College of Health Sciences

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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.
Assessment of Magnitude and Factors Affecting Nutritional Status of HIV Infected Under-Five Children at Five Public Hospitals in Addis Ababa and its Programmatic Implication.
(2014-02) Atnafu Mekonnen; Ababi Zergaw
Background: Even though malnutrition can affect any child who is at risk, HIV infected children are at a greater risk to have malnutrition due to the synergistic relationship between infection and malnutrition. Objective: to assess factors affecting nutritional status of HIV infected under-five children at five public hospitals in Addis Ababa. Methods: the research was conducted at five public hospitals in Addis Ababa using a cross-sectional research design and data was collected from June 3 to September 20, 2013. Using simple random sampling method 243 under five HIV infected children were included in the study. A structured questionnaire was used for data collection and data was analyzed by running simple frequencies, odds ratio and binary logistic regression. Result: The prevalence of underweight, stunting and Global Acute Malnutrition among the children were 15.4%, 62.1% and 2.5% respectively. Under multivariate analysis CD4 percentage equal to or above 25% was protective of stunting while always not having enough food in the family of the child was significant in the model for predicting stunting. Maternal age from 36-49 years old was found to be protective of being underweight while being a girl was protective of wasting. Conclusion and Recommendation: the magnitude of chronic malnutrition in the HIV infected under five children having follow up in the five public hospitals was very high which can affect survival. It needs intervention by addressing the food insecurity and CD4 percentage value of the child which were related to it.
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.
Assessment of Quality of Midwifery Care in Teaching and Non-Teaching Hospitals in Addis Ababa, Ethiopia.
(Addis Abeba Universty, 2016-06) Azeb Admassu; Ababi Zergaw
Background: Quality of midwifery care improves health outcomes by providing technically sound care for clients (1). This quality may affected by teaching and learning process. some literature says that teaching learning process has positive influence on quality of midwifery care (14) but others studies done in Iran says that quality of maternity care is poor in teaching hospital than non teaching hospital (20) . In our country Ethiopia no study is done on hospital teaching status affects quality of midwifery care. As this study is new and fill the evidence gap on issue. Objective: To assess the quality of midwifery care in teaching and non-teaching hospital by comparing the two types of hospitals and measuring satisfaction, Addis Ababa, Ethiopia. Methodology: Facility based cross-sectional comparative study was conducted on 416 mothers who had received labor and delivery service in St. Paul Hospital Millennium Medical College and All Africa Leprosy, Tuberculosis and Rehabilitation Training Hospital which are teaching and non- teaching hospitals respectively. A systematic random sampling technique was employed to select mothers who were admitted for delivery and gave birth in the study ward. Data collection was done by administrating structured questionnaire and using standard observation checklist. In the analysis, descriptive statistics was used and multivariate and bi variate analysis for significance and association were carried out. Ethical approval for the study was obtained from Addis Ababa University School of Public Health and St Paul Hospital millennium Medical Collage Ethical Review Committee and permission litter obtained from All Africa Leprosy, Tuberculosis and Rehabilitation Training Hospital. Results: It was found that mothers in the non-teaching hospital were 5.4 times more likely to be satisfied than in the teaching hospital (COR (C l) (5.46 (3.39, .8.31) p value 0.001)) and quality of midwifery care was 1.49 times more likely good in non-teaching hospital than in teaching; (COR (CI) (1.49 (1.018, 2.206) P value 0.040). Conclusion: In conclusion the quality of midwifery care is affected by teaching learning process which is quality carries higher in the non-teaching hospital compared with the teaching hospital. From bi variant logistic regression finding, mothers in the non-teaching hospital were 5.4 times more likely to be satisfied than in the teaching hospital.
Assessment of the Difference of School Feeding Programme on School Participation among Primary School Children in Bishoftu Town, East Shoa Zone, Oromia Regional State.
(Addis Abeba Universty, 2014-07) Asmamaw Guta; Ababi Zergaw
Introduction: Empirical studies reveal that school feeding programs have significant positive impact on school participation. Such studies suggest school feeding programs are effective in encouraging school enrollment, enhancing class attendances, and lowering student drop-outs. To the contrary, few other studies reveal that there are no observable impacts of school feeding program on school participation Objective: Compare the difference in school participation; specifically on school enrollment, class attendance and drop-out of students of school feeding program beneficiary and non-beneficiary children of primary school, in Bishoftu Town of East Shoa Zone, Oromia Regional State, Ethiopia. Methods: Community based comparative cross-sectional study was employed to compare the difference in school participation of 428 respondents from school feeding program and 428respondents from non-school feeding program schools. Simple random sampling technique was employed to identify the schools and study participants; household questionnaire, key informant interviews and school record review were used to collect data. Collected quantitative data were analyzed using mean, proportion, independent sample test and bivariate correlation techniques. The study was carried out after getting permission from research and ethics committee of School of Public Health, Addis Ababa University College of Health Science. Results: Except enrollment (p=.001) the study found no significant positive effect of school feeding program on two of school participation indicators (attendance and drop-out), although it has some roles with regard to these objectives. The result also shows that the major factors affecting school enrollment are availability of school, school factor, distance to school, the availability of food incentives and safety concerns. Whereas, those affecting class attendance and student drop-out were illness, domestic work (29.3% for SFP and 21.41% for non SFP households), school hour hunger and distance to school. Besides, it has been determined that even among beneficiary (p=0.001) households, the older the household head is the higher likely that the children get enrolled. However, it is found that neither household head education nor household income have significant effect on student drop-out in beneficiary households. Conclusion: The study recommends that both the nutritional and economic values of schoolfeeding program should be improved in order to significantly enhance school participation.
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.
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.
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.
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.
Enhancing the Completeness of Medical Records at Inpatient Department of Karat Primary Hospital KonsoWoreda, SNNPR
(Addis Ababa Universty, 2018-06) Kafita Katusa; Ababi Zergaw
Background: The completeness of medical records is key performance indicator that is related with delivery of healthcare services in the hospital and assessed with minimum set of indictors such as physician note, physician order sheet, Nursing care plan, medication administration sheet, discharge summary, progress note and clinical pharmacist record form. Objective: The objective of the study was to enhance the completeness of inpatient medical records from 22% to 60% in time period from Feb to June, 2018 at In-patient department of Karat Primary Hospital, KonsoWoreda, SNNPR Design: before-after interventional study was carried from Feb to June, 2018 using document review, observation, inpatient medical record review form and focus group discussions. Setting: Karat primary hospital, SNNPR, Ethiopia Participants: SMT, Medical director, matron and all IPD clinical staffs. Result: the overall completeness of medical records rose from 22% pre-intervention to 54% post-intervention in in-patient department of Karat primary hospital from Feb to June, 2018 with total budget of 25000.00 Ethiopian Birr.
Factors Influencing Utilization of PMTCT Service and Referral Linkage among HIV Positive Pregnant Women Before Delivery in Hawassa Public Health Facilities.
(Addis Abeba Universty, 2013-06) Fanna Adugna; Ababi Zergaw
Background : Mother -to- child transmission of HIV infection is the major source of infection under the age of 15 and global coverage of prevention of mother-to-child services reached 53%in 2009 .However, factors that influence utilization of PMTCT service and referral linkage to chronic ART clinic for HIV positive pregnant women are not well studied in Hawassa town. Objective: To assess factors that influence utilization of PMTCT service and referral linkage to chronic care before delivery in HIV positive pregnant women. Methods: Facility based cross sectional study was conducted in 6 Hawassa town public health facilities. Using systematic sampling procedure 588 study subject were included in the study. Indepth interview was also used to gather greater depth of information. A pretested structured questioner was used to collect data and the data analyzed using SPSS version 17. Moreover, bivariate and multivariate logistic regression model with crude and adjusted OR along with their95% confidence interval were used to see the independent effect of factors influencing utilization of PMTCT service. Results: A total number of 588 pregnant women were included in this study. Five hundred thirty one (90.3%) of the respondents reported they had under gone voluntary counseling and testing and 522(98.67%) of those who were tested received the test result and Four hundred ninety nine (95.6%) were negative and twenty three (4.4%) were positive. Out of 23 women who were positive HIV status twenty women were linked to chronic ART care service 12 of them with formal referral linkage and eight of with non-formal and nine of those who were linked to chronic ART care service started HAART while seven started ARV prophylaxis. Pregnant women who were two or more number of ANC attendance were more likely to utilize PMTCT service when compared to other sources [AOR=2.99% CI=1.44, 6.23]. The pregnant women believed that their husbands support couple testing were associated with utilization of PMTCT service [AOR=16.2,95% CI= 6.58, 39.67].The pregnant women who support the idea of every pregnant should be tested also associated with utilization of PMTCT service [AOR=9.86, 95%CI=3.67, 26.51]. Conclusion: partner involvement, increasing access of women to VCT, community based education and sensitization targeted to the women and promoting PMTCT service to all facility and improving referral system and getting feedback between facilities will create good referral system between facilities is recommended.
Improving the Implementation Status of Nursing Care Standards Process at Medical& Surgical Wards in Jogel General Hospital, Harar,Ethiopia.
(Addis Abeba University, 2019-06) Aynie Ali; Birhan Tasew; Ababi Zergaw
Background: Despite the important role of nursing care standard practice plays for the betterment of the health care, its implementation status is far below expected, particularly in developing countries. Similarly, the baseline assessment in this study showed that the implementation of Nursing Care Process in Jogel general hospital is poor. Thus, in light of the national and regional efforts to improve health care deliver y& improve a health care Quality. it is critically important to improve the implementation status of the Nursing care Process in Jogel General Hospital. Objectives: To improve implementation of Nursing/midwifery Care Standard Practice from 42 % to 70% in Medical & surgical wards of Jogel Hospital, by the end of June, 2019. Methodology: A facilit y based pre- post interventional study will be conducted from March to June, 2019 in Jogel General Hospital, Harar, Ethiopia. The interventions include give in service training for ward nurses; strengthening internal supportive supervision, nursing audit committee, and provide the update nursing care format preparation .observational questionnaires about the challenges in implementation of the standards for a total of 80 staff nurse(40 pre-40post).A total of 60 Medical Records (MR) have been reviewed ( 30 at baseline and 30 will be at the end of the study) to assess & compare the medical record completeness about t he at t ached & complete document at i on of necessary format s during pre and post-intervention periods respectively. The proportion of standard checklists which will me et Nursing Care Standard Practice with complete services, and observational self prepared questionnaires with10 item total of 100 inpatient admitted(50 pre-50 post intervention) about the nursing care quality and client satisfactions documentation a addition reviews standard 10item contain checklists fill and conduct focus discussion with a total of 14 staff (CEO, Matron, 2director of nurses and 1 2 s t a f f n u r s e ) of formats, and Chi-square test is calculated to test the difference in the outcome of interest between the pre –and post –intervention periods. Result:- The percentage of patient cards with complete Nursing Care Process increased from 42% in baseline to 70% after intervention. This change was statistically significant at (df = 1.44, P =0.0403). Similarly, the implementation of all components of the Nursing Process has increased: Nursing Admission Assessment (from 56% to 82% / P =0.0201), Nursing Diagnosis (from 38% to 78%, P =.0.0301); Nursing Care Plan (from 54% to 66% / P =0.0225); Nursing Implementation (from 47% to 64% / P =0.0152) and Nursing Evaluation (from 31% to 59%/ P = 0.0173), with all changes showing statistically significant at P < 0.05. Conclusion and Recommendations: - continuous on job training continuous flow of related forms can improve the implementation of the Nursing Process followed by. Continuous internal Supportive Supervision of Nurses in wards. Jogel general hospital managers should consider strengthening the internal Supportive Supervision to improve their health facility.
Predictors of Child Diarrheal Diseases in Cltsh and Phast Approach Implemented areas in Shebedino District, Sidama Zone, South Ethiopia.
(Addis Abeba Universty, 2013-07) Bilutkenaw Tamiru; Ababi Zergaw
Background: Diarrhea is mainly caused by poor water, sanitation and hygiene (WASH). It is the second largest single cause of death in sub-Saharan Africa. It kills more young children than AIDS, malaria, and measles combined. Direct consequences of diarrhea on children include growth faltering, malnutrition, and impaired cognitive development in resource-limited countries. Objective: To identify predictors of diarrheal diseases among children in CLTSH and PHAST approaches implemented areas in Shebedino district, Sidama zone, south Ethiopia. Methods: Unmatched case control study was conducted in ten Kebeles of Shebedino district. Census was done to identify all cases and controls. From 14,463 households a total of 294 samples (147 cases and 147 controls) were selected by simple random sampling technique. Cases were children in the age group of 6 to 24 months and who had three or more loose or watery stools in the last six months prior to survey. Pre-tested structured questionnaires were used for data collection. Collected data were entered in to Epi-info and transferred to SPSS version 16.0. Bivariate and multivariate stepwise logistic regression analyses were employed. Results: Children in households with none out of five latrine components [Adj. OR: 3.79, 95% CI: 1.25, 9.46)] and one out of five components [Adj. OR: 4.58, 95% CI: 1.65, 12.75)] were more likely to develop diarrhea compared to counterparts. Hand washing practice showed a significant odds [Adj. OR: 4.78, 95% CI: (2.14, 8.94)] of developing diarrhea. Attitude of mothers showed a significant odds [Adj. OR=2.12, 95% CI: (1.93, 5.10) of developing diarrhea. Similarly, diarrheal diseases were higher among children fed with hand compared to those fed using cap and spoon [Adj. OR: 4.37, 95% CI: 1.54, 12.42)]. Conclusion: poor latrine components, poor practice of hand washing, negative attitude and poor child feeding practice were strongly associated with the occurrence of diarrheal disease among children in the age group of 6 to 24 months in CLTSH and PHAST approaches implemented areas. Affordable simple designs of latrines construction with entire components should be included in the approaches; the approaches should also give strong emphasis on hygiene components, and provide simple and "easy to understand" information to the mothers or caretakers on how to prevent child diarrheal diseases.
Prevalence and Associated Factors of Acute Lower Respiratory Infection among Under Five Children, Yeka Sub City, Addis Ababa, Ethiopia.
(Addis Abeba Universty, 2017-06) Bashaw Wogderes; Ababi Zergaw
Background: Acute lower respiratory tract infections in developing countries cause considerable morbidity, hospitalization and mortality in children aged under five years. In Ethiopia acute respiratory infection is the leading causes of under-five mortality which accounts for 18% of total death among under five children. Objective: To assess risk factors associated with acute lower respiratory infection among under five children in Yeka sub city, Addis Abeba, Ethiopia. Methods: community based cross-sectional study was conducted with a sample size of 447. Data was collected by interview, entered to EPI data version 3.1, and was exported to SPSS version 22 for analysis. Descriptive statistics using frequencies, proportion and tables were used to present the study results. Binary logistic regression analysis was employed to see association between acute lower respiratory infection and different risk factors. To evaluate the association and adjusted odds ratio with 95%confidence interval were computed. Results: The prevalence of acute lower respiratory tract infection was 4.6%. Evidence from this study also showed that house hold with window (AOR=0.2, 95% CI: 0.1-0.6, p-value=0.002) and family size of less than five children (AOR=0.1, 95% CI: 0.01-0.6, p-value=0.01) were preventive risk factors. Conclusions and Recommendations: The prevalence of acute lower respiratory infection was low. This study has demonstrated that the preventive factors for acute lower respiratory infection were maternal education to primary or secondary level, household with window and less than five children in the household. These risk factors can be modified by encouraging and increasing community awareness for child spacing and increase and promote female education.
Quality of Antenatal Care Services and Factors Influencing Maternal Satisfaction in Public Health Facilities of Wolkite Town, Gurage Zone, Southern Ethiopia
(Addis Ababa University, 2023-06-23) Cheru Temesgen; Ababi Zergaw
Back ground: Although antenatal care (ANC) coverage in Ethiopia is increasing, the quality of ANC remains low. It is believed that increasing number ANC contact by itself is not enough to change current maternal health status and that the quality of ANC service can have important impact in the heath of mothers and new born. Objective: To assess quality of antenatal care services and factors influencing maternal satisfaction in Wolkite town public health facilities. Methods: The study was carried out in Wolkite town the administrative center of the Gurage zone located 155 km west of capital city of the country, Addis Ababa. A facility-based cross sectional study design was conducted. The study populations were all pregnant women who attended the service in data collection period. Sample size was 409. A pretested structured questionnaire was used. Data entry, coding, cleaning was done by Epi-Info and the analysis was done by using SPSS version 26. Binomial and multinomial logistic regression analyses were conducted to examine the association between the socio-demographic, obstetric factors, process aspects of quality and maternal satisfaction. Ethical clearance was taken from the school of Public Health of Addis Ababa University research ethics committee Result: Out of 409 sampled pregnant women attending ANC clinic 398 (97.3%) were responded. About 48% % of respondent were satisfied with ANC services. Residence (AOR = 5.839 95%CI 3.175, 10.739), pregnancy status (AOR = 6.216 95% CI 2.943, 13.127), frequency of ANC visit (AOR = 1.804 95% CI 1.056, 3.082), counseling on nutrition (AOR = 2.875 95% CI 1.709, 4.835), prevention of mother to child transmission (PMTCT) of HIV(AOR = 2.337 95% CI 1.427, 3.827) and birth preparedness and complication readiness (BPCR) (AOR = 2.426 95% CI 1.341, 4.389)and provision of iron (AOR= 2.816 95% CI 1.249, 6.350) had an association with maternal satisfaction. Conclusion: Generally, maternal satisfaction with antenatal care services in this study was low. Absence of clean latrine & adequate water supply was the main reason stated by respondents. Effort should be made to improve accessibility of safe and potable water supply.
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.

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