Browsing by Author "Abiy Seifu"

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    Assessment of Male Regular Sexual Partner Involvement in the Use of Modern Contraceptive and Associated Factors among Undergraduate Regular Female Students of Addis Ababa University
    (Addis Abeba University, 2020-03) Mahlet Mulugeta; Wubegzier Mekonnen; Abiy Seifu
    Background:University students most of which in the youth age category exposed to many risky sexual behaviors in the context of low knowledge of modern contraception can lead to several sexual health consequences. Besides, studies have documented that male involvement raised family planning uptake among females. However, there is limited information among the youth, which are not married, but in regular sexual partnership. The paucity of information is particularly high among University students. Objective: To assess the involvement of male regular sexual partner in the use of modern contraception, among regular undergraduate female students of Addis Ababa, University, 2017. Methods: A cross sectional study used on 634 undergraduate students from March 2017 to April 2017.Multi- stage stratified sampling used to select the study participants. First using purposive sampling five colleges and ten departments with the highest number of female students were selected respectively. Then simple random sampling technique used to select the study participants. The study measures magnitude of female students in sexual partnership. A composite variable is determined and measures the involvement of males in modern contraception. The overall association of different covariates with male involvement is assessed using multi-variants logistic regression. Result: 621 female undergraduate students enrolled after fulfilling the inclusion criteria with response rate 97%. Two hundred seventy eight (44.8%) of them had regular sexual partner in past 12 month at the time of data collection. In addition age (AOR=3.46, 95%CI [1.15, 10.32]), study year (AOR=8.62, 95%CI [3.99, 18.61]), current residence (AOR=11.01, 95%CI [4.25, 28.49]), average pocket money (AOR=3.22, 95%CI [1.65, 6.29]). Attending nightclub (AOR=3.24, 95%CI [2.02, 5.2]), watching pornography (AOR=2.83, 95%CI [1.38, 5.78]), peer pressure (AOR=1.83, 95%CI [1.15, 2.92]) were found to have association with sexual partnership in the past 12 month. One third 86 (31%) of the regular sexual partners were found to be involved in modern contraceptive use. Moreover, partners’ educational status (AOR=3.04, 95%CI [1.3, 7.11]), partners’ monthly pocket money (AOR=4.86, 95%CI [1.23, 19.1]), having sex after partner used substance (AOR=2.07, 95%CI [1.03, 4.19]) and using contraceptives in the past 12 month (AOR= 6.51, 95%CI [1.26, 33.48]), were found to have association with involvement of male regular sexual partner on modern contraceptive use. Conclusion: Almost half of university students were engaged in sexual partnership in the past 12 month. There was significant association between age, study year, current residence, average pocket money, attending nightclub, watching pornography and peer pressure with sexual partnership in the past 12 month. From female students who were in regular sexual partnership the male partners who were involved in contraceptive use were very low. Partner’s educational status, partner’s average pocket money and having sex after partner used substances, using modern contraceptive in the past 12, were tends to be associated with the outcome variable regular male sexual partner involvement in contraceptive use. To improve male sexual partner participation in contraceptive use, all stakeholders on sexual and reproductive health should focus on male sexual partners' involvement in modern contraceptive use.
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    Assessment of Postpartum Contraceptive Adoption and Associated Factors in Butajira Health and Demographic Surveillance Site (HDSS), in Southern Ethiopia.
    (Addis Abeba Universty, 2015-06) Mahilet Getachew; Abiy Seifu
    Background: Using PPFP during the first year after delivery helps the women to realize their desire of spacing between births and their wish to keep absent from child bearing. But women in postpartum period do not get the service that deal with their desire to extend birth interval and to evade untended pregnancy and its outcome. Resumption of sex exposes postpartum mothers to risk of unintended pregnancy even before return of menstruation after delivery. This study attempt to measure the 12 months FP experience of women. So, the result of this study is helpful on improving and designing appropriate family planning program during postpartum period. Objectives: To determine level of postpartum contraceptive adoption and identify factors associated among women of reproductive age group (15-49 years) in the first twelve months after delivery. Methods: Community based cross sectional study was conducted in Butajira HDSS from Feb 2016- Mar 2016. Single population proportion formula was used to calculate the final sample size of 421. All the ten Kebeles in the HDSS were included in the study. Using the demographic surveillance data as sample frame simple random sampling technique was applied to recruit the study subjects after allocation of the sample size proportional to the size of each Kebele. After getting informed consent from each study participant interviewer administered pretested questionnaire was used to collect the data. Data was entered using Epi Info 7 and exported to STATA12 for cleaning and analysis. Bivariate and multivariate logistic regression analyses were applied to estimate the crude and adjusted odds ratios with 95% CI to determine the presence and strength of association. Result: Nearly half (47%) of women use contraceptive during the extended postpartum period. Among this 10(2.4%) women adopted family planning in the first 42 days after delivery, 76(18%) adopted during the first three months and 156(37%) adopted during the first six months after delivery. The most commonly used method was inject able which is 77% during extended postpartum period. Discussion with husband [AOR =0.28;95%CI(0.10-0.77)], knowledge of family planning [AOR=3.71;95%CI (1.93-7.12)], menstrual resumption [AOR=3.71;95%CI(1.93-7.12)], having ANC [AOR=3.81; 95%CI (1.53-9.51)], having PNC [AOR =2.84;95%CI(1.44-5.58)] and having linkage to FP service during immunization visit [AOR =4.31 ;95%CI (2.10-8.81)] were collarets that have significant association with postpartum contraceptive use. Conclusion and Recommendation; PPFP use in Butajjira HDSS is low and is dominated by injectable contraceptives. Discussion with husband, knowledge of FP and use of ANC, PNC and child immunization services was positively correlated with likelihood of using PPFP. Integrating PPFP service with maternal and child health care service further improve the utilization of the service.
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    Assessment of Prevalence of Unintended Pregnancy and Understanding the Reasons in Preventing Unintended Pregnancy among Youth in Ethiopia, 2019.
    (Addis Ababa University, 2019-11) Tirfe Emshaw; Meselech Assegid; Abiy Seifu
    Background: Globally every day 830 women die from preventable causes related to pregnancy and childbirth and 99% of maternal deaths occur in developing countries. Young people and adolescents face higher risk of complication. Unintended pregnancy among young people increases risk of maternal morbidity and mortality. Objectives: The objectives of this study are to estimate the prevalence of unintended pregnancy among youth in Ethiopia and to explore the factors associated with the unintended pregnancy. Methods: We employed mixed methods. The quantitative part applied cross sectional study design using data from Ethiopian Demographic and Health Survey (EDHS) 2016. The dataset was accessed online www.measuredhs.com. The qualitative method applied in- depth interview of purposively selected 15-24 years old female who visited health facilities for antenatal or abortion care service. Quantitative data was analyzed using STATA version 14 software. Descriptive and binary logistical regression analysis techniques were used to estimate the prevalence unintended pregnancy and identify factors associated with unintended pregnancy. Qualitative data was analyzed by open code version 4.02 using content analysis method. Result: Four hundred youths (6.5%) were found to be pregnant from a total of 6,143 (weighted) youths who participated in the 2016 EDHS. Among the pregnant youths 141(35.3%) had no education, 197(49.3%) attended primary school, 372 (93%) were married, 235(58.8%) were unemployed, and 343(85.7%) live in rural area. The prevalence of unintended pregnancy among pregnant youth was 25%. In-depth interview data analysis showed contraceptive failure, not using any modern contraceptive, low risk prediction, lack of support by family, partner disagreement and desire to continue education were found to be the main reasons for having unintended pregnancy. Conclusion and Recommendation: The prevalence of unintended pregnancy among youth in Ethiopia is high. Effort should focus on empowering women to make them psychological and economic independent to enable them decide about their pregnancy. Changing the wrong belief and perception on modern contraception in the community is important to improve utilization of those methods by young women.
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    Assessment of the Magnitude of Bypassing Public Health Center Delivery Service and Associated Factors among Postnatal Women in Negist Eleni Memorial Hospital, South Ethiopia.
    (Addis Abeba Universty, 2016-06) Melesech Elisso; Abiy Seifu
    Introduction: Quality obstetric, medical and nursing care under safe, skilled and well equipped health facilities during pregnancy, child birth and within 6 weeks after birth can reduce the risk of obstetric complications that may cause death or serious illness to the mother, the baby or both. The use of recommended appropriate standard facility in the catchment area for delivery and post partum care strengthen maternal and child health care at individual, community, health care planners and the government level. In developing countries including Ethiopia, bypassing the nearby health facility for childbirth service wastes resources at all levels. However, the magnitude and factors influencing bypassing closer health facilities for childbirth care were not adequately explored. Objective: To assess magnitude of bypassing public health centers to hospital for childbirth and identify factors associated with bypassing in postnatal women in Negist Eleni Memorial hospital. Method: Facility based cross sectional study was conducted among postnatal women in Negist Eleni Memorial hospital from February to March 2016.A pretested and structured interviewer administered questionnaire was used to gather data from 393 randomly selected postpartum women included by using systematic random sampling technique, and then every 2nd eligible woman was interviewed. The data was coded and entered into Epi Info version-7 and exported, cleaned and analyzed using STATA12.1. Tables and charts were used to describe study population and to display results. Bivariate and multivariate analysis was done to identify correlates of bypassing public health centers to hospital for delivery service. Finding: Sixty seven percent of mothers who gave birth in Negist Eleni Memorial hospital bypassed their catchment public health centers. The likelihood of bypassing health center for delivery service were 4.5 times higher among respondents whose husband’s educational level was above secondary education [AOR=4.5; 95%CI=1.06, 20.29],Past obstetric complications[AOR=0.28; 95% CI=0.09,0.86] and antenatal care(ANC) attendance in the health centers [AOR=0.13; 95% CI=0.04,0.46] were associated with less likely hood of bypassing. The odds of bypassing were 7.8 times higher [AOR=7.8:95% CI=3.5, 17.5]for those who were living within 13.02km to Nigist Eleni Memorial hospital compared to those living farther. Conclusion: The proportion of women bypassing health centers to receive childbirth care at hospital in our study is high. Preference of the type of health facility for delivery care is associated with husband education, past obstetric complication, place of ANC follow up and distance to hospital.
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    The Association of Intimate Partner Violence During Pregnancy With Preterm Birth in Addis Ababa, Ethiopia
    (Addis Abeba University, 2019-11) Genet Melak; Mulugeta Betre ; Abiy Seifu
    Background: Preterm birth is a significant and growing public health problem leading to increased neonatal morbidity and mortality. Intimate partner violence during pregnancy is one of the factors that affect not only women’s health but also the health of the newborn. However, the association between intimate partner violence during pregnancy and preterm birth was not adequately studied in Ethiopia. Objective: To assess the association between intimate partner violence during pregnancy and preterm birth in Addis Ababa, Ethiopia. Methods: A facility-based age-matched case-control study was conducted among 420 women [140 cases (women who had preterm births) and 280 controls (women who had term births)] in six public hospitals in Addis Ababa, Ethiopia. Data was collected using a structured, interviewer administered questionnaire. A woman who reported the experience of at least one act of violent act, either physical or sexual or emotional or controlling behaviors by an intimate partner during the index pregnancy period was considered exposed to intimate partner violence during pregnancy. Descriptive statistics were computed to describe the characteristics of study participants. Additionally, the association between intimate partner violence during pregnancy and preterm birth was analyzed using multivariable conditional logistics regression model. Statistical significance was declared at P<0.05. The analysis was performed using Stata 14.0. Results: The odds of preterm birth was four times higher among women who experienced physical violence (AOR: 3.98, 95% CI: 1.03, 15.32), three times higher among women who experienced emotional violence (AOR: 3.64, 95% CI: 1.01, 13.06) and four times higher among women who reported controlling behaviors of their husbands/partners (AOR: 4.32, 95% CI: 1.10, 16.89) during their pregnancy. Conclusion and Recommendation: The study identified that women who experienced physical and emotional violence and whose husbands/partners demonstrated controlling behavior during pregnancy have a higher risk of preterm birth. To reduce the risk of preterm birth, prevention of physical and emotional violence during pregnancy and improving women’s autonomy should be integrated into perinatal care interventions.
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    Association of Maternal Knowledge of Neonatal Danger Signs and Postnatal Care Utilization of Neonatal Services, among Mothers in Butajira, Ethiopia, 2019.
    (Addis Abeba University, 2020-12) Seble Zenebe; Meselech Assegid ; Abiy Seifu
    Introduction: Neonatal period is the first 28 days of life; they face highest risk of death during this time. Global rate of neonatal mortality rate is 19 deaths/1000 births. One of the prevention method which could decrease neonatal mortality is postnatal care to mother and baby after birth up to 6weeks.Worldwide, about one third of the neonates use postnatal care, while its utilization coverage in Ethiopia is very low. Knowledge of the neonatal danger sign is one of important factor for utilization of neonatal postnatal care. Objective :The aim of this particular study was to determine the association between maternal knowledge of neonatal danger signs and postnatal care service utilization of neonate. Method: Community based cross-sectional study using quantitative method was conducted at Butajira Ethiopia. A total of 523 mothers who had given birth before one year were selected using simple random sampling. Data were collected using a pre-tested structured interviewer administered questionnaire. The data were entered using Epi-data v-4.4.3.1 and export to STATA14 for analysis. Bivariate and multivariate logistic regression were done to assess the association between knowledge of neonatal danger signs and utilization of postnatal care of neonate and P-value < 0.05 was used to declare the statistical significance. Result :Postnatal care service utilization of neonates was 78.1% and maternal knowledge of neonatal danger signs were 15.8%. Place of residence [AOR=4.54, 95%CI (1.23-16.77)], place of delivery [AOR=26.9,95% CI (11.5-63.37)] and wealth index [AOR=8.13,95%CI (1.49 - 44.29)] had significant association with postnatal care utilization of neonates with in the first three days. However, mothers’ knowledge of neonatal danger sign had no significant association with postnatal care utilization in the first three days [COR= 0.8,95% CI (0.45 - 1.42)]. Conclusion : In this study mothers’ knowledge of neonatal danger sign hadn’t shown association with neonatal postnatal care service utilization. Mothers in urban areas were found to utilize more neonatal postnatal care service than rural and mothers who had facility delivery were also found to utilize more than those with no facility birth. Strengthen and improve neonatal service provision in rural communities and also encouraging facility delivery is important.
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    Disrespect and Abuse During Facility-Based Child Birth in Yeka Sub-City Health Centers Addis Abeba, Ethiopia.
    (Addis Ababa University, 2019-11) Teshome Gebreamanuel; Mitike Molla; Abiy Seifu
    Background: In Ethiopia, only 48% of all births occur at health facilities. Disrespect and abuse of women by health providers during child birth is one of the main reasons that affect health care seeking from health facilities. Providing compassionate and respectful maternity care services to laboring and delivering women is one of the most important interventions to ensure positive newborn and maternal outcome. However, compassionate and respectful maternity care has received less attention both in practice and research. Objective: To assess the magnitude of disrespect and abuse faced by women during facility based child birth in Yeka Sub- City selected health centers, Addis Ababa, Ethiopia. Method: Institution based cross-sectional study design was employed among five health centers in Yeka Sub-City health centers, Addis Ababa, Ethiopia. Systematic sampling method was used to include 333 women who had given birth at health centers between February 14 and April 9, 2019. Data were collected using a structured face-to-face interview questionnaire. The data were analyzed by Statistical Package for Social Science (SPSS) Versions 22. Descriptive statistics like frequency, percentage, means and standard deviation were used to summarize the data. Bi-variable and multivariable analysis was performed using logistic regression model to identify factors for disrespect and abuse during childbirth. Result: A total of 319 women participated in the study; with a response rate of 95.8%. From the total respondents, 85.3% of women experienced at least one category of disrespect and abuse. The most prevalent forms of disrespect and abuse were ineffective communication 235 (73.7%) and unacceptable companionship 220 (69%) during labor and delivery. Disrespect and abuse were more prevalent during night shifts deliveries (adjusted odds ratio [AOR] = 4.42; 95% CI, 1.91 to10.23), on women who normalized disrespect and abuse (AOR = 2.20; 95% CI, 1.10 to 4.56) and on mothers who delivered by female attendants (AOR = 3.95; 95% CI, 1.10 to 14.64).Disrespect & Abuse during childbirth in Yeka Sub- City, Ethiopia Conclusion and Recommendation: The occurrence of disrespect and abuse was high in this study setting. To decrease the existence of this phenomenon, appropriate interventions should be designed, focusing on supervision during night shifts, empowering women of childbearing age about their rights at health facilities and providing training for health care providers about respectful maternity care. Further community based research incorporated with qualitative method will be needed to explore the possible reasons for disrespect and abuse during facility-based childbirth.
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    Effect of Topical Application of Human Breast Milk, Chlorhexidine and Dry Cord Care on Neonatal Umbilical Cord Separation Time and Rate of Cord Infection in Butajira, Ethiopia 2017/2018: Cluster Randomized Trial
    (Addis Abeba University, 2019-08) Melat Mesfin; Abiy Seifu; Mulugeta Betre
    Background: Annually 1 million newborns worldwide die of infection caused by bacteria that enter the body via the umbilical cord. Regarding this the Ethiopia national strategy of new born and child survival identified chlorhexidine (CHX) as one of the high impact intervention to minimize neonatal mortality. Whereas, studies have shown Human breast milk (HBM) application to the neonatal umbilical cord has a shorter cord separation time and lower rate of infection than CHX or the standard dry cord care (DCC). To the best of the investigators knowledge on to assess cord separation time and rate of cord infection, studies were not conducted comparing the standard DCC with that of CHX or HBM. Objective: Compare the effect of topical application of HBM, CHX and DCC on neonatal umbilical cord separation time (CST) and assess the rate of cord infection at the Demographic and Health Surveillance Site, Butajira, Ethiopia, 2017/18. Method: From May to November, 2018, a three arm, non- masked, community based, cluster randomized controlled trial was conducted at Butajira Demographic and Health Surveillance site (BDHSS) located in Gurage Zone of the Southern Nations, Nationalities and Peoples´ Region (SNNPR) of Ethiopia. Nine kebeles of the BHDSS were randomized into two intervention groups i.e. HBM and CHX and a control group which is the standard DCC using a lottery method. From a sample size of 337, data were entered and analyzed for 302 term singleton newborns. Baseline characteristics across the groups were compared by ANOVA for continuous variables and Chi square for categorical variables. Mean CST was compared among the groups using one way ANOVA whereas the secondary outcome i.e. rate of omphalitis was expressed in terms of frequency and was compared among the groups using Chi square. Level of significance was set at p <0.05 with 95% CI. Result : The mean cord separation time was 5.6 days in HBM group, 5.9days in CHX group, and 5.7days in DCC group but this difference was not statistically significant among the study groups (p value=0.40). The highest signs of cord infection rate were observed in dry care group and this was significant regarding the redness on the base of the cord stump (P<0.001). Conclusion and Recommendations: Topical application of HBM is related with shorter cord separation time compared to CHX or DCC. It also has reduced incidence of infection, as much as topical CHX application. Generally the readily available human breast milk should be given further emphasis.
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    Effective Early Kangaroo Mother Care Coverage and Associated Factors among Low- Birth-Weight Neonates in Selected Hospitals in Oromia Region, Ethiopia
    (Addis Ababa University, 2023-11) Beyene Roba ; Abiy Seifu
    Background: Globally, an estimated 13.4 million newborns were born preterm in 2020, with Southern Asia and sub-Saharan Africa contributing to 65% of cases. Despite the WHO endorsement of KMC for preterm infants, global KMC rates remained below 5% in 2021. In Ethiopia, despite efforts to expand KMC, less than 10% of eligible newborns received any form of KMC in 2021. Objective: This study aimed to determine the coverage of effective early Kangaroo Mother Care (EeKMC), examine associated factors, and identify facilitators and barriers to EeKMC initiation among <2000grams newborns in selected hospitals in the Oromia region, Ethiopia, in 2023. Methods: A facility-based cross-sectional study utilizing mixed methods was conducted. Secondary data were employed to determine EeKMC coverage (which is defined as proportion of <2,000g newborns for whom KMC, consisting of at least 8 hours of skin-to-skin care plus exclusive breast milk feeding, was provided within 24 hours after birth) and associated factors, while in-depth interviews and observations were carried out to explore barriers and facilitators of effective early KMC. The study spanned one year, from October 2022 to November 2023. We included 713 eligible low-birth-weight newborns in the quantitative data analysis. We applied bivariate and multivariate logistic regression analyses, with a significance level set at p < 0.05. We used thematic analysis to analyze the qualitative data. Result: Among 713 <2,000g newborns 4.6% (33/713) received EeKMC, while 55.5% (396/713) received exclusive breast milk feeding within 24 hours after birth. Newborns in the incubator (compared to those outside) [AOR=0.07; 95% CI (0.015-0.34)] were less likely to receive EeKMC. Our qualitative data identified health system related barriers to EeKMC including inadequate healthcare infrastructure, skill gaps, low motivation of healthcare provider, maternal emotional status, post-operative pain, lack of knowledge about KMC, and cultural norms that hasten mothers to go home after birth. Facilitators comprise quality improvement initiatives, visual aids, effective counseling, maternal willingness and regular pregnancy follow-up. Conclusion and recommendation: Our study found that the coverage of EeKMC is low. Comprehensive interventions addressing issues ranging from healthcare infrastructure inadequacies to cultural norms should be implemented.
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    Impact of Food and Nutrition Security on Adherence to Anti-Retroviral Therapy (ART) and Treatment Outcomes among Adult PLWHA in Dire Dawa Provisional Administration.
    (Addis Abeba University, 2007-06) Abiy Seifu; Fikru Tesfaye
    Background: Adherence to Anti-Retroviral Therapy (ART) is critical for optimal virologic suppression and improved CD4+ cell count that in turn determines the survival of People Living with HIV/AIDS (PLWHA) on ART. So far a range of predictors of adherence to ART in many different social and cultural settings have been identified. However, household food and nutrition security as predictor of adherence to ART is less understood. Objective: The main objective of this research project is to assess the effect of household food and nutrition security on adherence to ART and treatment outcomes. Method: A cross-sectional study was conducted to assess the effect of household food and nutrition security on adherence to ART and treatment outcomes. Both quantitative and qualitative research methods were applied to triangulate the findings of one with another. Adult PLWHA on ART for at least 3 months were the study participants. Availability of enough food/money to buy one, behavioral and subjective questions, meal frequency, dietary diversity, food aid and BMI were used as indicators to measure the household food and nutrition security situation of PLWHA and self-reported adherence as an indicator to measure adherence to ART. Change in CD4+ cell count, body weight, functional status and frequency of opportunistic infections were used to measure treatment outcomes. Result: Based on food security assessment core module close to 90% of PLWHA on ART in Dire Dawa were food insecure and 30.1% had at least mild malnutrition. Onpatient self report of adherence 96.6% of them were adherent to 95% of the ART drugsprescribed. The median change in CD4 count after 6 months and the median change inweight after 3 months of ART were 116 (IQR 82-182) and 3kg (IQR 1-6kg) respectively.Reported diarrhea and lung disease among the study participants were 17.9% and 54.1%respectively. Food and nutrition security indicators were associated with treatmentImpact of food and nutrition security on adherence to ART and treatment outcomesAAU, FM, DCH, RH specialty track IXoutcomes. Food aid contributed to functional improvement (OR 1.89, 95% CI 1.20-2.97).Dietary diversity and meal frequency were significantly positively correlated with changein weight and change in CD4 count respectively (p<0.05). Pre-ART nutritional status wassignificantly negatively correlated with change in weight after 3 months of ART(p<0.001).Discussion: Food and nutrition insecurity is a serious problem of PLWHA on ART.Overcoming all the odds to adhere to the treatment PLWHA in the present study wereadherent to ART more than any documented adherence findings. But food and nutritioninsecurity was silent factor that impede treatment outcomes. Food aid, dietary diversityand meal frequency were positively associated with functional improvement, weight gainand CD4 increase. Pre-ART nutritional status was negatively correlated with weight gainindicating better improvement among severely malnourished. Current malnutrition wassignificantly associated with reported opportunistic infections. Conclusion and recommendations: The mere success in achieving high level ofadherence among PLWHA taking ART should not undermine the impact of food andnutrition security on the treatment outcomes which is the ultimate goal of the program.Lack of food to take with medication is the main reason for those few non-adherents and food ration improved functional status of PLWHA on ART. Food aid as relief together with a sustainable income generating activities need to be included in ART program.
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    Inequality in Perinatal Mortality and its Covariates: Secondary Analysis of the Ethiopian Demographic Health Surveys from 2005-2016
    (Addis Abeba University, 2020-07) Abebech Demise; Mulugeta Betre; Abiy Seifu; Mekonnen, Wubegzier
    Background: Perinatal mortality is an important indicator of health and the quality of health care. Countries or regions are often compared using perinatal mortality rate. The aim of the study is to determine the trends and inequality in perinatal mortality and its covariates in Ethiopia by using the three round of Ethiopian Demographic Health Survey (EDHS) data (2005, 2011 and 2016). Method: EDHS sample designs were stratified, clustered and two-stage probability sampling. The trend of perinatal mortality rate was computed using the annual rate of reduction and the 95% confidence interval also used to indicate statistically significant reduction. The inequality in perinatal mortality was measured by using both the simple (ratio and difference) and complex measure of inequality (relative concentration index). The concentration index was decomposed using the “decomp” package in R studio. Result: The trend of perinatal mortality rate in Ethiopia showed slow rate of reduction with 0.72 percent reduction per annuum. Annual rate of reduction for the stillbirth rate was -1.3% whereas the early neonatal mortality was 1.5%. The ratio and difference inequality summary measure for the region showed high disparity across region with highest mortality (Oromiya) and lowest mortality (Harari region), difference (D)= -0.0070, 95% CI (-0.0117, -0.0023) and the ratio(R) = 0.7868 95% CI (0.6619, 0.9354). However, place of residence showed insignificant disparity (difference (D)= -0.0118, 95% CI (-0.0276, 0.0041) and ratio (R)= 0.7254, 95% CI (0.4962, 1.0605)). The results indicated that the concentration index for wealth-based inequality across the three survey years were 0.0158926, -0.0117815 and 0.01130234, respectively. While the concentration index for the level of maternal education over the three-survey year was (-0.00011, -0.0013 and 0.0010), respectively. Conclusion and Recommendation: Even though trend show some rate of reduction in PNMR, the rate remains high in the country. In all survey years (2005,2011 and 2016) there was wealth and level of maternal education-based inequality in perinatal mortality. In order to minimize the inequality in perinatal mortality in Ethiopia effort should be made narrowing the economic variation within population (regions).
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    Level and Reasons for Misclassification of Very Early Neonatal Death into Stillbirth in Public Hospitals of Addis Ababa, Ethiopia.
    (Addis Abeba University, 2020-01) Hanna Feleke; Wubegzier Mekonnen; Abiy Seifu
    Background: Report on stillbirth and early neonatal deaths are susceptible for misreporting, misclassification and omission. The distinction between the two events is that the presence of faint sign of life after delivery. The accuracy and reliability of intrapartum mortality data is very essential for preventing deaths. There is evidence gap in knowing the exact magnitude and reason behind misclassification of very early neonatal death. Objective: To assess Level of and reasons for misclassification of very early neonatal death into stillbirth from March, 2018 to March, 2019 in public hospitals of Addis Ababa, Ethiopia. Method: Cross sectional study with qualitative and quantitative method was conducted among stillbirths and health care providers. 410 still births data were collected from selected hospitals registration. Verbal autopsy was conducted among mothers who had stillbirth through household visits. The collected data was reviewed by three coders. Disagreement on cause of death among two initials coders were resolved by third physician’s independent assessment. In depth interview was conducted among health care providers. The magnitude of misclassification was defined as percentage of stillbirth reported in HMIS registration book that was later classified as early neonatal death in verbal autopsy data. Frequency distribution and cross tabulation was done to measure the level of misclassification. Bivariate and multivariate analysis was done to see the association between misclassification status and health care provider characteristic. Qualitative data was analyzed using thematic analysis. Result: The level of misclassification of very early neonatal death into still birth was 8.54% (35/410). Denial of safe traditional practice was significantly associated with misclassification of very early neonatal deaths, [AOR =0.21; 95% CI =0.05-0.93]. We found that confusion in understanding of the exact definition of perinatal loss, fear of blame, work load and medico legal issues drive health care providers to misclassify very early neonatal death into stillbirth at health facility level. Conclusion and Recommendation: This study shows significant number of very early neonatal death are misclassified into stillbirth. It also describes driving factors for misclassification such as personal, health facility and system related factor. Standard cause of death classification training, creating culture of accountability and favorable working environment are essential to prevent misclassification of very early neonatal death which occur immediately after birth.
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    Magnitude and Factors Associated with Late Stage at Diagnosis of Cervical Cancer Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Abeba University, 2020-12) Wintana Fitiwe; Meselech Assegid; Abiy Seifu
    Background: Globally, cervical cancer is the fourth most common cancer in women with most of the deaths occurring in developing countries, particularly in low- and middle income countries. In Ethiopia, evidences suggested that many women seek treatment in the advanced stage of the disease which complicates management and intervention of the disease. Data on levels and factors associated to late stage of diagnosis are limited. Objective: To assess the magnitude and factors associated with late stage at diagnosis of cervical cancer among cervical cancer patients at Tikur Anbessa Specialized Hospital, Addis Ababa,Ethiopia from July 22 to October 30, 2020. Methods: A facility based cross sectional study was conducted among cervical cancer patients referred to Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Data was collected using a structured interviewer administered questionnaire and patient’s medical records were reviewed to extract relevant information. Every consecutive new case of cervical cancer patient who came during data collection period were enrolled in the study.Data was codedand entered in to Epidata 4.64 and exported to Stata 14 for cleaning, recoding and analysis. Descriptive statistics were computed to describe the characteristics of study participants. Those variables with p-value<0.05 at 95%CI in the multivariable binary logistic regression were considered as having a statically significant association with the outcome variable, late stage at diagnosis. Stage at diagnosis was determined using the International Federation of Gynecology and Obstetrics (FIGO) staging system. Result: A total of 392 women with confirmed cervical cancer were enrolled. The mean age of the patients was 58 ± 10 years, majority 257(65.56%) were married, more than half (56.63%)came from rural area and 229 (58.42 %) had no formal education. About 53.8% of patients were diagnosed with late stage disease. The odds of late stage diagnosis of cervical cancer was more than two times higher AOR=2.38 [95%CI: 1.03, 5.11] among those patients who had poor knowledge, about four times higher AOR= 3.41 [95%CI: 1.69, 6.88] among patients who were residing in rural areas, two times higher AOR=2.03[95%CI: 1.03, 3.99] among patients who had shared their symptom late with someone. Conclusion: This study identified that poor knowledge of cervical cancer, women residing in rural areas and patients who shared their symptom late with someone were more likely to be diagnosed at late stage of cervical cancer. Providing health education for women on early detection methods and raising public knowledge in more comprehendible way is needed for early diagnosis of cervical cancer.
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    Maternal Risk Factors for Prematurity Related Neonatal Mortality among Preterm Neonates Admitted to Neonatal Intensive Care Unit of Selected Referral Hospitals in Addis Ababa
    (2017-11) Dirreba Gemeda; Abiy Seifu
    Background: The neonatal period is considered high risk period in terms of mortality. Globally, approximately 15 million infants are born prematurely each year, which is more than one tenth of all newborn infants. Mortality due to complications of prematurity is the leading cause of neonatal and children under five age death. Little is known about specific maternal risk factors for prematurity related neonate mortality. Objective: The aim of the proposed study was to identify risk factors for prematurity related neonate mortality. Methods: A facility based nested unmatched case control study design was employed to identify maternal risk factors for prematurity related neonatal mortality. Cases were preterm neonates who died and controls were preterm neonates who survived 28 days of neonatal period among those admitted to NICU ward. The study was conducted from July 25, 2016 to May 29, 2017 at neonatal intensive care units of three Referral hospitals in Addis Ababa city. The total sample size was 471 with 157 cases and 314 controls. Data was entered using Epi Info 7 and analyzed by STATA 12. Bivariate and multivariate logistic regression models were applied to measure the associations between the prematurity related mortality and maternal risk factors. Results: The mean/median gestational age of cases and controls were 30.6/30 and 33.6/34 weeks respectively. The mean (±SD) age of the mothers of cases was 25.8(±4.6) years and that of mothers of controls was 26.6(±4.7) years. Having no formal education [AOR (95% C.I): 6.586 (2.467, 7.582)], ANC visit [AOR (95% C.I): 2.791 (1.604, 4.857)], maternal anemia during pregnancy [AOR (95% C.I): 2.921 (1.396, 6.112)], urine test suggesting infection [AOR (95% C.I): 3.513 (1.261, 9.787)], and antepartum hemorrhage [AOR: (95% CI): 3.151 (1.509 , 6.577)] were found to be risk factors for preterm neonatal mortality. Conclusion and Recommendations: Maternal education, poor antenatal care, maternal anemia, and ante partum hemorrhage have strong association with mortality among premature babies. Reduction of mortality among premature babies requires multi-sectorial response. The Ministry of Health (MOH) should give more emphasis to strengthening routine antenatal care and management of obstetric complications like antepartum hemorrhage. The Ministry of Education (MOE) on the other hand should pay special attention to women’s higher education; Promotion of proper maternal nutrition could be enhanced through joint effort of the ministries of education and health.
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    Utilization of Long Acting Contraceptives among Reproductive Age Women in Addis Ababa Public Health Centers.
    (Addis Abeba University, 2014-06) Bizuayehu Nigatu; Mesfin Addisie; Abiy Seifu
    Background: Long acting contraceptives such as intrauterine devices and hormonal implants are among the most effective methods that prevent unintended pregnancies. Long acting contraceptive is more convenient to clients who want to space or limit their births. Clients have better compliance to long acting contraceptive than the short acting methods, since they do not need to remember to use them or to visit family planning clinics frequently for method re-supply or administration. Objectives: To assess the utilization of long acting contraceptives among female family planning users at public health centers in Addis Ababa. Methods: A facility based cross sectional study that employed exit interviews with family planning clients and an assessment of the availability of the necessary resources was conducted in selected five public health centers, from March 11 –April 4, 2014 in Addis Ababa. Systematic sampling technique was used to select 447 study participants .Pre tested structured Amharic version questionnaire was used to collect the data through interview and inventory was carried out by using checklist. Both bivariate and multiple logistic regressions were used to identify associated factors. Result: Of 447 female family planning users interviewed 98.9% of them were aware of long acting contraceptive methods and 23.9% were using the methods. However, 48.3% respondents have negative attitude towards long acting contraceptive. Facility assessment showed that in the health centers assessed there were no shortages of resources for provision of long acting contraceptive including equipment's and supply, trained health provider and contraceptives Methods. Attitude of clients, previous use of long acting contraceptive, desire to have no children in the future and discussion with partners about long acting contraceptives were factors associated with long acting contraceptives use. Conclusion and recommendation: Knowledge about long acting contraceptive is high in contrary to the negative attitude for most respondents have towards the methods and low level of utilization. Providing appropriate counseling on long acting contraceptive, strengthening continuous education by model long acting contraceptive user, strengthening couple discussion and availing printed materials on long acting contraceptive are recommended.