Browsing by Author "Berhane, Yemane(PhD)"

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    Assessment of Quality of Service Delivery in Immunization in Western Gojjam, Amhara Region Ethiopia
    (Addis Ababa University, 1997-12) Teklu, Teshome; Kassaye, Mesfin(PhD); Taffa, Nigussie(PhD); Berhane, Yemane(PhD)
    Many developed and developing countries have achieved the 1990 uel target. However ,few countries, like Ethiopia, have neither achieved nor maintained it. The coverage in Western Gojjam in 1995\6 for three doses of DPT was below 40%, far below the coverage level expected to bring morbidity and mortality reduction. A cross-sectional health facility based study to assess the quality of immunization service delivery using qualitative and quantitative methods was conducted from March to May 1997 in 10 districts of Western Gojjam zone. All hospitals and health centres in the zone and randomly selected health stations were included in the study . Exit interview, observations of client-provider interaction, document review, inventory of equipment, interview with service providers, and focus group discussions with service providers and mothers were the techniques uti! ized. Though the geographical access is satisfactory, vaccine shqrtage, lack of incentives and transport facilities , delayed replacement of needles and syringes were among the structural factors that affect the quality of service delivery , while poor communication, lack of aseptic procedure, lack of proper screening, weak supervision, and absence of EPI target disease surveillance were weakness in the process of service delivery. More than 98 % satisfaction rate was reported by clients of the service during the exit interview on the dichotomous scale. But the finding was not consistent with the FGDs and the specific items addressed to assess the satisfaction. Therefore, it is concluded that quality of service delivery in immunization was not satisfactory and hence need improvement to have an effect on coverage and mortality and morbidity reduction targets
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    Child prostitution in Bahir Dar
    (Addis Ababa University, 1998-12) Ayalew, Tesfaye; Berhane, Yemane(PhD)
    In Ethiopia, very little is known about prostitution In general and about child prostitution in particular. The purpose of this research is to determine the magnitude of child prostitution and to identify factors associated with and problems of child prostitution. A cross-sectional study design was utili zed. Data were collected using structured questionnaire. Data entry and analysis was done using Epi Info version 6 stati stical software. A total of 650 commercial sex workers were interviewed. Eighty eight (13.5%) were below the age of 18 years at the time of data collection and 268(41.2%) at the time of joining prostitution. Poverty, disagreement with family and peer influence were the major reasons reported for prostitution. Child prostitutes were more likely to have STDs than adult prostitutes [OR= 1. 68; (95% C.l.) 0.95,2.96]. Condom use was poor among child prostitutes compared LO adult prostitutes [OR=1.67; (95%C.I.) 0.97,2.87]. Child prostitutes were iikely to be victim of physical violence [OR= 1.93; (95% C.l.) l.l 8, 3.15] and sexual violence [OR=2.20; (95% C.l.) 1.36,3.35] compared to adult prostitutes. More child prostitutes observed having the ambition to rejoin their family. It is recommended that strategies need to be developed to rescue child prostitutes from on-job violence, to minimize entry in prostitution and to establish a rehabilitation program for those interested to discontinue prostitution. Further study is required to more deeply understand the cause and effect of child prostitution
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    Does Community-Based Distribution (CBD) of Pills increase the Contraceptive Prevalence rate? A Comparative study between CBD and non-CBD areas in Central Tigray, Northern Ethiopia
    (Addis Ababa University, 1997-12) Legesse, Tsegay; Taffa, Negussie(PhD); Berhane, Yemane(PhD)
    A retrospective cohort study was undertaken to assess the effectiveness of Community-Based Oistribution (CEO) of Family Planning services as a strategy to increase Contraceptive Prevalence rate (CPR) in Central Tigray. Thirty "Tabias" each from the CBO and the non-CEO areas were chosen; 683 and 676 panicipants from CEO and non-CBO areas respectively were interviewed. Men and women panicipated in the study were 672 and 687 respectively. The CPR was fOllnd to be [4.4% in CBO and 4.4% in non-CEO areas (OR = 3.67; 95% CI = 1.88/ 5.7). Eighty nine percent of the women in CBO and 82.7% in non-CBO areas (OR = 1.70; 95 % CI = 1.07, 2.7), and 94.1 % of the men in CBO areas and 87.5 % in non-CBO area (OR = 2.26; 95 % CI = 1.26, 4. I) knew at least one method of modem contraception. Similarly, 87.3% of women in CEO areas and 79.5% in non-CBO areas (OR = 1.77; 95% CI = 1.15, 2.73), and 92.9% of the men in CBO area and 84.8% of men in non-CBO areas (OR= 2.33; 95% CI = 1.4, 4.0) approved the use of family planning. Among the current non-users who knew about modem contraceptives, 86.4% of the women in CBO and 80.5% in non-CBO areas had a future intention to use them. Reasons for non-use in both groups were need for more children, lack or low knowledge, and naturally spacing. Reason for discontinuation of modem contraceptives use in CBO areas were need to get pregnant, lack of method choices, and health concerns. With these findings we coneiude that CBO was effective in raising knowledge, positive attitude towards FP and CPR. We recommend that the CBO program has to be strengthened and extended to other villages of the region. IEC with emphasis on mechanisms to encourage inter-spousal communication about FP should be expanded and adequate method mb:es must be available to CBO agents cognizant to their level of training
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    Health and Social Problems of Street Children in Nazareth Town
    (Addis Ababa University, 1995-05) Beyene, Yemane; Berhane, Yemane(PhD); Farrow, James(PhD)
    The exact number of street children in any given country is not known. To determine the number, health, and social problems of the street children, a cross sectional survey was conducted in Nazareth town, south eastern Ethiopia, from November to December 1994. Accordingly 5138 street children were counted during a one day census , by means of a systematic sampling. 597 subjects were selected into the study, 526(88.1%) Males and 71(11.9%) Females. The age ranged from 5 to 18 with mean age of 12.9 and SD of 3. 16. (41.2%) of the children left their families when they were 10-14 years old, and 30 . 7% were separated in early childhood (0-4 years). Onl y (1 8 . 3%) were attending school currently, (54.6%) were children "on" the street and t he rest (45 . 4%) were "of" the street children, (67.2%) of the children eat at least twice daily, (14. 6%) of the children reported the use of at least one of the substances like Alcohol, cigarette, and chat. (61.6%) of the children reported an illness during the survey. The major health complaints were abdominal pain, cough and chest pain, eye and ear problems, headache and leg ulcer . This survey indicated that substance use, police arrest, sexual intercourse and STDs were reported more frequently among the "of " the street chi ldren . In conclusion, the street children have complex social and health problems which need to be addressed utilizing a multisectoral approach
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    Health and Socio-Cultural Problems of Women in Rural Butajira
    (Addis Ababa University, 1998-12) Gossaye, Yegomawork; Berhane, Yemane(PhD)
    Studies on the social and cultural problems affecting the health of women is rare in Ethiopia. This study illustrates the common socio-cultural problems influencing the health of women and the women's perception towards health and illness in rural Butajira. Qualitative and quantitative methods ·,~ere employed to develop the data collection instrument and actual collection of data, respectively . A total of 675 randomly selected rural women participated in the study . Over 94 percent of women are illiterate and only 8 . 7 percent of girls are sent to school . The mean ·",o r "'ing hour for rural women in Butajira is 15 hours. Very higl: proportion (96 . 6%-) women are victims of FGr'l. The decision making power of women at 3. house bold leveJ. is 10\.\1 . vlomen have almos t no access to informatioD, atYJut 88 percent of them never listened to the radio for the last six months . About 97 percent of women reported trat they are suffering from some kind of infectious ,- obstetrics or mental illness at the time of the survey . Punishment from God, lack of nutritious food, exposure to cold, evil eye and evil spirit possession were the major perceived causes of illness. The participants mostly use herbal medication during sickness or buy drugs with out consulting health workers in response to illnesses. They give high regard to traditional healers, witchcraft and vii religious leaders to solve health problems . The women by large have no idea on how to promote health except t hat they resume individual or group prayer . Therefore, it is concluded that women in rural Butajira are surrounded by traditional taboos and social problems affecting health . In order to improve the situation of women the health service strategy needs to be devised after considering what women believe, what they actually do and need. Such strategies should be based on local problems and the involvement of locally accepted healers
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    Magnitude, Pattern and Differentials of Internal Migration in Meskan and Mareko Woreda Southern Ethiopia
    (Addis Ababa University, 1996-05) Abicho, Tesfaye; Berhane, Yemane(PhD); Teller, Charles(PhD)
    Internal migration is observed to cause major imbalances in the availability of economic and social opportunities due to fluctuation in composition and size of the population. A retrospective longitudinal study was conducted in Meskan and Mareko Woreda to describe the magnitude, patterns and differentials of internal migration in 9 PAs and 1 UDA sampled using probability proportionate to size. Data on variables of population mobility were collected by BRHP using monthly household visits for the period 1987-1994. In addition, in-depth interviews with key informants, focus group discussions & observation were conducted in the study sites. Results showed that during the 1987-1994 there was a total of 18,426 moves, of which 9,610 (52%) were in-migrants and 8,816 (48%) were out-migrants. The sex distribution of both in- and out-migrants demonstrate that females outnumber males. The age group with the highest percentage of internal migrants is in the range of 15-24 years. The observed rates per 1000 mid-year population are 36.0 and 33.1 for in- and out-migration respectively while the net-migration was 2.9 per 1000 mid-year population. It is observed that both in- and out-migrants are in the active and productive age group. The pattern of population movement is mainly seasonal. Employment & marriage appear to be the main motives for the population movement in the area while education is also becoming important. The pattern of age/sex selectivity of migration has important public health implications, in that they affect the relative size of important target group, such as children 0-4 & female 15-24 years. Further detailed studies to fully understand migration streams, determinants & consequences are essential
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    Neonatal Survival in Addis Ababa
    (Addis Ababa University, 1995-05) S/Mariam, Yodit; Berhane, Yemane(PhD)
    Neonatal mortality is estimated to be high in many developing countries but, very few studies were conducted in this area. To illucidate the magnitude of neonatal mortality and identify its determinants, a descriptive cross sectional study on a cohort of newborns was carried out in Addis Ababa health institutions between November 8 to January 19 1994. A total of 1334 newborns participated in the study . Baseline information on the risk behavior of the mother and child characteristics were recorded just after delivery. Then follow up interview were carried out by visiting each neonate at home on the 7th and 28th day . In this study the prevalence of neonatal mortality was found to be 71.9 per 1000 live birth with early and late neonatal mortality of 50 . 9 and 20.9 live birth respectively. LOW birth weight babies, premature babies and babies born from mothers who were not family planning users were found to be at higher risk of neonatal death using both bi variate and multi - variate analysis. The study concluded neonatal mortality is very high and strengthening of neonatal care facilities and further study to determine the prevalence rate of neonatal mortality among home deliveries are recommended
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    Reasons for Default from Prevention of Mother to Child Transmissions (PMTCT) of HIV Program in Addis Ababa
    (Addis Ababa University, 2007-07) Bekele, Yonas; Berhane, Yemane(PhD)
    Back Ground: As of February 2004 Prevention of Mother to child transmission of HIV program was started as “hareg” project at five health facilities in Addis Ababa which later expanded to 33 sites. Since its starts, yearly regional health bureau report showed that the region didn`t achieved the national Prevention of Mother to child transmission of HIV program target in relation to counseling and test acceptance. More ever less than half of HIV positive mothers and their infant have taken full course of Nevirapin while the other half default from Prevention of Mother to child transmission of HIV program and they didn`t take Nevirapin. Objective: the main objective of the study is to identify reasons of HIV positive women for defaulting from PMTCT program and not taking ARV prophylaxis in Addis Ababa after they receive their post test HIV result. Methods: Prevention of Mother to child transmission of HIV program uptake analysis was done among ANC attendants for Prevention of Mother to child transmission of HIV –Voluntary counseling and testing uptake and on the uptake for Nevirapin for all Prevention of Mother to child transmission of HIV mothers and their newborns during two years of Prevention of Mother to child transmission of HIV program implementation at “Hareg” pilot sites by reviewing national registration, recording and reporting formats. Qualitative study through in depth interview with HIV positive mothers who lost from PMTCT program and focus group discussion with health professional working at PMTCT clinic and mother to mother support group were conducted to investigate the women`s reasons for not accepting ARV prophylaxis in PMTCT program in Addis Ababa at “Hareg” PMTCT pilot sites. Collected data were translated, transcribed, prepared in Microsoft word document which is changed to plain text. The document imported to Open code soft ware, and coding, listing of frequencies, and data reduction were done. The data then summarized. Interpretations of data, drawing of conclusion were performed. Result:- Total of 95378 new antenatal care attendants were registered during this two-year period, of whom 44095 (46%) enrolled for VCT at the PMTCT program and 28635 (65 %) tested for HIV. Three thousands four hundreds and eighteen (3418) (11.9%)mothers tested HIV positive and were therefore enrolled in the PMTCT program. However, only 1913 (56%) HIV positive pregnant mothers received the Nevirapine during delivery. Moreover: only 1965(57%) newborns received Nevirapine within 72 hours after birth showing close to half of mother`s lost to follow up and didn`t receive Nevirapin. Quality of health care during PMTCT counseling, follow up, and delivery, stigma and discrimination were identified as the main reasons for loose from PMTCT follow up and not took ARV prophylaxis during delivery. Additional reasons mentioned includes personal factors associated with the clients including religion related factors, distance from facilities, changing of place and disclosure. Conclusion and recommendation Strengthening monitoring and Evaluation of PMTCT programs, mothers to mothers support group, community mobilization, quality assurance program in PMTCT, nutritional support and involvement of families in PMTCT program would have paramount benefit in increasing ARV prophylaxis uptake. Key words: PMTCT, ARV prophylaxis, Mother to mother , Nevirapin
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    Utilization of PMTCT Services among Pregnant Women in Western Amhara Region
    (Addis Ababa University, 2007-04) Worku, Tilahun; Berhane, Yemane(PhD)
    Background: Ethiopia is one of the countries hard-hit by HIV/AIDS. Amhara region has the largest proportion of HIV positive women, HIV positive live births and AIDS orphans. PMTCT programs are starting to be launched in many health facilities of the country. Thus it is imperative to study the utilization of the services by pregnant women to ensure programme effectiveness. Objectives: - The objective of this study was in general to determine the level of utilization of PMTCT program in western Amhara region and specifically to determine the level of antenatal VCT service utilization, to examine factors influencing acceptance of voluntary HIV counseling by pregnant women; and to explore client preferences and suggestions on PMTCT program implementation by which acceptance may be increased. Methodology: - A health facility based cross sectional survey was conducted using structured questionnaire among 452 pregnant women following antenatal care (ANC) at selected facilities of west Amhara region between April and June 2006. Four focus group discussions (among pregnant women not following ANC for the current pregnancy and spouses of pregnant women) and eight in-depth interviews (among traditional birth attendants and counselors) were conducted. Results: - Response rate was 98%. Three-hundred and four (67.3%) of the respondents had under gone the process of voluntary counseling and testing for HIV. Two hundred eighty-nine (97.6%) of them were tested for HIV and 274 (94.8%) of those who were tested received the test result. Of all the socio-demographic variables, education was positively associated with acceptance of ANC counseling (AOR (95% CI) for formal schooling Vs no formal schooling = 3.67 (1.56, 8.61)) while being a rural women and being a farmer were associated with less likelihood of undergoing HIV counseling in ANC [AOR (95%C.I.)= 0.22 (0.14, 0.35) and 0.44 (0.22, 0.98] respectively). Correct knowledge with respect to transmission of HIV during labor and that it can be prevented by chemotherapy were associated with higher likely hood of using PMTCT services. The main barriers for utilization of PMTCT services identified were incorrect perceptions regarding HIV/AIDS and stigma by husband, family and community. Conclusion: Based on the findings Community based education and sensitization targeted to women, increasing access of women to VCT, promoting PMTCT to all facilities caring for women in the catchments areas is recommended Key words: Pregnant women, PMTCT, VCT, HIV/AIDS, ANC, Ethiopia