Public Health

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Browsing Public Health by Author "Ababi Zergaw"

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    Assessment of Hand Hygiene Practice and Associated Factors among Undergraduate Medical Students in the College of Health Sciences; Addis Ababa University, Tikur Anbessa Specialized Hospital, Ethiopia.
    (Addis Ababa University, 2014-09) Kassahun Yimam; Ababi Zergaw
    Background: Hand hygiene is an important measure to prevent and control infection particularly in developing countries, the identification of several risk factors associated with poor hand hygiene compliance is of extreme importance. Objective: to assess hand hygiene practices and associated factors among undergraduate medical students on clinical year in Addis Ababa University; Tikur Anbessa Specialized Hospital, Ethiopia. Method: Institution based quantitative cross sectional study design was used to assess the practice and associated factors that influence hand hygiene practices among undergraduate clinical year medical students. A total of 257 medical students were included and selected by simple random sampling. Data collection was made by using self-administered structured and pre-tested questionnaire. EPI INFO version 3.5.1 epidemiological software package was used for editing, cleaning and coding. Descriptive statistics, logistic regression analysis were done to see association of dependent and independent variable and confounding factors and analysis of variance (one- way ANOVA) were done to see variation in hand hygiene practice. Variables with 95% confidence interval and P value < 0.25 during the bivariate analysis were included in the multivariate logistic regression analysis. Result: A total of 257 questionnaires were completed. Only 48% indicated that alcohol based hand rub is effective for less than 60 seconds. Overall compliance of hand hygiene was found to be 59% (95 % CI (53.3, 65.0). Demographic and most environmental factors had no association with hand hygiene compliance among medical students only factors: knowledge (AOR [95%CI] = 2.1 [1.06, 4.14]), sex‘female (AOR [95%CI] = 1.88 [1.05, 3.35]) and beliefs: (AOR [95%CI] = 2.71 [1.5, 4.87]) were significantly associated with the hand hygiene compliance. Conclusion: Good hand hygiene compliance was indicated "after" caring for a patient; whereas poor hand hygiene compliance was reported "before" having direct contact with a patient and there were no variation in hand hygiene practice and were significant difference in knowledge and belief among groups of medical students in different educational year.
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    Assessment of Quality of Expanded Program on Immunization In Oromia Zone of Amhara Region
    (Addis Abeba Universty, 2006-06) Negussu Ashene; Ababi Zergaw
    One of the goals of global program on immunization for the last two decades has been to reach all children of the world with vaccination services. Though the program aimed to reach all children of the world, around three million children still die each year from vaccine preventable disease. These deaths mostly occur in developing countries where health systems may be weak and less able to cope with an overwhelming set of health problem. Moreover, in previous time much of the attention was given to increase the EPI coverage, but now the expanded program on immunization (EPI) is placing emphasis on the quality of the services and a review of existing literature strongly suggests that the quality of service provided is an important determinant of acceptance and compliance with the service. In Ethiopia, some of the important factors that impede progress towards the achievement of the expected EPI coverage are; poor staff motivation, infrequent in-services training and inadequate supervision, and most EPI service evaluation focused on achievements of coverage and give less regard to the quality of services. Therefore, this health service based cross-sectional descriptive study was carried out to assess the quality of EPI service in Oromia Zone of Amhara National Regional State. Health institutions were selected based on simple random sampling technique and level of client satisfaction was assed by interviewing mothers /caretakers at the exit site of the selected health institutions after taken the immunization service. Data from the health institutions were taken by Observing cold chain system, interview with immunization service providers and inventory of logistics. The result showed that 422 (93.7%) of mothers/ caretakers were satisfied with the quality of the services. Out of the nine selected health institutions, three (33.3%) had no refrigerator, all service providers working in the selected health institutions have adequate knowledge on immunization activities, and most health institutions were not supervised for the last 6 months. Adjusted Odds ratio results from multiple logistic regression for mothers /care takers satisfaction suggested that waiting time, history of facing problem after taking vaccination and discussion with health workers during immunization sessions were found to be significant determinants of mothers’/care takers satisfaction towards EPI services. Generally, the quality of EPI service in the study area was found to be good but for a generalization to be made, further studies has to be made with large sample size at regional and national level to assess the quality of the programme.
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    Attitude and Participation Level of Households Towards Health Extension Program (HEP) at Nefas Silk Lafto Sub-City, Addis Ababa, Ethiopia.
    (Addis Abeba Universty, 2015-08) Mesafint Wana; Ababi Zergaw
    Background: Health extension program (HEP) is an innovative community based strategy to deliver preventive and promotive services. It brings community participation through creation of awareness, behavioral change, community organization and mobilization. It also improves the utilization of health services by bridging the gap between the community and health facilities. Objectives: Assessing attitude and participation level of households towards health extension program in Nefas Silk Lafto Sub-city, Addis Ababa, Ethiopia. Method: Community based cross-sectional study design was used to assess the attitude and participation level of households with the sample size 423, which was determined by single proportion formula (P) of 0.5 and 95% confidence interval. Households were included in the study using systematic sampling method. Health extension workers were randomly selected first and households under health extension workers were included into the study by calculating the interval between the households. Structured pre-tested questionnaire was used to collect data. Frequencies, proportions, odds ratio (95% CI), adjusted odds ratio(95% CI) and logistic regression were used for description of the study population, to determine dependent and independent variables association strength and relative effect of independent variables on dependent variables. Result: Participation level of households in health extension program was 42% (95% C.I= 0.37-0.47) and attitude of households on the change HEP implementation brought, satisfaction of HHs on HEP services, communication skill of HEW, believing HEW skillful and satisfaction of HHs on HEW service provision were associated with participation level of households in HEP [AOR(95%C.I):0.15(0.04-0.54),21.08(2.32-191.38),0.06(0.01-0.64),0.11(0.03-0.35)and 2.67(1.01-7.09) respectively. Conclusion: Majority of the respondents have poor attitude and low participation level in HEP. This is due to household’s attitude towards change that the program has brought was very low and their satisfaction on the program was low. Households’ attitude on the technical competence of HEW and communication skill of health extension worker was unfavorable and influence participation in the program.
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    Comparison of Factors Influencing Utilization of Modern Contraceptive Methods among Rural and Urban Women Currently using Family Planning Service in South Wollo Zone, Amhara National Regional State
    (Addis Abeba University, 2010-07) Jemal Ali; Ababi Zergaw
    Background: Utilization of modern contraceptive methods is related to sociodemographic, reproductive and fertility factors. Previous studies concentrated on identifying these and other determinant factors in rural or urban but it is unclear whether the magnitude of these factors in rural and big urban population similar or not. Objective: The objective of this study is to assess and compare factors influencing utilization of modern contraceptive methods among rural and urban women currently using family planning service in South Wollo Zone, Amhara Region. Methods and materials: Health facility based comparative cross-sectional study was conducted in Dessie town, Jamma and Wereilu Weredas of South Wollo Zone from February to March-2010.The Two rural Weredas were selected from the ten remote weredas located in the western part of the Zone by using simple random sampling methods. All health centres and one potential health post per weredas were the study unit. After obtaining permission to proceed from all level of relevant bodies, data were collected by trained health workers using pre-tested interviewer administered close ended questionnaires from 534 women who visit 12 health facilities as current MCM users. Data were entered and analyzed using SPSS Soft Ware. Result. Rural women use modern contraceptive methods for the first time on average after they had 3 children and only (4.5%) of users before the first child as compared to urban users after they had 1.4 children and (24.3%) before the first child. Desire to limit family size by rural users less (25.8%) than (31.5%) urban users. Decision making to use modern contraceptive by rural users less (21.7%) than urban users (25.5%).(90.3%) of rural and (86%) of urban users had past history of pregnancy. Rural women whose perceived economic status as average were three times more likely to practice modern contraceptive as compared to urban women. Conclusion: This study has clearly described that rural women use modern contraceptive methods after they had higher number of children and less desire to limit family size as compared to urban women. It is recommended that strong behavioral change intervention targeting the high fertility desire of rural women and modern contraceptive methods utilization is needed.
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    Comparison of Factors Influencing Utilization of Modern Contraceptive Methods among Rural and Urban Women Currently using Family Planning Service in South Wollo Zone, Amhara National Regional State.
    (Addis Ababa University, 2010-07) Jema Ali; Ababi Zergaw
    Background: Utilization of modern contraceptive methods is related to sociodemographic, reproductive and fertility factors. Previous studies concentrated on identifying these and other determinant factors in rural or urban but it is unclear whether the magnitude of these factors in rural and big urban population similar or not. Objective: The objective of this study is to assess and compare factors influencing utilization of modern contraceptive methods among rural and urban women currently using family planning service in South Wollo Zone, Amhara Region. Methods and Materials: Health facility based comparative cross-sectional study was conducted in Dessie town, Jamma and Wereilu Weredas of South Wollo Zone from February to March-2010.The Two rural Weredas were selected from the ten remote weredas located in the western part of the Zone by using simple random sampling methods. All health centres and one potential health post per weredas were the study unit. After obtaining permission to proceed from all level of relevant bodies, data were collected by trained health workers using pre-tested interviewer administered close ended questionnaires from 534 women who visit 12 health facilities as current MCM users. Data were entered and analyzed using SPSS Soft Ware. Result. Rural women use modern contraceptive methods for the first time on average after they had 3 children and only (4.5%) of users before the first child as compared to urban users after they had 1.4 children and (24.3%) before the first child. Desire to limit family size by rural users less (25.8%) than (31.5%) urban users. Decision making to use modern contraceptive by rural users less (21.7%) than urban users (25.5%).(90.3%) of rural and (86%) of urban users had past history of pregnancy. Rural women whose perceived economic status as average were three times more likely to practice modern contraceptive as compared to urban women. Conclusion: This study has clearly described that rural women use modern contraceptive methods after they had higher number of children and less desire to limit family size as compared to urban women. It is recommended that strong behavioral change intervention targeting the high fertility desire of rural women and modern contraceptive methods utilization is needed.
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    Cost of Major Mental Illnesses to the Public Health Service Provider, Amanuel Hospital, Ethiopia
    (Addis Abeba University, 2013-10) Mideksa Adugna; Ababi Zergaw
    Background: Mental health is about enhancing competencies of individuals and communities and enabling them to achieve their self-determined goals. Since mental illness is problem of society as a whole, it is a major challenge to global development. Objectives: To estimate the economic cost of major mental illnesses and determinants of cost from the public health service provider’s perspective. Methods: The design of the research was hospital based cross sectional quantitative survey. The costing method that the research used was prevalence based bottom-up costing approach. The cost identified is direct costs incurred by the health service provider for providing mental health service during one year period for major mental illnesses. Using this method cost was estimated by calculating average costs of major mental illnesses (Schizophrenia and Bi-polar). The average cost of treatment was identified by adding together the various pieces of cost of treatment. Cost items identified from outpatient, inpatient and emergency departments and laboratory units. Additionally physical resources of the hospital used were also added. Results: The hospital incurred a unit cost of 1,204.2 ETB to provide mental health services for major mental illnesses. The marginal cost of providing health care for each additional patient at the hospital was 118 ETB. The hospital incurred a unit cost of 229.3 ETB to provide emergency health service, 23,016.1 ETB to provide inpatient health and 611.4 ETB to provide outpatient health service for major mental illnesses. Among the total hospital cost the drugs cost amount was 31.5 ETB, 220.4 ETB and 496.6 ETB for providing emergency, inpatient and outpatient mental health service respectively. Conclusion: Distribution of the hospital cost significantly differs by the residence area of the patients. Distribution of the hospital outpatient cost significantly differs by the number of visits made to the outpatient department of the hospital. Providing inpatient mental health service is more costly than outpatient and emergency mental health services.
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    Status of Adoption and Implementation Level of Integrated Mental Health Service at Primary Health Care Units in Addis Ababa, Ethiopia,2017.
    (Addis Abeba Universty, 2017-06) Roman Mehari; Ababi Zergaw
    Background: In middle and low income countries it is believed that three in four persons with mental disorder do not receive appropriate treatment. To address this extensive unmet mental health need in low-income countries. World Health Organization (WHO) recommends integration of mental health service into primary health care level that is providing mental health services which involve diagnosing and treating people with common mental disorders within the general framework of available health services. Ethiopia implemented this program based on World Health Organization (WHO) scale up program called mental health gap action program (MH-GAP). Objective: The objective of this study was to assess integrated mental health service adoption status and extent of implementation in primary health care units in Addis Ababa, Ethiopia in 2017. Methods: Facility based cross-sectional study was conducted and subjects were selected randomly using proportional size allocation among health care workers in selected health centers in 2017. The total sample size for the study was estimated by single proportion population formula and total sample size was estimated to be 422.Data was collected from selected participants using self-administered questionnaires. Epi data 3.1 was used to enter and clean the data. Stata 14.1 was employed for data analysis. Descriptive analysis percentage and summary measures were conducted for adoption status and implementation level of integrated mental health service. Bivariate and multivariate logistic regression was calculated to examine association between general characteristics of respondents, health care provider’s factors and adoption status of primary health care providers. Result: More than half of respondents (61.69%) 238 of health care providers were found to be under mean score or having poor status of adoption. Majority of respondents 236 (58, 7%) had stated that there were poor implementation level of mental health integration in their facility. Work experience more than 11 years [AOR: 12.34.95% CI :( 3.76- 40.56)], pre -service training[AOR: 2.1.95%CI: (1.249 -3.533)], Presence of discussion with colleagues or higher supervisor [AOR: 1.82. 95%CI :( 1.066- 3.068)], having role or responsibility to diagnosis and assessment of mental disorder cases. [AOR: 1.93.95%CI :( 1.021 -3.683)]have found to be influencing factor for adoption status of integrated mental health service. Conclusion and Recommendation: -Status of adoption towards mental health integration among majority of primary health care providers is poor. The influencing factors for adoption status of integrated mental health service in primary health care units are work experience, preservice training, having a role or responsibility to diagnosis and assessment of mental illness, presence of discussion with colleagues and supervisors in the facility. Majority of primary health care providers are indicated that there is poor level of implementation in the primary health care units. Ministry of health and health science colleges should consider pre-service training to several field of study. Mental health global action implementers should facilitate consistent support and supervision after in-service training. In addition several interferences should be used to change awareness and attitude of health workers towards mental health service integration.