AAU-ETD :: Browsing by Author " Wubegzier Mekonnen"

Browsing by Author "Wubegzier Mekonnen"

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Age at First Sexual Debut and Condom Use among in School Youth in Debre Markos Town, Amhara Region, Ethiopia.
(Addis Abeba Universty, 2013-01) Behailu Dagne; Wubegzier Mekonnen
Background: Early initiation of sexual activity has been escalating among young people and it leads to risky sexual behaviors. This might lead to health and health related burden among youth. In order to prevent this problem as well as to implement youth reproductive health (RH) programs effectively conducting different researches is necessary. Objective: To assess the age of first sexual debut and condom use among in school youth in Debre Markos town Method: A cross sectional study was employed in Debre Markos town from December, 2013 to December, 2014. The study populations were secondary school students in the town. Seven hundred students were selected from three secondary schools. Self-administered structured questionnaire and in depth interview was a method used to collect data. Data entered into EPI-info software and analyzed using the SPSS statistical package. Descriptive statistics, Chi square test, bivariate and multivariate logistic regressions were used. Result: About a fifth (22.3%) of study participants started sexual intercourse at the time of the study. The median age at first sexual intercourse was 16. Socio-demographic factors such as being grade nine (AOR =5.5: 95%CI (1.2, 25.6), living with renting alone AOR=1.7:95%CI (1.2, 17.6) and getting less than 100 birr/month pocket money AOR=5.1:95%CI(1.1,26.0)were significantly associated with early sexual activity. Similarly, students who did not hear about the negative effect of early sexual activity AOR=3. 5:95%CI (1.1, 11.2) and who did not agree with the idea of their parental connection and supervision might postpone sex AOR=3.5:95% CI (1.1, 10.7) significantly associated with early sexual debut. Majority 109 (69.9%) did not use any family planning method including condom at the time of their first sexual intercourse. Those who planned their first sexual intercourse (36.5%) and who had willingness to get condom themselves (36.8%) used condom more than their counter parts.Those who got more than 200 Birr per month pocket money (AOR=5.7: 95%CI (1.1, 29.9) were used condom more at last sexual intercourse. Among student’s community norms, lack of comprehensive knowledge and misconception about condom is a reason not using condom during sex. Conclusion: Age of sexual debut among high school students was low in the town. Students’ knowledge about early sexual activity influence to start sex at earlier age. Parental connection and supervision has a role to start sex at early age. Use of condom or other family planning method at first sexual intercourse among student was low. Students who are not willing to get condom themselves used condom lower than others. Recommendation: In order to decrease early sexual activity, equip students with comprehensive sexual health knowledge is a crucial work. This could be done by the collaboration of family, governmental and non-governmental organizations. Condom use at sex might be increased by improving their willingness to get condom themselves. Awareness creation in the community and avoiding misconception could be a strategy.
Assessment of Antenatal Care Utilization and Associated Factors among Internally Displaced Reproductive Age Amhara Women (15-49 years) in North-Shewa Camps of Amhara Region, 2023
(Addis Ababa University, 2023-12) Hana Meseret; Wubegzier Mekonnen; Assefa Seme
Background: Ethnic induced conflict has displaced over 1.8 million people in Tigray, more than 1 million people in Amhara, and 334,196 in Afar regions. There is paucity of information on the utilization of maternal and child health services among internally displaced persons (IDPs). Objective: The aim of this study was to assess the magnitude of antenatal care (ANC) service utilization and its associated factors among internally displaced reproductive-age Amhara women in the North-Shewa camps of Amhara region. Methods: A facility based cross-sectional study was conducted from February to March, 2023 among internally displaced women in Semen Shewa zone Amhara region. Thus a total of 512 women were included in the study with simple random sampling. The bi-variable and multi-variable logistic regression model were employed to identify factors significantly associated with ANC utilization. Adjusted odds ratio (AOR) with 95% CI was estimated to show the strength of association. Finally p-value 0.05 in multivariable logistic regression analysis was used to identify factors associated with ANC service utilization. Finally, key findings of the study are portrayed using tables and graphs with adequate textual descriptions. Result: Overall 51% of mothers received at least one Antenatal care service during pregnancy and 5.2% of women had the recommended four and above visits. Women whose husbands attained primary and above level of education [AOR: 2.6, 95% CI: (1.24-5.27)], pregnancy complications [AOR: 4.1, 95% CI: (2.07-8.07)], good knowledge on ANC services [AOR: 5.67, 95% CI: (2.93-10.99)], wanted pregnancy [AOR: 8.1, 95% CI: (3.97- 16.55)] and distance to health facility[AOR: 4.45, 95% CI:(2.07-9.45)] were significantly associated with ANC service utilization. Using Poisson regression, empowered women (AIRR=1.3: 95% CI (1.07-1.59), those with good knowledge about ANC (AIRR=1.29: 95% CI (1.09-1.53), living in a camp where health facilities are available (AIRR=1.72: 95% CI (1.32-2.35) and women whose pregnancies are both wanted and desired (AIRR=1.27: 95% CI (1.09-1.48) had association with frequency of ANC visits. Conclusion and Recommendations: Close to half of women didn’t utilize ANC services during their pregnancy and only about 5% of them had four plus ANC visits. Availing health facilities in the camps, and enhancing education and awareness creation about ANC service could help women utilize ANC service.
The Assessment of Determinants of Family Planning Use and Unmet Need among Women of Reproductive Age Group with Disabilities in Addis Ababa
(Addis Abeba Universty, 2016-06) Solen Abera; Wubegzier Mekonnen
Background: The 2007 Census of Ethiopia revealed 32630 of the 2739551 Addis Ababa population was persons with disability among which 7,835 are reproductive aged women. Persons with disabilities are the most marginalized groups concerning reproductive health services. Unmet need for family planning (FP) and Contraceptive Prevalence Rate (CPR) in Ethiopia was estimated at 25.3% and 29% in 2011 respectively. It may be difficult to achieve sustainable development goal without a focus on including people with disabilities. Objectives: This study is designed to assess levels and determinants of family planning use and unmet need among women of reproductive age group with disabilities in Addis Ababa. Method: Cross sectional study based on associations of persons with disabilities with stratified sampling was used to select 727 women’s with disability. Data were collected using structured questionnaire by eight trained females who completed grade twelve; two of which communicate by speaking and sign language. Data were cleaned and analyzed using Epi data and Stata 12. Descriptive statistics, binary and multivariate logistic regression analyses was employed to identify factors associated with contraceptive use and unmet need for family planning. Cut-off point for the detection of significance is p<0.05. Result: Current CPR among all reproductive age women and sexually active women with disability in Addis Ababa was 44.4% and 64.5% respectively. Unmet need of contraception was 20% among sexually active women with disabilities (10.6% for spacing and 9.4% for limiting) making percentage of demand satisfied 68.9%. Contraception was 6.8 (95% CI: 1.47, 31) times higher in women aged 30-34 compared to age group 45-49. Women whose partners attained primary education had about 3.1 (95% CI: 1.04, 9.5) times more likely to use FP compared with uneducated partners. Unemployed women were 0.8: (95% CI 0.3, 2.04) less likely to use FP methods compared with employed. Women discussing about contraception with partners were 3.3 (95% CI: 1.08, 10.34) times more likely to use FP. While unmet need is less likely among women aged 30-34, 0.05 (95% CI 0.04, 0.7) compared to age group 45-49. Besides women who discuss with their partner about contraception were less likely to have unmet need compared to counterparts 0.23 (95% CI 0.07, 0.7). Those women with number of living children above two are 3.3 (95% CI: 1.03, 10.7) times more likely to have unmet need compared to women with living children less or equal to two. Conclusion and Recommendation: Unmet need is found to be high among women with disabilities in Addis Ababa, therefore public and private sectors should promote targeting programs for women with disabilities and their partner for the uptake of the family planning services. Focus should be given to women with disabilities who are unemployed and those whose partners have never been into school.
Assessment of Factors Affecting Adherence and Utilization of Isoniazid Preventive Therapy among HIV Patients Yekatit 12 Hospital, Addis Ababa.
(Addis Ababa University, 2014-02) Yitagesu Getachew; Wubegzier Mekonnen
Background: Isoniazid (INH) is given to individuals with latent infection of tuberculosis in order to prevent progression to active disease. It is important to understand factors associated with non-adherence so that high adherence can be maintained or low adherence improved since adherence to effective treatment improves health outcomes. Objective: To assess factors affecting adherence and utilization of IPT in HIV patients and to explore the opinions of patients and health care providers about factors affecting adherence and use of INH Methods: Participants eligible for the study 403 individuals who were HIV positives taking INH on follow up at yekatit 12 hospital randomly selected and Adherence measured by self-report of INH tablets taken for past 3, 7 and 30 days and in depth interview for recruited patients, adherence counselor and health professionals at ART clinic was done. Results: Adherence to INH was 94% by self-report for last 7 days .The odds of adherence to INH was 7.7 [95% CI (2.6, 22.9)]times higher among those with no skin rash compared to patients with skin rash. Conclusion: The prevalence of adherence to INH among people living with HIV in yekatit 12 hospital has a better rate of adherence than other local and African studies and the reasons for poor adherence was strongly associated with occurrence of jaundice, skin rash and seizure and rate of utilization is perceived to be low because of interrupted drug supply. Recommendation: Availability of comprehensive care and support such as nutritional support and appointment per demand adequate time for counseling, follow up, sustainable drug supply, evaluation and treatment of side effects
Assessment of Intrauterine Contraceptive Device Utilization and Associated Factors for Low Utilization among Clients of Family Guidance Association Clinics in Addis Ababa, Ethiopia.
(Addis Abeba Universty, 2016-11) Mohammed Ali; Wubegzier Mekonnen
Introduction: Although intrauterine contraceptive device (IUCD) method is the safest, very effective, long acting and reversible contraceptive method, it has been used at a very low rate in many developing countries compared to other modern contraceptive methods. Objective: The objective of the study was to assess the utilization of IUCD method and factors associated with utilization among women of reproductive age in Addis Ababa family Guidance Association of Ethiopia (FGAE) clinics. Methods: Facility based cross sectional study was conducted from March 1, 2016 to April 30, 2016, employing both quantitative and qualitative methods. Data for quantitative study was coded, entered and cleaned using Epi-info and transferred and analyzed by using SPSS version 21.0 for windows. Group comparison was assessed using Chi square analysis. Multivariate Logistic regression model was used to detect factors associate with IUCD utilization. All the tests were considered significant at p < 0.05. The qualitative data was analyzed using the qualitative thematic analysis approach. Results: A total of 108 respondents were currently using IUCD making the utilization rate 35.2%. The median duration of IUCD use was 33 months (Range: 1 - 120 months). Group comparison showed that marital status (p = 0.032), knowledge score (p = 0.010), and being told about IUCD duration (p = 0.044) had statistically significant association with current IUCD use. Thus, it was found that larger proportions of married women (66.9%), clients with good knowledge score (70.1%) and those who have been told about the duration of contraception of IUCD (67.3%) were not to using IUCD. Logistic regression analysis showed that clients with high knowledge score were about 1.8 times less likely to use IUCD (AOR 1.779: 95% CI = 1.087-2.913, p = 0.022). Qualitative study showed that rumors about IUCD from other users and clients' perception about IUCD such as its side effects, including bleeding and infection, as well its possible effect to cause infertility were important barriers affecting the level of use of IUCD in the study area. Conclusion and Recommendation: The present study revealed that the proportion of IUCD use & duration of IUCD use was low in the study setup and clients with good knowledge level were less likely to use IUCD. The clients in this study population were much more influenced by the rumors and wrong perceptions about IUCD use, particularly towards side effects and other perceived untoward effect. Thus, Family guidance association of Ethiopia and other public and private health institutions should extend focused (method specific) education to their clients to remove misconceptions about IUCD use.
Assessment of Knowledge, Attitude and Practice of Breast Self-Examination among Women Aged 20-49 Years in Addis Ababa, Ethiopia.
(Addis Abeba Universty, 2017-06) Chala Chimdi; Wubegzier Mekonnen
Introduction: Breast cancer is the most prevalent cancer among women globally and the second commonest cancer overall. In Africa, breast cancer was also the most commonly diagnosed cancer and the second leading cause of death among women in 2008. In Ethiopia it is also an emerging public health problem and top leading causes of cancer mortality and morbidity among women of reproductive age group. However, only few researches were done regarding knowledge, attitude and practice of breast cancer self-examination. Objective: To assess the knowledge, attitude and practice of breast self-examination among women aged 20-49 years in Addis Ababa, Ethiopia, 2017. Methodology: A community based cross- sectional study was conducted with a sample of 630 women aged 20-49 years in Addis Ababa. A multi-stage sampling technique was applied to select the study participants. Four out of ten sub-cities were selected randomly. One woreda was randomly selected in each sub-cities and systematic random sampling technique was used to select households in each selected Woreda .If there are more than one woman in the selected household one of them were randomly selected. A pretested structured questionnaire was used to collect data. Likert’s scale was applied to measure attitude and bloom cut classification score for knowledge score. Data was entered in to epidata and analyzed by (SPSS) software version 20. A Cross-tabulation was used to know the overall association of explanatory variables with breast self-examination. Bivariable and multi-variable binary logistic regression were also fitted to identify factors associated with breast self-examination practice. Result A total of 608 respondents participated in the study, of these only 155 (25.6%) of them had good knowledge and 53.4% had positive attitude towards breast self examination. Only 241 (39.6%) of the respondents had practiced BSE, from these study subjects only 96 (39.8%) of them practiced monthly. Occupational status and good knowledge of BSE were found to be significant association with the practice of breast self examination. Women of reproductive age group who are government employee were about 2 times more likely to practice breast self examination than those non-governmental employee [AOR=2.13, 95%, CI (1.19,3.84 ),p=0.011].Women who had good knowledge towards of breast self examination were 6 times more likely to practice BSE than those who had poor knowledge [AOR=5.99, 95%CI (4.1, 8.9), p=0.000]. Conclusion and Recommendation: knowledge and practice of breast self examination was low, even if majority of them had positive attitude. I suggest that the ministry of health and other concerned bodies should have to promote awareness creation for the community about breast cancer and BSE
The Assessment of Low Birth Weight among Children Born to Elder Women and its Associated factors in Addis Ababa, Ethiopia.
(Addis Abeba University, 2020-03) Meseret Melaku; Wubegzier Mekonnen
Background: Birth weight is the single essential factor determining the survival, growth, and development of infants. LBW is defined by the WHO as weight at birth less than 2500 gram, while very LBW is considered as a; birth weight less than 1500gram, on the other hand very extremely LBW a; birth weight less than 1000gram, regardless of gestational age. Pregnancy after the age of 35 confers risk to both child and maternal health it has been broadly documented. In particular, positive association between old maternal age and risk of LBW and preterm birth. Neonatal mortality is 20 times higher among LBW babies compared to their counterparts. Objective: To assess the prevalence of LBW born to older women and its risk factors in Addis Ababa, Ethiopia 2020. Method: Institutional based cross-sectional study was conducted from Oct 2019 to DEC 2020, in Addis Ababa, Ethiopia. A total of 625 old age women delivered in health institutions were selected by using systematic random sampling. Data were collected using an interviewer administered structured questionnaire. The collected data were coded and entered into the computer using Epi Data version 3.1 and the data were analyzed using STATA version 15 descriptive statistics was carried. In addition binary logistic regression model was used to determine the association between different factors and low birth weight. Finally, adjusted odds ratio results from a multivariate logistic regression were used to measure the strength, direction, and significance of the association between the different independent variables and low birthweight, the dependent variable. The level of significance was decided to be when p < 0.05, that given a 95% confidence interval for the test statistic. Result: The prevalence of low birth weight was found to be 15.04 % (95% CI 12.4-18.1). Age of the mothers (40-49 years) [AOR=[AOR=3.16: 1.06, 9.46]], low-income status [AOR=4.33:1.24, 15.19], mothers who had mid-upper arm circumference less than 23cm [AOR=4.49:1.26,16.02], mothers who gave birth before 37 weeks gestational age [AOR=6.87:2.76,17.07], mothers who had a previous abortion history [AOR=4.22:1.45,9.66] and those who had pregnancy-induced hypertension [AOR=5.80:2.23, 15.18] were more likely associated with low birth weight. Conclusion: The prevalence of low-birth-weight is high compared with national studies among elderly mothers. Age group, monthly family income, mid-upper arm circumference, gestational week, history of abortion and pregnancy induce hypertension were found to be significantly associated with LBW.
Assessment of Magnitude and Factors Associated with Unmet Need for Family Planning among Married Women of Reproductive Age who are in Extended Postpartum in Tahtay Koraro Woreda, Tigray Regional State, Ethiopia.
(Addis Abeba University, 2014) Gurja Embafrash; Wubegzier Mekonnen
Background: About 222 million women in developing countries had unmet need of contraception. Women in their first year after childbirth had the largest proportion of unmet need for contraception. This first year after delivery is described as an extended postpartum period. Objective: To determine the magnitude and factors associated with unmet need among women who are in extended postpartum in Tahtay Koraro Woreda, Tigray regional state, Ethiopia. Methods: A cross sectional facility based study complemented by in-depth interview of key informant was implemented. A total of 409 Women in the 1st year after delivery were recruited. The study period was from 1st February to March 30, 2014. For quantitative data Epi-Info version 3.5.4 software was used for data entry, and then data exported to SPSS Version 21 software for further analysis. Logistic regression model was used to identify factors associated with the outcome variable. The transcribed and translated qualitative text data were imported into an Open Code program and coded. Then codes were categorized and thematically described. Results: The overall unmet need for family planning was 150 (36.7%), with 121 (29.6%) for spacing and 29 (7.1%) for limiting. One hundred twenty (29.3%) women were using family planning. And 84 (70%) of them were using injectable. The commonest reasons for non-use of FP were non-menstruating since last birth 201 (69.6%), side effects 39 (13.5%) and infrequent sex 22 (7.6%). Rural residence (AOR=7.16, 95% CI 2.57-19.95), postpartum week (38-52 week; AOR=8.71, 95% CI 3.90-19.44) and low perceived risk of pregnancy (AOR=1.79, 95% CI 1.04-3.09) were significantly associated with high unmet need. Opposition from different groups of the community, low perceived risk of pregnancy, provider refusal of removal of implants and misunderstanding of FP use and side effects were additional triggering factors for unmet need. Conclusion and Recommendation: The unmet need for family planning was high. Rural residence, increased maternal postpartum week and low perceived risk of pregnancy were associated with high unmet need. Opposition from different groups of the community and refusal of implant removal were also other factors affecting unmet need. Empowering women with knowledge of the risk of pregnancy and FP use during extended postpartum period should be enhanced. Further awareness creation should be extended to periphery at different levels of the community.
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.
Assessment of Men Involvement on Family Planning In Rural Communities of Jeldu Woreda, West Shewa Zone, Oromia Region, Ethiopia.
(Addis Abeba Universty, 2010-06) Fufa Daba; Wubegzier Mekonnen
Background: In order to slow the current rapid population growth particularly in less developed countries, family planning programs have always been considered as the intervention of choice. These programs, however, are seen to give little attention to the roles that could be played by men regarding family planning. Different studies focus mostly on the role that is played by women neglecting those of men. As a consequence, there is shortage of information on factors which prevent men to be involved on family planning in Ethiopia. Objective: To assess the role of currently married men in family planning utilization in rural communities of Jeldu Woreda, West Shoa Zone Methods: A cross-sectional survey was conducted on a total of 804 currently married men in the age group of 15-59 years. A total of 6 kebeles were selected from 38 rural kebeles of the Woreda using simple random sampling method. Study households were selected from each kebeles through systematic random sampling. A pre-tested, structured questionnaire was used for data collection. Results: Virtually all men (91.8%) had heard of family planning, but only 31.4% could correctly define the term. Nearly two-third of respondent knew presence of male contraceptives, and 92.3% of them know where to get information about them. About 95.3% of the respondent said family planning is important and a similar proportion of them approved use of contraception. About half of study participants were currently using at least one method of contraception with their wives. A multivariate result showed a significant relationship between knowledge of family planning (AOR=26.03, 95 %CI6.180, 109.624), joint decision making (AOR=2.66, 95% CI 1.038, 6.536), decision made by wife alone (AOR=1.66, 95%CI 1.046, 2.634), possession of radio (AOR=1.46, 95%CI 1.045,2.038) and current use of family planning. Conclusion: In conclusion, knowledge of contraceptive method, joint decision making, decision made by wife alone and possession of radio, were identified as key factors affecting contraceptive use among married men in the study area.
Assessment of Men’ S Involvement In Long Acting and Permanent Contraceptive Use among Currently Married Men Aged 20-64 Years, in Mizan-Aman District, South Western Ethiopia.
(Addis Ababa University, 2014-06) Kebadnew Mulatu; Wubegzier Mekonnen
Introduction: Though women bear the physical, psychological and emotional strain of pregnancy and childbirth, it could not mean that fertility and contraception are based exclusively on the female population. Thus, the social roles of men who are dominant not only in decision making within the family, but also at community leadership levels have been overlooked. Most family planning programs give less attention to the understanding of men’s role in the effective and steadfast utilization of contraceptives. Objective: the main aim was to assess the role of men in long acting and permanent contraceptive use among currently married men aged 20-64 in Mizan-Aman District, South Western Ethiopia. Methods: Community-based cross-sectional study was conducted. A mixed method of quantitative and qualitative research was used. A total of 554 study participants were recruited for the study. The investigator prepared, pre-tested and structured questionnaire was used to collect data. Odds ratio along with 95% Confidence interval in Multivariate Binary Logistic regression was used to assess the strength and significance of the association. Thematic analysis has also been adapted for analyzing the qualitative data. Results: A total of 521 men were included in the analysis. Only 11.5% the respondent's wives used LAPMs though no study participant used any of these methods. Discussions between couples about LAPMs in the last 12 months (AOR=4: 95% CI.1.9-8.2) and on the number of children they want to have (AOR=3.1: 95% CI.1-9.2), going to health facilities with wives to discuss about FP with health providers (AOR=2.7: 95% CI. 1.3-5.6), and supporting the use LAPMS (AOR=4.5: 95% CI. 1.6-12.5) were significantly and strongly associated with utilization of LAPMs compared to their respective counterparts. Conclusions and recommendation: Discussion between couples on the use of LAPMs and on the number of children they should have; and men’s approval of LAPMs' utilization were factors that influencing utilization of LAPMs in the town. Health extension workers should enhance discussion between couples. Town level health programmers should advocate discussion between couples and men’s awareness on LAPMs. Further research, including both men and women is recommended in the Town and beyond.
Assessment of Quality of Clinical Laboratory Service and Clients’ Satisfaction at Public General Hospitals in Addis Ababa, Ethiopia.
(Addis Abeba University, 2013-12) Yalemzewoud Ayalew; Wubegzier Mekonnen
Background: - Laboratory services are essential components in the diagnosis and treatment of patients infected with a variety of diseases. The laboratory infrastructure and quality remain in its nascent stages in most countries in Africa which demanded strengthening them. There are limited studies on quality of clinical laboratory services in Addis Ababa, Ethiopia. Objectives: - To assess quality of clinical laboratory services and clients satisfaction in public general hospitals in Addis Ababa. Methods:- A facility based quantitative study was conducted using two study instruments. The WHO-AFRO accreditation tool was used to measure the quality standard according to the WHO-AFRO score. Service quality descriptive measures were used to measure quality. On the other hand, customers’ satisfaction was measured using 422 clients’ exit interview in five public general hospital laboratories. Sampling proportionate to size technique was employed. Descriptive summary measures and odds ratio along with 95% CI in binary logistic regression was used to measure magnitude and association respectively. Results:- The mean score of all five public general hospital laboratories in the observational study using WHO/AFRO accreditation checklist were 65.5%, and ranked as two stars. Whereas only 47.6% of the respondents perceived the clinical laboratory service as good quality or satisfied. Politeness and willingness of health providers,(66.1%). Professionals’ neatness and physical appearance, (61.2%)were better attributes in clients’ satisfaction. However, clients were highly dissatisfied by cleanliness of latrine, (47.6 %) and turnaround time, (30.5 %)of the results. Conclusion: - The quality of laboratories in public hospitals of Addis Ababa were found to be much less than WHO/AFRO international accreditation quality standards. And satisfaction rate of clients was also low. The satisfaction was found to be much lower in turnaround time and cleanliness of latrines in laboratories. Recommendations: - The Regional Government and Regional Office of laboratory coordinators should take measures to enhance quality of clinical laboratory services within the public general hospitals. In service trainings should also be availed to laboratory personnel. Continuous monitoring of laboratory services should be done to achieve full accreditation and maximum patient satisfaction. The Ethiopian Health Sector Development Program should have targets with regards to laboratory quality improvement. Detailed studies should also be done at national level.
Assessment of Quality of Life among Children with Epilepsy and Associated Factors in Governmental Hospitals of Addis Ababa, Ethiopia,2021.
(Addis Ababa University, 2022) Samuel Hailu; Wubegzier Mekonnen
Background: Quality of life (QOL) is increasingly recognized as an important patient-reported outcome in health care research. However, the use is still restricted. Epilepsy impact was far more frequently evaluated considering QOL but only focused on adult patients so this research focused on children. Objective: To assess the quality of life among children between (7-18) with epilepsy and associated factors in governmental Hospitals in Addis Ababa, Ethiopia 2021. Methods: A facility-based cross-sectional study design was employed and data was collected from 564 children using a face-to-face interview in Addis Ababa from November 2020 to January 2021 selected using multi-stage sampling method. Probability proportionate to size technique was applied to select children from each hospital. The data was cleaned, entered through EPI-INFO 3.1and exported to STATA version 15.0 for analysis. Frequency distributions of variables were tabulated. The raw numbers of the five-point Likert scale for QOLIE-CH-48 domain scores were converted into a 0-100-point response scale, with higher scores indicating better QOL.ANOVA was used to assess the relationship between quality of life and the independent variables. Multiple linear regression was conducted to identify factors predicting quality of life. The threshold for statistical significance was p<0.05. Result: -A total of 564 children participated with a response rate of 94.1%. The mean score of quality of life was 60.18±8.68 (95% CI: 59.05, 61.23). Self-depression (P= 0.0094 F=3.39), number of anti-epileptic drug (AED) (P=0.0021 F=4.97), types of seizure (P= 0.000, F=52.26) were statistically significant predictors of QOL.A score in quality of life increased by 5.03 for every unit increase in a score of seizure frequency per week with (β= 5.0395% CI:0.4 -0.9).Quality of life of epileptic patients increased by 0.19 and 1.99 in every unit increase in a score of stigma and anxiety (β= 0.1995% CI: (-0.1 - 0.1) and(β=1.99, 95%CI: 0.007- 1.03) respectively. Conclusion: -The quality of life among children with epilepsy was low. Stigma, seizure, depression and anxiety, and AED side effects were statically significant for quality of life. Implementing interventions that focus on early detection like self depression and stigma in children with epilepsy should be of great concern for healthcare providers.
Assessment of the Influence of Duration of Cohabitation, Obstetrics & Gynecologic, Behavioral and Nutritional Risk Factors on Preeclampsia among Nulliparous Women in Selected Hospitals of West Amhara Zones, Ethiopia
(Addis Ababa Universty, 2018-06) Maru Mekie; Wubegzier Mekonnen
Introduction: Preeclampsia is the major cause of maternal and perinatal morbidity and mortality in developing countries. Identifying risk factors of preeclampsia is crucial for early diagnosis and management. Though several studies have been conducted related to preeclampsia, the influence of duration of cohabitation, obstetrics and gynecologic, behavioral and nutritional factors have not been well understood among nulliparous women. Objectives: To assess the effect of duration of cohabitation, obstetrics and gynecologic, behavioral and nutritional risk factors on preeclampsia among nulliparous women in selected public hospitals of West Amhara Zones, Ethiopia Method: Age-matched case-control study design was employed on a total of 330 preeclamptic and non-preeclamptic women who come for delivery at Felege Hiwot, Addis Alem, and Debre Tabor hospitals. Double population proportions formula with a 2:1 control to case ratio was used to calculate sample size with 95% confidence interval and 80% power. Epi data version 3.1 was used for data entry, and analysis was done by SPSS version 20. Descriptive statistics were computed to reveal the magnitude of duration of cohabitation, obstetrics and gynecologic, behavioral and nutritional factors among preeclamptic and non-preeclamptic nulliparous women. Chi-square test was used to assure statistical significance. Conditional bivariable and multivariable logistic regression were also used to calibrate the association between the above factors and preeclampsia. Both crude and adjusted odds ratios were used to measure the strength, direction, and significance of association at 95% confidence interval. Result: The risk of preeclampsia among nulliparous women was 2 times higher among women with short duration of cohabitation (AOR: 2.13(1.10, 4.11), 2.35 times higher among those with unplanned pregnancy (AOR: 2.35 (1.01, 5.52), and 2 times higher among those with MUAC ≥ 25cm (AOR: 2.00(1.10, 3.63). On the other hand, the risk was (AOR: 0.52(0.29, 0.96), (AOR: 0.42 (0.22, 0.82) and (AOR: 0.45(0.24, 0.87) lower among nulliparous women who got advise at antenatal care, had vegetable and fruit intakes, respectively compared with counterparts. Conclusion: Special attention should be given to nulliparous women who found to have a short duration of cohabitation, unplanned pregnancy, and high body weight. Nutritional counseling shall be given to women during antenatal care follow-ups to reduce the risk of preeclampsia.
The Assessment of the Magnitude of Risky Sexual Behavior and its Association with Self-Esteem and Other Covariates among in-School Adolescents in Addis Ababa: an Explanatory Mixed-Methods Study.
(Addis Abeba University, 2021-09) Shimeles Zewdie; Wubegzier Mekonnen
Background: Most of the sexual initiation and sexual practice of adolescents begins at secondary school which is very risky. Low self-esteem may predispose adolescents to sexual risk through negative schemata and attributions. However, not enough was done to assess the effect of self-esteem development in reduction of risky sexual behaviors among Ethiopian adolescents. Objective: The study aims to assess the magnitude of risky sexual behavior and its association with self-esteem and other covariates among in-school adolescents in Addis Ababa. Methods: Facility-based explanatory sequential mixed methods design was employed during December 2020- February 2021. Self-administered questionnaire was used to collect quantitative data from 629 high school students selected using a multi-stage sampling method. Quantitative data was entered to Epi-data version 3.1 and exported to STATA version-15 for analysis. Frequency distributions of variables were tabulated. Bivariable and multivariable binary logistic regression analyses were performed and p-values less than 0.05 were considered to calibrate statistical significance. The views of 18 qualitative participants selected by maximum variation sampling procedure were explored using an in-depth interview. The qualitative data were coded and classified into themes and sub-themes and findings were represented by way of a narrative. Results: A total of 605 participated in the study (response rate of 96.2%). About 248(41%)of students reported that they ever had sexual intercourse. About 546(90.3%) of the students had high self-esteem. The overall prevalence of risky sexual behavior was 160(26.5%). Perception about the risk of STIs and pregnancy (AOR=2.34; 95% CI, 1.51-3.63), self-esteem (AOR=3.48; 95% CI, 1.88-6.42), and school type (AOR=2.08; 95% CI, 1.14-3.79) were independent predictors of risky sexual behaviors. The strong reasons for the practice of risky sexual behaviors among these adolescents were perception about sexual and reproductive health, low self-esteem, school type, peer influence, substance use, pornography viewing and social media activities. Conclusions: Over one in four high-school students have risky sexual behavior. Risk perception, self-esteem and school type are significantly associated with risky sexual behavior. Sexual and reproductive health programs for in-school adolescents should be tailored to address their specific needs by building friendly public policies; creating a supportive environment, developing personal skills, and reorienting the health services that help develop self-esteem and change poor perceptions about STIs and pregnancy.
Assessment of Utilization and Factors of Skilled Birth Attendance among Women of Childbearing Age in Ankasha Guagusa Woreda, Awi Zone, Amhara Regional State, Northwest Ethiopia, 2014.
(Addis Abeba Universty, 2014-05) Mulunesh Alemayehu; Wubegzier Mekonnen
Introduction: The Ethiopian Demographic and Health Survey in 2011 reported maternal mortality ratio of 676 maternal deaths per 100,000 live births which made our country among the 10 highest contributors’ of maternal death. Many Thesis results showed that properly equipped and supported skilled birth attendance reduce many of these complications. However, only 11.5 % of Ethiopian mothers were supported by skilled birth attendant during their labour and delivery. Objective: To assess prevalence and factors to utilize skilled birth attendants among mothers who gave birth during the last one year in Ankasha Guagusa district. Methods: A mixed study design employing a cross sectional household survey with in-depth interview and focus group discussion were employed. A total of 373 women age 15 to 49 years who gave birth in the past one year were asked. The sample size for the qualitative method was determined by saturation of ideas. Descriptive summary measures and associations between the various factors with skilled birth attendance were done employing Binary and Multivariate Logistic Regression. Thematic analysis was also used for the qualitative study. Result: The study showed that the prevalence of skilled birth attendance utilization among women who gave birth for the last one year in the study area were 70(18.8%). Main determinant factors associated to low utilization of skilled birth attendance in the study district were; women residence, educational status, ANC visit, type of health facility near to them, problem during labour and respondent’s attitude towards pregnancy and labour service. The odds of skilled birth attendance utilization among urbanites were AOR=5.5:195%CI (2.23, 13.57), educational status 2nd and above AOR=6.27 :( 1.31, 30.05), numbers of ANC visit 4th and above AOR=12.96:95%CI (3.20, 52.51) and women who encountered complications during their labour AOR=61.97:95%CI (19.83, 193.65) times higher than those counterparts. On the contrary mothers reside near to health post and unfavourable attitude of mothers towards maternal health care services were 83% and 65% less likely assisted by skilled birth professionals during their delivery than those the opposite parts respectively. Moreover, cultural practices, beliefs and barriers were other concomitant factors for low utilization of skilled birth attendance. Conclusion: Skilled birth attendance utilization in the study area was very low due to different barriers. Hence, to bridge this gap especially women’s educational and awareness towards maternal health care services and cultural influences; sustainable awareness should be created by designing appropriate strategies including provision of targeted information, education and communication and integration among health care providers and other stakeholder at the community and health facilities.
The Association of Intimate Partner Violence During Pregnancy and Spontaneous Abortion in Adigrat General Hospital, Tigray Region, Northern Ethiopia.
(Addis Abeba University, 2020-01) Helen Teweldebrhan; Wubegzier Mekonnen; Emyu, Solomon
Background: intimate partner violence-affected 30% of women in their lifetime globally. In Ethiopia, according to the Ethiopia Demographic and Health Survey 2016 report, the prevalence of intimate partner violence among ever-married women was 34% that varies across regions (between 9% in Somali and 38% in Oromiya regions). Several studies showed that women who experienced intimate partner violence had a high risk of spontaneous abortion than women who didn’t experience intimate partner violence. Objectives: To measure the association of intimate partner violence during pregnancy and spontaneous abortion among those who attended maternal health service in Adigrat general hospital, from July 2019 to June 2020, Tigray region, Ethiopia. Methods: Explanatory sequential mixed-method study design was used. Systematic probability sampling and convenience nonprobability sampling was used to select study participants for the quantitative and qualitative approach. Bivariate and multivariate logistic analyses were performed to identify the association between intimate partner violence and spontaneous abortion. Muticollinary test was performed to test collinearity between independent variables. For the qualitative approach data were analyzed using thematic analysis. Result: women who were exposed to intimate partner violence during pregnancy had 4 times higher odds of spontaneous abortion than mother who don’t expose to any form of intimate partner violence (AOR 4.65, 95% CI 1.94-11.14). Women who were exposed to physical intimate partner violence during pregnancy had 3 times higher odds of spontaneous abortion compared to those who didn’t expose to physical intimate partner violence (AOR 3.06, 95% CI 1.09-8.59). However emotional and sexual intimate partner violence doesn’t have a significant association with spontaneous abortion. From the qualitative approach study participants believed that physical beating and stress had a relationship with spontaneous abortion. Conclusion: This study shows that spontaneous abortion is significant associated with exposure to any form of intimate partner violence and physical intimate partner violence during pregnancy. We could prevent spontaneous abortion-related to intimate partner violence by Health care providers’ identifying and counsel mothers about intimate partner violence when assessing spontaneous abortion patients.
Comparative Study on the Utilization of Reproductive Health Services and Factors Affecting it among Students with and without Disabilities in Public Universities in Addis Ababa, Ethiopia
(Addis Abeba Universty, 2017-06) Selamawit Meshesha; Wubegzier Mekonnen
Background: Reproductive health services (RHS) and health education are fundamental human rights. However, utilization of reproductive health services among adolescents and youth is low. Particularly, people with disabilities have lower knowledge on reproductive health related issues and service utilization. Objective: The objective of this study is to compare reproductive health service utilization and assess factors affecting it among students with and without disabilities in public Universities in Addis Ababa, Ethiopia. Method: Institution based comparative cross sectional study was carried out in two public higher learning institutions in Addis Ababa from September 2016 to June 2017. Multi stage sampling was used to select a total of 548 respondents. The data analysis was done using STATA version 14 software. Odds ratio, 95% CI in conditional logistic regression was used to identify associated factors with RHS utilization. Result: The RHS utilization among students with and without disabilities were 40.52% & 69.1% respectively. RHS accessibility and awareness were the main reasons for not utilizing RHS among students with disabilities whereas religious and cultural barriers were reasons for students without disabilities. Those students without disabilities were (AOR=3.11: 1.86, 5.19) times more likely to utilize RHS than those students with disabilities. For students with disabilities those who knew RHS providing facilities [AOR=4.9: 1.47, 16.2], who ever had sex [AOR=30.1: 9.6, 94.4], who ever had discussed RH issues with any one [AOR=3.59: 1.6, 7.9], who were exposed to any type of mass media in the last 12 months [AOR=2.9: 1.03, 8.1] and who had a nearby health facility as other health facilities [AOR=4.36: 1.01, 18.7] were more likely to utilize RHS. For students without disabilities those students who were in the age group of 25 and above were [AOR=5.01: 1.19, 21.2] times and those students who had ever had a girl\boyfriend were [AOR=6.65: 3.2, 13.2] times more likely to utilize RHS than those who were in the age group 15-19 years and those who had never had a girl\boyfriend respectively. Conclusion and Recommendation: reproductive health service utilization among students with disabilities is low compared with those students without disabilities. Awareness on RHS provision facilities, ever having sex, discussion on RH issues, mass media exposure in the past 12 months, availability of other HFs than University clinic were found to be significantly associated with RHS use among students with disabilities while age and having a boy/girl friend were the predictors of RHS use among students without disabilities. All stakeholders on RH working with people with disabilities should focus on awareness creation through mass media, discussion and training to increase the RHS utilization level.
The Effect of Youth Centers on Reduction of Risky Sexual Behaviors among Youth in Addis Ababa, 2016.
(Addis Abeba Universty, 2016-06) Nigusie Fetene; Wubegzier Mekonnen
Introduction: Risky sexual behaviors negatively affect the health of adolescents and young adults putting them at high risk of sexually transmitted infections and unwanted pregnancy for females, which may cause serious health consequences, social and economic problems. In addition, unwanted pregnancies may lead to school dropout and end up with unsafe abortion. No attempt was done to assess the effect of youth centers in reduction of risky sexual behaviors. Therefore, this study was designed to assess the difference in engagement of risky sexual behaviors between users and non-users of youth centers among youth in Addis Ababa. Methods: A comparative cross-sectional study design was employed among 524 youth in Addis Ababa from September, 2015 to June, 2016. Multi-stage sampling was used to select youths from randomly selected sub cities. The data was cleaned, entered and analyzed through EPI-INFO 7 and SPSS version 16.0. First distribution of variables was presented by using tables and descriptive statistics to calculate some statistical data's and then logistic regression model were used to measure magnitude of risky sexual behaviors among users and non-users. Results: Nearly half 254 (48%) of the respondents ever had sexual intercourse. The mean age of first sexual initiation was 18.56 (±3.019) years and about 37% of those who ever had sexual intercourse started it before the age of 18 years. Among those who ever had sex 47% of them never used condom. The over all prevalence of risky sexual behavior was 43.1% and the prevalence of risky sexual behavior among users and non-users were 38.5% and 47.7% respectively (P-value = 0.042). Utilization sataus of the youth center and age of the respondents were significantly associated with risky sexual behavior. Non-users of the youth center RH clinic were 1.570 times more likely to engage in risky sexual behavior compared to users of the youth center (AOR= 1.570; 95%CI = 1.056, 2.333). Youth aged 15-19 years were 92.1% less likely to practice risky sexual behavior compared to youth aged 25-29 years old (AOR = 0.079; 95%CI = 0.041, 0.376). Conclusion: A significant number of youths had risky sexual behavior that might lead them to different reproductive health risks. Non-users of the youth center were at a significantly higher risk of sexual behaviors than users.
Exploration of Barriers Related to Family Planning Use among Pastoralist Communities of Ethiopian Somali Region, Eastern Ethiopia: Qualitative Study.
(Addis Ababa Universty, 2017-12) Gemu Tiru; Wubegzier Mekonnen
Background: Rapid population growth is a threat to wellbeing in the poorest countries. In Ethiopia there was a dramatic increase in contraceptive prevalence rate (CPR) from 8.2% to 36% in 2016. Although such encouraging results have been achieved, there are significant variations among the regions, with very low coverage in the pastoralist regions ranging from 1.5 percent in Somali region to 56 percent in Addis Ababa. No studies in Somali region have qualitatively explored for barriers accessing and utilizing family planning from the pastoralist community perspective. Objectives: The objective of this study was exploring barriers related to family planning use among pastoralist communities of Ethiopian Somali region. Methods: Qualitative inductive content analysis through purposive sampling with maximum variation mixed with snow ball were used to conduct four FGD among married women and their husbands, fifteen KII among programmers, service providers and community chiefs. On top this 6 facility observation were undertaken. Data analysis was done using Open code version 4.02. Results: Six major themes were emerged during the study:Religion prohibition, socio cultural factors, limited access to family planning services, gender roles and social pressure, myths and misconceptions related to family planning and provider negative attitude affected family planning service uptake. Conclusions: Poor women empowerment and limited male involvement, Religion prohibition, Cultural barriers such as clan leaders influence affected family planning service uptake. Women and girls remain largely marginalized in terms of development and full participation in the health program as a whole family planning in particular which contributes to low service uptake at the household and community levels due to underdevelopment, low literacy and prevailing socio-cultural perceptions. Recommendations: Massive community mobilization, women empowerement and male involvement through chiefs and religious leaders, Capacity building on family planning program, new service provision modality that will fit to mobile community is crucial to increase family planning service uptake.

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