Browsing by Author "Mulugeta Betre"

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    Assessment of Health Care Service Working Mothers Exclusive Breast- Feeding Practice and Their Perception Towards the Breastfeeding Support Program at Work Place in Governmental Hospitals in Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-06) Tseganesh Tesfaye; Mulugeta Betre
    Background: In different parts of Ethiopia employed mothers wean breast feeding earlier than unemployed mothers due to early returning to work after child birth. A recent World Health Organization (WHO) internal employee's based study recommended that the employer should provide, prenatal/ postpartum services, which include separate rooms for breastfeeding, nursery childcare and provide flexible time and lighter job to working mothers. Objectives: To assess health care service working mothers exclusive breast-feeding practice and determining factors and their perception towards the breast-feeding support program at work place in Governmental hospitals in Addis Ababa, Ethiopia 2020. Methods: A mixed methods research of institutional based cross sectional quantitative study design supplemented with qualitative method was conducted in Addis Ababa Governmental hospitals. For the quantitative portion the sample size was estimated using a single population proportion formula and become 403. For the qualitative, in-depth interview was done for working mothers having child less than 2 years until information of interest is saturated. Simple random sampling technique was used for the cross sectional quantitative research design and purposive sampling for the qualitative. The data for the quantitative was collected using a face to face interview questionnaire and semi-structured interviews for the qualitative data. For the qualitative, during dada collection period, the obtained data through Interviews was audio taped by digital sound recorder. Descriptive statistics such as frequencies, proportions, and measures of central tendency and measures of variation used to describe the distributions of variables. The logistic regression model was used to assess the relation between dependent and explanatory variables. The qualitative data analyzed using content analysis. Result: Only 95(24.1%) continue EBF after returning to work and majority of them stop EBF before six months due to work related reason 270(89.9%) while the rest were due to different reasons 30(10.15%). The odds of discontinuing EBF after return to work is 8 times higher (OR: 7.98, 95% CI 1.64-38.90) among women who works in shift compared to women who works by the regular office hours. With all the importance that the mothers mentioned about the breast feeding support program but they prefer not to use the program due to cleanliness issues and transport related problems. Conclusion: Health care service working mothers discontinue EBF before 6 month due to different reasons but mainly due to work related reason and mothers intention to use the breast feeding support program which helps mothers to continue EBF is affected due cleanliness issues, transport difficulties, hospital acquired infections and work overload.
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    Assessment of Magnitude and Factors that Affect Care Givers’ Disclosure of HIV Diagnosis to their HIV Infected Children in Addis Ababa Ethiopia 2013/2014.
    (Addis Abeba Universty, 2014-05) Roman Negewo; Mulugeta Betre
    Background: Most studies conducted on HIV disclosure to infected children report on the challenges experienced by caregivers to disclose HIV status to their HIV infected children. Therefore it‟s essential to look for factors that affect care givers' disclosure of HIV diagnosis to their HIV infected children in these settings. Objective: To assess magnitude and factors affecting care givers' disclosure of HIV diagnosis to their HIV infected children in Addis Ababa Ethiopia. Methods: A facility based cross-sectional study was conducted. A study was conducted from February 2014 to April 2014 among 372 primary caregivers of HIV infected children aged 6-15 years in nine health facilities, Addis Ababa, Ethiopia. Data were collected through structured pre tested questionnaire. It consisted of both closed- and open-ended questions. Data were entered into EPI Info version 3.54 and analyzed by using SPSS version 21 for windows. Descriptive statistics such as frequency, mean, median, standard deviation, and range were used to summarize the results. Bivariate and multivariate logistic regression analyses were done. Qualitative study were used to support the quantitative study. Data were summarized by using tables. Results: Based on caregivers reports, 111 (29.8%) of the children knew about their HIV positive status. Marital status of caregivers, age of the child, Caregiver's HIV status, those caregivers discuss about disclosure issue with healthcare providers and children who get aid or support from charity organizations. were found to have statistically significant association with disclosure of HIV positive status to HIV infected children at p<0.05 in multivariate analysis. Conclusion: Parents or guardians may have a critical need for health education and counseling in order to develop a plan for disclosing to their children. Addressing and scaling up efforts on stigma and discrimination in neighborhoods, communities, and school settings; and developing guideline for disclosure of children with HIV/AIDS in Ethiopian context will increase the rate of disclosure of children's HIV positive status.
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    Assessment of Menstrual Hygiene Management (MHM) Practice, Associated Factors and its Effects among School Girls of Northern Shewa, Ethiopia
    (Addis Abeba University, 2021-09) Engidashet Tsedeke; Mulugeta Betre; Solomon Emyu
    Background: Menstrual hygiene management (MHM) is a process of managing menses wi necessary supplies and conditions by health and development promoted. Adolescents and youte specially school girls in the rural area are the prime victims of MHM problems. MHM challenge in low and middle income countries gain global attention recently. Generating context specifevidences would have paramount importance to design proper interventions. Objective: To assess menstrual hygiene management practice, associated factors and its effecamong school girls of Mida Woremo District in North Shewa, Amhara Region, Ethiopia, 2019/20. Method: School based cross-sectional study design with stratified sampling procedure waapplied. Samples were selected by lottery method from each stratum. Data was collected by sel administered questionnaire, FGDs and observation. Data was entered to Epidata version 4.6.2 anexported to SPSS version 25 for analysis. Both descriptive and binary logistic regressioconducted for quantitative and thematic analysis for qualitative part. Association expressed terms of COR and AOR with 95% CI by using p-value<0.05 as cutoff point. Result and Conclusion: Response rate of the study was 98%. MHM practice among schogirls was 39% (95%CI: 35%, 44%). Good knowledge, father’s occupation (government emplo other), family income ≤3350, have no pocket money, having TV and having private water line were significantly associated with MHM practice. Both health related (depression, illness/pain and development related (absenteeism, distraction of concentration etc.) problems were commoamong school girls. Improving knowledge of school girls and the general public, strengthening existing intervention and its monitoring and evaluation and cooperation and integration wouhave benefit of in improving MHM practices among school girls.
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    Assessment of Parent-Adolescent Communication on Sexual and Reproductive Health Matters in Awassa Town, Snnpr, Ethiopia.
    (Addis Abeba Universty, 2009-07) Martha Fikre; Mulugeta Betre
    Introduction :Sexual and reproductive health problems of adolescents in Ethiopia are rising from time to time. This may be associated with early sexual initiation. Different researches done in different countries had showed that good family communication regarding sexual risk behavior has been positively associated with a delay in sexual activity. There are different factors affecting communication between parents and adolescents regarding SRH issues which are uncovered. Objective: The study is done in an attempt to identify those factors and the influence of parent-adolescent communication on sexual and reproductive health of students Methodology- A cross-sectional descriptive study involving 694 randomly selected students among four high schools in Awassa, Ethiopia. A pretested structured anonymous questionnaire was used to collect quantitative data, which was entered, cleaned and analyzed using SPSS version 11.0 statistical package. Qualitative information was obtained from four focus group discussions and sixteen peer-to-peer interviews segregated by gender. A binary logistic regression analysis was used to asses the impact of determinants. Results: Two hundred five (30.4%) of the students discussed with either of their parents in at least two topics of SRH. Nevertheless, most of the respondents preferred to discuss SRH issue with their peers/friends than their parents. Mother being literate [OR=1.63; 95%CI=1.17, 2.27], adolescents’ having knowledge on STI, contraceptive, fertile period during menstrual cycle and emergency contraceptive [OR=2.56; 95%CI=1.51, 4.62, OR=2.17; 95%CI= 1.32, 3.53, OR=1.57; 95%CI=1.13, 2.18 and OR=2.58 95%CI=1.84, 3.63 respectively] were associated with communication of parent and adolescents on SRH. The most reported factor that affects communication between parents and adolescents on SRH issues were shamefulness, parents’ lack of knowledge and that the issue is culturally unacceptable. Both males and females were more comfortable to discuss sexual and reproductive health issues with mother. There is significant difference across gender where more females being comfortable discussion with mother [OR=2.37; 95%CI= 1.60, 3.49]. Conclusion and Recommendation: The overall research finding shows that communication on SRH issues promotes healthy behaviors of adolescent. Nevertheless, there is low communication between parent and adolescent on different SRH issues with different reasons for not discussing. Hence, based on the findings obtained in this study it is recommended that comprehensive family life education (FLE) should be initiated for the students and parents in school, home, religious institution, and health facilities for effective communication to occur on SRH. In addition programs working in ASRH should include parents to address parental influences on adolescents’ reproductive health and work to alleviate those factors which affect communication between parent and adolescents. Additional research needs to explore the influence of parent –adolescent communication on SRH issues on adolescent reproductive health especially using analytical studies.
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    Assessment of Parental Influence on Pediatrics highly Active Antiretroviral Therapy (HAART) Adherence in Addis Ababa, Ethiopia, May, 2010.
    (Addis Ababa University, 2010-05) Frie Hailu; Mulugeta Betre
    Back ground: Ensuring good adherence is critical to the success of highly active anti-retroviral therapy (HAART). Failure to adhere very closely to the regimens results in continued viral replication, treatment failure and the emergence of drug resistant strains of human immune deficiency virus (HIV). Although parents and caregivers may have primary responsibility for their children©s medication-taking, there is no single study that examined parents influence on pediatrics highly active anti-retroviral therapy (HAART) adherence in our set up. The result of the study is expected to help device intervention strategies to improving children’s adherence on highly active anti-retroviral therapy (HAART). Objectives: To assess the status, determinants of adherence and identify parental factors influencing pediatrics highly active anti retroviral therapy (HAART) adherence in Addis Ababa. Methods: An observational: descriptive, cross sectional study was conducted in 9 Health institutions: public, private and Non Governmental Organizations (NGOs) in Addis Ababa. Multi-stage sampling procedure was used to select a total of 586 children: age 0 - 14 years, Human Immune Deficiency Virus (HIV) infected and started anti-retroviral therapy (ART) 12 weeks ago.Primary care givers of the children were enrolled after the nature of the study was explained that allowed informed decision to be made and written consent obtained. Data was collected from February 8- May 10, 2010 on socio demographic, parent factors, clinical markers,care givers to provider relationship and regimen variables. Structured questionnaire and focus group discussion were used. Univariate, bivariate and multivariate analysis was carried out. Result: The parental factors were strongly associated with non adherence; children who had non biological parents [OR=9.805(95%CI= 2.198, 43.736)], parents who didn’t communicate about HIV and ART adherence to their children [OR=3.915 (95%CI= 1.273, 12.036)], and parents who hadn’t good relationship with health care providers [OR=29.592(95%CI= 1.326, 660.333)] were more likely non adherent. Children who had more than four siblings [OR= 5.676 (95% CI=2.100, 15.339)] were also significantly associated with non adherence. Conclusion: The parental factors were strongly associated with non adherence. The need for providers to have smooth relation ship with the care givers of the HIV infected children on antiretroviral therapy, support caregivers to communicate with their children about the disease and antiretroviral therapy adherence is critical. Further research is recommended to explore the validation of self report adherence using longitudinal study designs.
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    Assessment of Quality of Care in Tikur Anbesa Specialized Teaching Hospital Neonatal Intensive Care Unit, Addis Ababa, Ethiopia
    (Addis Abeba Universty, 2015-06) Redeat Workneh; Mulugeta Betre
    Background: Despite the increasing population and unsatisfactory decline of neonatal mortality rate (NMR) less attention was given to Neonatal Intensive Care Unit (NICU) until recent years where a little effort is being made to improve the services provided. Currently there are 27governmental NICUs; Tikur Anbessa Specialized Teaching Hospital (TASTH) is one of these hospitals which serve as the main referral center. Regardless of the few number of NICUs there is complaints on the quality of care provided which might be due to a variety of reasons that are crucial for the survival of the neonates. Objectives: To assess the quality of care in TASTH, NICU in Addis Ababa, Ethiopia. Methods: Hospital based cross sectional study was used. The study has two categories of participants; primarily mother of the neonates who were available in the NICU during the data collection period and health professionals (n=35) working in the NICU. Sample size of the study on mothers was calculated using single population formula considering 50% prevalence which gives a total 384 participants. The unit was observed using inventory checklist from WHO Hospital Care for Mothers and Newborns: Quality Assessment and Improvement Tool. For the qualitative portion head of the unit (neonatologist), practicing neonatologist and the head nurse were included. Structured questionnaire was adopted from WHO Hospital care for mothers and new-born babies: quality assessment and improvement tool, and they were filled by the date collectors after obtaining an informed consent. Data was analyzed using SPSS version 20. P value of 0.05 was the cut off point for the level of significance. Adjusted odds ratio was used to show strength of association. Result: The study found that the quality of care that is provided in the neonatal intensive care unit in TASTH is inadequate. Overall service satisfaction was found to be 96.4% and 47.1% for the clients and health professionals respectively. Clients whom their neonates shared bed with others were 6.6 times not satisfied than those clients whom didn’t, AOR (95%CI) 6.612[3.604, 10.109] Health professionals who don’t think that there are a sufficient number of staffs were dissatisfied 3.15 times compared to those who think the number of staff is sufficient. AOR (95%CI) 150[0.050, 5.611] Conclusion and Recommendation: Quality administration demands several strategies thus, it is fundamental to identify the problems, aiming at implementing effective actions, and monitoring the processes. The findings from this assessment would assist in scaling up of such units. More over the presence of national guideline which is specific to NICU would be a key to solve the problems associated with quality of care in NICUs.
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    Assessment of the Extent and Determinants of Functionality of Health Extension Workers in East Gojjam Zone, Amharra Regional State, Ethiopia.
    (Addis Abeba University, 2009-06) Getachew Hailu; Mulugeta Betre
    Background :Previous studies have identified factors affecting Health Service Extension Program implementation as well as working conditions of Health Extension Workers in Ethiopia. Most of the studies conducted were qualitative and none of them raised the question to what extent HEWs are functional and what are its determinants. The present matched case control study was conducted to evaluate risk factors for functionality of HEWs after a cross sectional census survey determination of extent of HEWs functionality. Objective: A study was undertaken to determine the extent of HEWs functionality and to evaluate determinants of functionality of HEWs in East Gojjam Zone, Amharra National Regional State. Method: A population based matched case control study after a cross sectional preliminary census survey was conducted in East Gojjam Zone from March to May 2009. A total of 632 health extension workers were included in the cross sectional census survey. All of the (n=25)eligible cases (nonfunctional HEWs) in the zone were included in the study. Two randomly selected controls [(n=50)(functional HEWs)] working from 2003 to 2008 in the same zone from which the cases were enrolled were matched for each case for age, service year, marital status and woreda of the case. Data collection instruments of separately designed self administered and interview based structured questionnaire were used for the cross sectional and matched case control studies respectively. Result: Over all non functional prevalence of HEWS in East Gojjam Zone was 4 %( n=25) The final multivariable model identified health institution support (adjusted matched odds ratio [Adj.mOR=40, 95% CI=4.5_360]), selection pattern [Adj.mOR=11.2, 95% CI=1.3_98.9], and Future aspiration,[Adj.mOR=2.1 95% CI=1.3_57], as independent determinants of functionality of HEWs after adjusting for other variables in the model. Conclusion: In general functionality of HEWs was found to be encouraging. The majority (96% n=607) were functional where as 4 %( n=25) were non-functional. HEWs are doing better the family health, personal hygiene and environmental sanitation and health education services but communicable disease prevention and control service needs more effort. Health institution support, selection pattern and future aspiration had been identified as independent determinants of HEWs functionality. The program need to employ many qualified HRH for training, supervision and support. Therefore, the real cost of scaling up HEP, including the additional qualified HRH for supervision and training, should not be neglected. Moreover the need for career structure for HEWs is a high concern.
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    Assessment of Use of Information Technology in Pharmacies and Drug Stores in Addis Ababa, Ethiopia
    (Addis Ababa University, 2010-06-01) Tadesse Gebre; Mulugeta Betre
    Back ground: Advance In information technology (IT) provides easy use and access to exploit its benefits. Information technology is currently important in improving healthcare delivery system. They improve efficiency, effectiveness, and reduce medication errors . However, the use and access of this in formation technology at pharmacies and drug stores level among d rug dispensing professionals is little known in Ethiopia, particularly in Addis Ababa. Objective: To assess the u se and access of information technology among pharmacists and druggists in pharmacies and drug stores in Addis Ababa and to identify the factors that affecttheusc of this technology. Method: A cross sectional survey was conducted in pharmacies and drug stores in Addis Ababa. The quantitative data were collected using pretested and self Administered questionnaire. The study Vas complimented with in-depth interview. Data were entered and analyzed by SPSS version 15.0. Result: A total of 257 pharmacist and druggists pa reticulated the study. The current means of giving service to customers .in pharmacies and drug stores was about t 93.0% paper -based (manual ) system and 7.0% were u sing computer system. Only 30(1 2.0%) professional had in tenet access in pharmacy/drug s tore. The most preferred source to obtain drug information was combination of printed sources and d rug inserts (manual system) 169(68.1%). Use of IT in pharmacy/drug store was poor. Conclusions and recommendations: The study indicated poor utilization status of IT for pharmacy practice service. The findings indicated the need for creating awareness among professionals In giving more skill oriented and also forma l in service IT re la ted trainings for the professionals. Further, the drug profess Iona t raining centers as well as other stakeholders should cons id reapproving the IT facilities for drug dispensing professional is to achieve better universal access and see of IT so as to improve healthcare delivery system, particularly pharmacy practice
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    Association Between Women’s Empowerment Stunning among Children Aged 6to59 Months: from 2016 Ethiopian Demographic and Health Survey.
    (2019-11) Yirgalem Shibiru; Mulugeta Betre; Mengistu Yilma
    Background : Stunting is predominantly irreversible nutritional deficiency disorder of children. Evidences on the impact of women empowerment to reduce child stunting are limited in Ethiopia. Objective: To determine the association between women empowerment on stunting among childrenaged6to59 months from the2016 Ethiopian Demographic and Health Survey datasets. Methods: The study used the Ethiopian Demographic and Health Survey 2016 dataset, which is a cross sectional study. The study participants were current married women of there productive age(15– 49years) group living with their husbands or partners whohavechildrenaged6-59monthsinthehousehold who were alive at the time of the survey. Data selected and exported to SPSS version 22foranalysis. Complex sample binary logistic regression analysis was employed to determine the association between children stunting aged 6-59 months and the predictor variables. In addition, multivariable logistic regression model was performed using variables that are significant at Pvalue ≤.05with95%ofconfidencelevel. Result: The prevalence of stunting among children aged 6- 59 month with 95% confidence interval was 41%(3,318) (95%CI: 39% - 43.3%). Around 45 %( 3806) of mothers employed in the last 12 months before the survey. Among mothers who had a job, 2072(54%) had seasonal jobs and the rest 1734(45%) had jobs throughout the year. About 50.5 %( 1921)of the mothers have been not paid for the job they were engaged with. Approximately 5855(69%) of mothers have had a positive attitude towards the husband justifying hitting or beating his wife. Maternal attitude towards wife beating (AOR [95% CI]) = 1.057[0.889, 1.256]), decision on large household purchase (AOR [95% CI] = 1.001[0.807, 1.243])had no association with child stunting .In contrast, Household wealth index (AOR [95% CI]) = 1.98 [1.44, 2.726]), Maternal height (AOR [95%CI] = 1.9[1.280, 2.82]), child sex (AOR [95% CI] = 1.255[1.077, 1.463]) were significantly associate with child stunting. Conclusion and Recommendation: The study indicated very high child stunting among children age 6-59 month. It also identified low women’s economic and socio-familial empowerment. Thus, it is recommended that Ministry of Health up to local health service authority should strengthen their effort on the implementation programs which aim to improve childhood undernutrition. Advocacy programs should be introduced to strengthen the practice on implementation policies and proclamation that enshrines women’ right so as to support women empowerment and thereby improve young childhood nutrition in Ethiopia.
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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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    Current Utilization of Reproductive Health Services and the Role of Peer Influence among Undergraduate Students of Wachamo University, Hosanna, SNNPR, Ethiopia
    (2017-11) Tsegaab Temesgen; Mulugeta Betre
    Background: Youth health is dependent on several complex and interdependent factors such as socio-cultural influences, social support structures (such as families, peers and communities), access to health services, education and employment opportunities. Objectives: To assess current utilization of reproductive health service and role of peer influence among regular undergraduate students of Wachamo University, Hosanna, SNNPR (Southern Nations and Nationalities People Region), Ethiopia. Methods: An institution based quantitative cross sectional study supplemented by qualitative method was conducted in Wachamo University, Hosanna, Hadiya zone, SNNPR, Ethiopia March, 2017. Multistage sampling method was used to select study subjects. A total of 389 study participants were selected for quantitative part. The data from the quantitative part of the study was entered in Epi info version 7 and analyzed using SPSS version 21. Whereas purposive sampling technique was used to select2interviewees for indepth interview which were health care providers and 40 regular undergraduate students in Hosanna campus of Wachamo University for 4 focus group discussions (FGD) . For the qualitative component, recorded data was transcribed and open code software was used to carry out content analysis, then results were triangulated with the quantitative findings. Results: From the total of 385 respondents, 227 (59%) utilized at least one of the reproductive health (RH)services in the past 6 months. sex(AOR=3, 95% CI: 1.15, 8.37), friend mentioned about importance of utilization of RH services(AOR=3.02, 95% CI: 1.19, 7.64), attitude of peer /friend on utilization of RH services(AO R=2.97, 95% CI: 1.11, 7.89), experience of discouragement not to use RH services(AOR=4.38, 95% CI: 1.44, 13.28) remained significantly and independently associated with current utilization of Sexual and Reproductive Health (SRH) services (CI 95%, cut off point for significance level P<0.05). The main problems identified from the qualitative finding hindering the current utilization indicated were lack of awareness, fear of being seen and feeling ashamed ,shortage of equipment and skilled provider as well as small service provision rooms of the facility. Conclusion: In general, it was found that current RH services utilization among youth in this study area was low. Interventions such as improving knowledge of the youth with regard to SRH issues, strengthening youth and RH centers in the campus with necessary supplies as well as training of the staffs and peer educators should be sought.
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    Demand for Long Acting Contraceptive Methods and Associated Factors Among Family Planning Service Users in Public Health Centers, Addis Ababa, Ethiopia, 2017
    (Addis Ababa Universty, 2018-07) Bahrnesh Debella; Mulugeta Betre
    Background: All individuals and couples have a basic human right to decide freely and responsibly the number, spacing, and timing of their child. However, the use of FP in Ethiopia has been limited to short-acting methods due to limited access to LAFPM, commodity shortages, and lack of skilled health care providers to offer services at the community level. The prevalence of LACMs use is 13% in the world and LACM use coverage is 2%, for Sub-Saharan Africa [6] and for Ethiopia, LACM use coverage is 3.7% [7] also the prevalence of implant in 2000, 2005, 2011 and 2016 show (0, 0.3, 3, 8) respectively but still the trend show slow improvement [8]. Objective: To measure the demand for long acting contraceptive methods and associated factors among family planning service users in public health centers, Addis Ababa, Ethiopia, 2017. Methods: Cross-sectional facility based descriptive quantitative study was conducted from July 1 - August 1, 2017 in selected government HCs in Addis Ababa, Ethiopia. Multi stage sampling technique was used to select the 848 study samples. A pre-tested and structured questionnaire was used to collect the data. The data analysis was performed using Statistical Package for Social Sciences (SPSS) version 20 software. Descriptive, bivariate and multivariable logistic regression analysis was done. Odds ratio from logistic regression was used to identify their association with demand of LACMs. P-value <0.05 was considered to show statistical significance. Result: The demand for LACM was 650 (76.7%). Among demanded LACM, 305 (36%) meet need and 345 (40.7%) unmet need. The multivariate analysis showed that being married [AOR: 0.562(0.335, 0.941)], primigravida [AOR: 0.402(0.228, 0.709)], ever heard about LACM [AOR: 2.762(1.529, 4.991)], knowledge on LACM [AOR: 2.210(1.298, 3.763)], attitude [AOR: 15.755 (9.628, 25.782)], perceived good quality service at health facility [AOR: 4.219(2.781, 6.40)] were found predictors of the demand for LACM in this study. Conclusion: the demand for LACM according to this study was high and the unmet need for LACM also high. Marital status, gravidity, information on LACM, knowledge on LACM, attitude on LACM and perceived quality of health facility service affect the demand for LACM in this study. Recommendation: Based on this study the demand and unmet need for LACM was found high so it is better to utilize the opportunity to provide the service to meet
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    Effect of Time of Cord Clamping on Serum Bilirubin Level among Full Term Babies Born at Tikur Anbessa Specialized Hospital: A Randomized Control Trial.
    (Addis Abeba University, 2020-06) Biruk Hailu; Mulugeta Betre
    Background: The right timing for umbilical cord clamping has been a topic of interest for a very long time. Delayed cord clamping above one minute has linked with short and long-term nutritional and developmental benefits; otherwise delaying cord clamping associated with elevated serum bilirubin level as potential harm that could lead to jaundice requiring phototherapy at the early ages of life. Objective: To evaluate the effect of the time of cord clamping on the serum bilirubin level and measure the serum bilirubin level difference between immediate and delayed cord clamping groups within 24 hours of birth from October 2019 - January 2020. Methods: This study is ethically cleared three-arm, single blinded, randomized controlled study among healthy, full term neonates born in Tikur Anbessa Specialized Hospital, Ethiopia. A total of 141term babies calculated with 95% CI and 90% power as samples and enrolled in the study after screening for eligibility and have their mothers’ consent. Study participants were randomly assigned across the two arms of the study; immediate cord clamping (< 1 minute and delayed cord clamping (1-3 minutes). The newborns are assessed for the outcomes at the age of 24 hour and before discharge to home using bilirubinometry and Bhutan nomogram. Basic descriptive analysis conducted to assess the maternal social, obstetric and demographic characteristics with number and percentage. Pearson Chi-square, Fisher’s exact and Kruskal Wallis tests used to compare the association between maternal, fetal factors and time of cord clamping by groups. Simple and linear regression analysis used to predict serum bilirubin level from the predictor variables. Result: Maternal demographic, social and obstetrics factors were not different between the groups except labour duration that had a P-value < 0.05. Time of cord clamping was not a significant predictor of total serum bilirubin levels at the age of 24 hours rather Cord blood total serum bilirubin (TSB) (coef. 0.24) and bilirubin nomogram high risk zone (Coef. 6.25) were significant predictors with P-value of 0.011 and < 0.001 respectively. Conclusion: Time of umbilical cord clamping have no significant association with the total serum bilirubin level of neonates at least within 24 hours of birth.
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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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    Examination of Current and Future Determinant Factors of Modern Contraceptive Use among Youth in Addis Ababa, Ethiopia.
    (Addis Abeba University, 2019-12) Abilba Mark; Mulugeta Betre; Nigussie Assefa
    Background: Family planning and modern contraceptive use have relatively little attention to the roles that could be played among the youth regarding fertility regulation. Consequently, there is a shortage of information on modern contraceptive use as regards to knowledge, attitudes and practices among the youth alongside future intentions, and their fertility preferences in Addis Ababa. Objective: To identify current modern contraceptive use, intention to use in the future and determinant factors among the youth population of 15 to 24 years in Addis Ababa Methods: The study used a community-based cross-sectional quantitative survey conducted from July 2018 to June 2019 in Addis Ababa. A total of 552 youth within the ages of 15-24 years were included in the study through multi-stage random sampling technique. Data were collected through structured pre tested questionnaire. Data were entered into Epidata 4.4.3.1 and analyzed by using SPSS version 23 for windows. Descriptive statistics such as frequency, mean, median were used to summarize the results. Bivariate and multivariate logistic regression analyses were done. Quantitative data were summarized by using tables. Results: Main source of information was the media, 407(82.9 %) which formed the highest. Out of 522 participants, Two hundred eighty eight (52.2%) are ever users, 249(45.1%) are current users, and 264(47.8%) are never users of modern contraceptives. In multiple logistic regression analysis, age, having a partner, discussion with partner or spouse, was significantly associated with current modern contraceptive use. Conclusions: The study showed a high prevalence of knowledge of contraceptive methods among the youth, and high intention to use in the future. Age group 15 to 19 years had high level of modern contraceptive use. Generally current use of modern contraceptives methods is below fifty percent (45.1%) which is below the Government target goal in Addis Ababa. Family planning/modern contraceptives programs should focus on having partners, spousal discussion; encourage youth ages 19 to 24 years to use modern contraceptives and more media advocacy on modern contraceptive
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    HIV Seroconversion and Associated Factors among Booked Seronegative Pregnant Women in Kobo Town and Raya Kobo Woreds, North Wollo, Ethiopia: Institution Based Cross- Sectional Study.
    (Addis Abeba University, 2020-12) Dawit Sisay; Mulugeta Betre; Ewunetu Firdawek
    Background: Under the current practice, pregnant women who were Human Immunodeficiency Virus (HIV) negative on the first test are considered to be HIV negative throughout. A repeat HIV test three months later would identify HIV seroconversion and ensure early intervention to prevent mother to child transmission of the virus. The objective of this study is therefore to measure the magnitude of HIV seroconversion and to identify factors associated with HIV seroconversion among booked first-time test seronegative pregnant women. Methods: An institution-based cross-sectional study was conducted among HIV negative pregnant women in Kobo Town and Raya Kobo Woreda, North Wollo, Ethiopia from June to July 2020. Data were collected using a questionnaire through face-to-face interviews along with a client card review. HIV re-testing was performed to know the current HIV status of pregnant women. The collected data were entered into Epi data version 4.4.1 and were exported and analyzed by SPSS version 25. A p-value < 0.25 in the bivariate analysis were entered in the multivariable logistic regression analysis and a p-value of < 0.05 was taken as statistically significant. Result: From a total of 494 pregnant women who were screened and reported negative for HIV at first ANC, six (1.2%) were HIV seropositive during retesting. Upon multivariable logistic regression, pregnant women who have had a reported history of sexually transmitted infections [AOR=7.98; 95% CI (1.206, 52.818)], participants’ partners reported travel history for work frequently [AOR=6.00; 95% CI (1.093, 32.993)], and sexually abused pregnant women [AOR=7.82; 95% CI (1.194, 51.243)] were significantly associated with HIV seroconversion. Conclusion: The notable seroconversion rate found in this study implies that it is not enough to test pregnant mothers once during the first antenatal care clinic. Rescreening of pregnant women after the booking is a beneficial strategy to allow the timely provision of ART prophylaxis to HIV seroconverting women and their exposed babies for the elimination of mother to child transmission of HIV. Further expanded and large scale study should be conducted to understand the magnitude and the factors of HIV seroconversion during pregnancy at various levels.
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    Individual and Family Factors on Adolescents’ Engagement in Risky Sexual Behavior among High School Students in, Addis Ketema Sub City, Addis Ababa, Ethiopia
    (Addis Ababa University, 2013-06) Tewodros Fantahun; Mulugeta Betre
    Background :Adolescents undergo a period of development when biological, physical, cognitive, and social traits mature from childhood to adulthood. Many important life events and health-damaging behaviors start during the youth years. As a result, adolescence is a time of both risk and opportunity. Objective :The objective of this study is to assess, the role, individual and familial factors have on adolescent’s engagement in risky sexual variable among high school adolescents in Addis Ketema sub-city, Addis Ababa, Ethiopia. Methodology :A cross-sectional study was conducted; comprising quantitative method of data collection, on 412 high- school adolescents with ages from 15-18 years. Sampling proportional to size technique was used to select the study units from a total of 10,194 regular students enrolled in 4 private and 4 governmental secondary and preparatory schools. A pretested, structured self administered questionnaire was used to collect the data in Feb. 2013. Result The response rate for this study was 99%. From the total of 412, 83 (20.1%) of the respondents already had history of sexual intercourse with mean age of sexual debut 16.48 ± SD 0.91year.Among sexually experienced, 52(62.7%) reported having sexual intercourse with 2 to more than 4 persons in their lifetime, earning pocket money, religious service attendance, substance use, peer influence and parental monitoring, were some of the factors significantly associated with adolescents risky sexual behavior. Discussion and conclusion :The result of this study shows, adolescent risky sexual behavior cannot only be decided by the individual‘s lifestyle rather it’s influenced by multiple social and familial characteristic. Addressing determinants of adolescent risky sexual behavior is the key step which provide for interventions aiming to solve adolescent risky sexual behavior problems, the findings of this study, thus, can serve as an asset for programmers aiming to address adolescent’s sexual health.
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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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    Modifiable Risk Factors for Coronary Heart Disease among Young People in Addis Ababa.
    (Addis Abeba Universty, 1995-05) Mulugeta Betre; Derege Kebede
    In view of the increasing life expectancy and adoption of the western life-styles in the city of Addis Ababa, it was important to document the prevalence of the modifiable risk factors for coronary heart disease in the community so that preventive plans can be worked out. This study is a community-based cross-sectional survey which measured the risk factors for coronary heart disease among 15-24 years population in Addis Ababa, 1994 . Thirty clusters with 52 subjects in each were targeted. With the response rate of 92.1%, a tot.al of 1,436 adolescents (851 females and 585 males), 15 - 24 years of age participated in the study. Structured questionnaires were administered and selected physical examinations performed using trained and supervised research assistants . Current smokers were 11.8% males and 1.1% females. About 34% of the respondents consume alcoholic beverages regularly, but only 7 . 0% of them take 100 grams and over alcohol per week. High fat intake and sedentary life-styles were registered in 4 . 5% and 8.4% of the respondents , respectively. About 6.0% of the females and 0.7% of t he males were obese. The prevalence of elevated diastolic blood pressure was 7.1% . After adjusting for potential confounders, male sex and increasing age were found to be important determinants for current smoking and heavy alcohol consumption . For obesity being female and increasing age were the mos't important determinants. Sedentary lifestyle and high fat intake were strongly related to each other. Elevated diastolic blood pressure was strongly associated with obesity . The current prevalence of modifiable risk factors among the young people are not that l ow and this community based study emphasizes the initiation of primary preventive activities as soon as possible.
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    Patient Satisfaction on Quality of Health Care Delivery on Private wing of the ALERT Hospital
    (Addis Abeba University, 2013-07) Zeyneba Abdella; Mulugeta Betre
    Background: To improve the quality of health care, the health care provider needs to know what factors influence patient satisfaction. Many cases of patient dissatisfaction can occur due to inadequate discovery of their needs. There was no adequate study related to patient satisfaction of health care on private wing. Therefore, the objective of this study was to assess patient satisfaction on quality of health care delivery on private wing of the ALERT Hospital, Addis Ababa, Ethiopia. Methodology: A cross sectional descriptive study was conducted fromJune 17 to July 6, 2013 in All Africa Leprosy and Tuberculosis Rehabilitation Training Center /ALERT/ Addis Ababa Ethiopia. The data was collected by using structured questionnaire and checklist. Face to face interview was employed. Participants of the study were interviewed after leaving consultation/physician room. The check list was filed by the principal investigator of the study. Results and discussion: The study has shown that the overall satisfaction level of the patients with the quality of care they received was 238(62.8%). Majority of the clients believed that the hospital compound was clean, quiet (no sound pollution) and not crowded 333(88%), 358(95%), and 319(84 %), respectively. Patient satisfaction with the health care provided was found to have no significant association with the socio- demographic characteristics of clients. More than half (57.5%) of clients from those who are going to pharmacy were not getting the prescribed drug from Hospital’s pharmacy. This survey has shown that waiting time for registration and being seen by a health professional, the health service cost, courtesy and respect by nurses, patients who believed will come again and recommends the private wing of the ALERT Hospital to others, were predictors of patient satisfaction after adjusting for other variables. Conclusion and recommendation: Generally the study revealed that, the overall patient satisfaction on the private wing of the ALERT Hospital was moderate. However their satisfaction with specific elements (indicators) of quality of care was varied. The Hospital responsible body needs to understand the extent of the problem with drugs and supplies and plan to look for different mechanisms to keep adequate stock of essential drugs and standard medical equipment's. and effort should be made in different dimensions on reducing waiting time and giving quick service in the Hospital.