to20), counseling on unintended pregnancy (AOR=1.87; 95% CI=1to3.4). According to the IDI responses, refusal of spouses and dislike of condom were the reasons mentioned for inconsistent condoms use while from the service provider views, fear of drug side effect was attributed to inconsistent contraceptive use. Conclusion : In this study 40.8% of people living with HIV used at least one method of contraceptive method and condom being the leading contraceptive methods. The major predictor identified for some program improvements need to target on women having alive child, in marital union, heard of contraceptive method, counseled on unintended pregnancy and age group between 20 and 29 years and ultimately avoid unintended pregnancy among HIV positive women.
Consumption of food pattern refers to any edible or drinks taken during A specified period which ... more Consumption of food pattern refers to any edible or drinks taken during A specified period which could vary across different seasons, geographic locations, economic situations, physiological status and culture [1-6]. During pregnancy, women are advised to take more diversified food to get adequate energy and multiple nutrients to satisfy their demand as well as the growing fetus [7-9]. Such advice, however, in most developing countries including Ethiopia are not practiced and consequently results in multiple micronutrient deficiencies Background: Maternal undernutrition during pregnancy is likely to face a wide range of poor pregnancy outcomes in most developing countries including Ethiopia. Recent evidence in Ethiopia showed some reduction in the trend though the problem is still prevalent and underlines the need for uncovering the attributes for plausible intervention particularly among pregnant which this study has addressed. Objective: To assess the maternal attributes for optimal nutrient intake among pregnant women that they are antenatal follow-up. Method: Data from 380 of women of reproductive age was extracted from a large data set collected for partial fulfillment for master's in public health which is titled as Food consumption pattern, nutrient intake and associated maternal attributes of antenatal care attendees in Bishoftu town, eastern Ethiopia. A facility-based cross-sectional study. Dietary intake was assessed using a semiquantitative food frequency questionnaire composed of 70 food items. Data were cleaned and analyzed using STATA version 12.1. Consumption patterns were identified using factor analysis and each pattern was further analyzed using a multivariate regression model adjusted for age and calorie intake. A P-value<0.05 was considered statistically significant. Result: All women had low intake of calorie, fat, vitamin A, folic acid and calcium throughout their pregnancy period. Interestingly, inadequate intake of zinc was found only during third trimester. Older maternal age, being married, increased maternal and husband education, being employed, higher socioeconomic status, and snack habits were positively correlated while increasing household size and gravidity, fasting, food restriction and chronic diseases were negatively associated with adequacy of intake. Conclusion: Except for zinc otherwise all the necessary nutrients taken by the participants were inadequate underscores the need for supplementary feeding targeting the most at risk groups. 02
Background: Iron deficiency anaemia (IDA) is one of the most common causes of nutritional problem... more Background: Iron deficiency anaemia (IDA) is one of the most common causes of nutritional problem, and is of great public health significance affecting children, adolescents and women of reproductive age world wide. The magnitude of IDA in the general population of Ethiopia has not yet been well documented. Objective: To estimate the magnitude of IDA among women of reproductive age in nine administrative regions. Methods: A cross-sectional study of analytical nature was conducted in 270 clustered villages drawn from 9 administrative regions of the country between June and July 2005. A total of 22,861 women of reproductive age (15-49 years) were examined clinically for pallor and 5% of these subjects were systematically selected and assessed further for their haemoglobin (Hgb) and serum ferritin (SF) status. Results: The prevalence rate of clinical anaemia, anaemia, ID (iron deficiency) and IDA were 11.3%, 30.4%, 49.7% and 17.0% respectively. The majority of anaemic women were in the category of mild (19.3%) to moderate (10.3%) and severe anaemia was 0.9%. A significantly higher proportion of clinical anaemia [26.7% (95% CI: 24 to 28%)], anaemia (Hgb) [79.4% (95% CI: 72 to 86%)], ID [65.1% (95% CI: 72 to 86%)] and IDA [58.0% (95% CI: 55 to 76%)] was observed in Afar signifying distinct regional variation. The most affected age groups were those between 36-49 years and the difference noted was statistically significant. Conclusion: This study substantiates the existence of mild to moderate form of IDA among women of reproductive age and underlines the need for iron supplementation to all reproductive women during the antenatal period with more attention to the most affected regions.
Ethiopian Journal of Health Development, Dec 16, 2010
Background: The predictive validity and applicability of Theory of Planned Behavior (TPB) may be ... more Background: The predictive validity and applicability of Theory of Planned Behavior (TPB) may be a promising model for understanding and predicting intended behaviors to use VCT services. The need for theory based study would thus be essential in designing evidence based HIV-related interventions in the future. Objectives: To examine the applicability of the Theory of Planned Behavior and the additional predictive role of perceived risk in predicting intended use of Voluntary HIV Counseling and Testing (VCT) services. Methods: A cross sectional study design was conducted among 20 randomly selected schools in Harari Region between March and April 2009. Four hundred ninety seven randomly selected teachers consented to participate in the study giving a response rate of 87.8%. Self administered questionnaire, adopted from the TPB was used for data collection. Multiple linear regression models were used to predict the role of important variables that can influence the intention to use VCT among teachers using SPSS version 15. Result: More than half (53.7%) who had never used VCT service were considered in the analysis for the intended VCT service use. All the modal variables correlated significantly with behavioral intention. Subjective norm (r=0.45, p<0.001), perceived behavioral control (r=0.42, p<0.001) attitude (r=0.33, p<0.001) and perceived susceptibility(r=0.25, p<0.001), were significantly and positively correlated while perceived severity to the illness (r=-0.14, P<0.001) was significantly but negatively correlated with behavioral intention. Perceived severity of the illness, normative belief and having high level of self control were the major predictors for intended use of VCT. Conclusion: The study demonstrated that the TBP is a useful model for evidence based educational programs focusing mainly on creating supportive social system and strengthens their self efficacy for positive VCT uptake. [Ethiop.
The South African journal of clinical nutrition, 2010
Objective: To investigate the country-wide extent of folate deficiency and risk factors in Ethiop... more Objective: To investigate the country-wide extent of folate deficiency and risk factors in Ethiopian women. Design: Cross-sectional study. Methods: Multistage cluster sampling and systematic sampling were used to select 970 women aged 15 to 49 years from nine accessible regions of Ethiopia. Demographic and health information was collected via questionnaire. Biological samples were collected by medical technologists. Outcome measures: demographic and health variables, food frequency, haemoglobin status, ferritin status and folate status. Results: Mean ± SD plasma folate was 5.57 ± 3.84 ng/mL. Forty-six per cent of women had severe folate deficiency (≤ 4 ng/mL) and 21.2% had marginal folate deficiency (> 4-6.6 ng/mL) with unequal prevalence across the country. Severe folate deficiency was higher in women who were unmarried (p = 0.002), had parity of 4-6 (p = 0.001), used oral contraceptives (p = 0.01), had no illnesses (p = 0.001), had intestinal parasites (0.001), followed lower plant food diets (0.001), followed lower animal product diets (0.001), had no anaemia (0.001) and had no iron deficiency (0.001). In logistic regression analysis, only low plant food diets (p = 0.001) and iron deficiency (p < 0.001) retained their significance with regard to folate deficiency. The odds for developing folate deficiency was 0.9 times less likely among those with higher plant food intake (AOR-0.9;95%CI-0.72-1.2) and 0.2 times less likely among those with adequate iron (AOR-0.2;95%CI-0.17-0.34). Conclusions: Folate deficiency is widespread in Ethiopian women, emphasising the need for sustainable folate intake through dietary diversification and appropriate public health measures.
Background: The Ethiopian Demographic and Health Survey 2019 shows that 59% of children are exclu... more Background: The Ethiopian Demographic and Health Survey 2019 shows that 59% of children are exclusively breastfed for the first 6 months of life, then the rate decreases sharply with age. Nearly half of the Ethiopian labor force (46%) is comprised of women. This is encouraging since women's employment is one way of ensuring women's empowerment. However, various factors related to employment make it one of the commonly mentioned factors contributing for the low prevalence of breastfeeding. Hence, there needs to be a conducive work environment that accommodates maternal needs to not fall back from empowerment and to improve breastfeeding practice. There are not many studies in Ethiopia that focus on work environment in relation with employers' experience and their perception of breastfeeding of employed mothers. Therefore, this study aims to explore employers' experience and perception of employed mothers' breastfeeding experience in different working environments in Addis Ababa, Ethiopia. Methods: A qualitative study design using a descriptive phenomenology strategy was employed in this study and purposive sampling technique was used to recruit study participants. Data was collected between December 2016 and May 2017 in Addis Ababa city from 10 employers from private, governmental and non-governmental institutions through an in-depth interview. Thematic data analysis was performed where collected data was organized, coded and categorized into themes to give meaningful contributions to answering the research questions. Results: Understanding breastfeeding, current maternity leave, perception of breastfeeding supporting the conditions and mother-friendly work environment were the themes generated after analysis. Almost all employers in this study recognized the importance of breastfeeding despite their different work environments and they also acknowledged the importance of making the working environment mother-friendly for stability and motivation of employed mothers. Conclusions: Providing mothers with a friendly environment is understood as a positive thing by employers. The current maternity leave of 3 months has low acceptance and both onsite childcare center and six-month maternity leave are believed to help in creating a mother-friendly work environment despite their pros and cons.
Background: Maternal underweight is a challenging public health issues globally affecting women i... more Background: Maternal underweight is a challenging public health issues globally affecting women in most developing countries and consequently affect their newborns. Such information however is scantly in the study area and thus we examined the contribution of low dietary diversity score towards underweight among expectant mothers from rural Ethiopia. Methods: This study was based on data extracted from a large data set gathered from three rural villages from September 2017 to June 2018 in a district of North-Shewa Zone of Amhara Regional State which is 220 km north of Addis Ababa, the capital city of Ethiopia. Data on socio demographic characteristics food groups consumed and Mid-Upper Arm Circumference (MUAC) measurement were taken for all expectant mothers by trained health extension workers in accordance with relevant ethical guidelines and regulations. The collected data were entered into Epi-data software version 3.02 and analyzed using SPSS version 20. Statistical signi cance was a rmed at a p-value ≤ 0.05. Result: Of the 400 consented participants, 380 of them had adequate information and thus analyzed for their variety of food groups consumption and their MUAC measurement outcomes. The magnitude of underweight was 18.2% and the mean (±SD) dietary diversity score was 4.45(±1.32). interestingly, the relationship between poor dietary diversity score and underweight of the participants was signi cant (AOR= 2.4; 95% CI=1.05 to 5.3). Conclusion: Our study revealed a signi cant relationship between low dietary diversity score and
There is nothing worse than leaving home country. Instability in many parts of the world has led ... more There is nothing worse than leaving home country. Instability in many parts of the world has led to massive displacement of civilian population with associated shortage of basic services such as food, water, shelter and health services often leading to higher incidence of morbidity and mortality. Malnutrition and anaemia remain one of the most common causes of morbidity and mortality among displaced population throughout the world. The most vulnerable to suffer from the consequences of malnutrition and anaemia are refugee children due to their living condition. Although the burden of malnutrition and anaemia is expected to be high in protracted refugee areas, the magnitude of malnutrition and anaemia and their determinants among refugee children are not well identified and documented. The objective of this work is to assess the magnitude and determinants of under nutrition and anaemia among refugee preschool children in Kebribeyah refugee camp, Ethiopia.
Background : Patient satisfaction questionnaires are the commonly used patient satisfaction measu... more Background : Patient satisfaction questionnaires are the commonly used patient satisfaction measure, and may be global or multidimensional in focus. Global patient satisfaction consists of overall patient satisfaction while multidimensional patient satisfaction has multiple items focusing on different dimensions of the healthcare. Objective : To develop reliable and valid patient satisfaction questionnaire for an outpatient neurology services in Ethiopia. Methods : A facility based cross-sectional study was employed to assess patient satisfaction from Outpatient Neurology Clinic (ONC) of Zewditu Memorial Hospital in Addis Ababa, Ethiopia from August to October, 2009. A total of 193 consecutive patients that had a follow up in the ONC during the ten weeks period were invited and included in the study. Data were entered and analyzed using SPSS version 15. Factor analysis was used to describe the structure of the multidimensional patient satisfaction questionnaire for reliability (Cronbach’s alpha) and validity. Results : Of the 193 patients enrolled, 176 of them completed the study making the response rate 91.2%. Exploratory factor analysis identified three distinct subscales (waiting time, accessibility and physician services) in the patient satisfaction questionnaire which accounted for 84.1% of the total variance. All subscale Cronbach’s alpha values were more than 0.80. Analyses of the content, criterion and construct validity yielded complimentary evidences for the overall validity of the patient satisfaction questionnaire. Conclusion : The instrument used in the study is psychometrically good for the measurement of patient satisfaction in the Outpatient Neurology Clinic. Keywords : Questionnaire validation; patient satisfaction; outpatient neurology services, Ethiopia.
East African journal of public health, Oct 23, 2014
Background: Malnutrition remains one of the most common causes of morbidity and mortality among c... more Background: Malnutrition remains one of the most common causes of morbidity and mortality among children throughout the world, and is an important public health problem affecting preschool children. Refugee children, due to their living condition, are the most vulnerable to suffer from this problem. The magnitude of malnutrition and its determinant factors among refugee children are not clearly identified and documented. Objective: To assess the magnitude of malnutrition and its determinants among refugee preschool children Methodology: A cross -sectional study with analytic component was conducted in Kebribayah refugee camp during March 2010. A total of 671 refugee children aged between 6 and 59 months were randomly selected using simple random sampling and assessed for their nutrition status based on weight and height measurements. Data were entered into the computer using EPI-INFO software version 3.5.1. (has Epi – Nut) to compute the nutritional using the NCHS/WHO reference population and then exported to SPSS version16.0 statistical software package program for data cleaning and analysis. Results: The prevalence of stunting, underweight and wasting were 27.6%, 26.1% and 8.9% respectively. The main determinant factors of stunting were child age, maternal illiteracy, paternal lack of education, and family size (p< 0.05). Child sex, age, maternal lack of education, childhood illness such as diarrhea and ARI, and lack availability of toilet facility were associated with underweight (p< 0.05). Age of child, sharing and selling of food ration, duration of ration lasting, presence of ARI and poor personal hygiene (number of baths took) were the most important determinants of wasting (p< 0.05). Conclusion: The present study delineated the factors associated with stunting, underweight and wasting among refugee children. Underweight is serious in the area and chronic malnutrition (stunting) was also of particular concern. To achieve success in nutritional status of refugee children provision of adequate food ration, sufficient provision of micronutrients, early child illness treatment, and educating parents should be respected and pressure from the food aid donors/concerned bodies to reduce families sharing and selling their food ration should be encouraged. Furthermore, provision of non-food items should be strengthened to improve the hygienic practice of the beneficiaries.
Background. Antenatal care (ANC) is an entry point for the prevention of mother-to-child transmis... more Background. Antenatal care (ANC) is an entry point for the prevention of mother-to-child transmission (PMTCT), particularly when a man accompanies his spouse for voluntary counselling and testing (VCT), even though this seldom happens in Ethiopia. Objective. To study the role of male partners in improving PMTCT/ANC, which is essential to prevent HIV/AIDS transmission in this country. Our study focused on identifying barriers for the low involvement in PMTCT/ANC among male partners whose spouses received ANC. Methods. A total of 422 male partners in Goba town, Oromia regional state, Ethiopia, were recruited in September-October 2014 and enrolled by a systematic sampling method. A facility-based cross-sectional study and two focus group discussions (FGDs) were conducted. Binary logistic regression and odds ratios were calculated to ascertain sociodemographic and other important information compared with the outcome variable and PMTCT/ANC, while the findings of the FGDs were grouped according to the emerging themes and analysed manually by means of a thematic approach. Results. The percentage of male partners (22.7%) accompanying their spouses for HIV testing and counselling at antenatal clinics improved threefold when an invitation letter was introduced as a new initiative to increase male participation. Individuals in the age group 15-29 years (adjusted odds ratio (AOR) 5.4, 95% confidence interval (CI) 1.66-17.85), and whose duration of marriage was ˂5 years (AOR 5.6, 95% CI 1.83-17.30), were more likely to be tested than their referent groups. Men without a higher education (AOR 0.1, 95% CI 0.02-0.50), who disagreed with legal enforcement (AOR 0.1, 95% CI 0.07-0.32), were less likely to be tested, while those who did not notify their partners (AOR 8.4, 95% CI 1.92-37.12) were more likely to use the service. Being busy, proxy testing, fears of testing HIV-positive, neglecting the importance of VCT, and inadequate knowledge about the PMTCT/ANC programme were other barriers that came to the fore in the FGDs. Conclusion. Identified barriers have to be addressed, and helpful practices, such as using invitation letters to increase the uptake of the service by male partners, have to be instituted.
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Papers by Jemal Haidar