Browsing by Author "Berhane, Yemane (PhD)"

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    A Community Based Study of Health-Related Problems among Adolescents in Awassa Zuria Woreda, Southern Ethiopia
    (Addis Ababa University, 1995-05) Mengiste, Solomon; Berhane, Yemane (PhD)
    The prevalence and determinants of substance use (alcohol, khat, cigarette), mental illness, suicidal attempt, STDs and teenage pregnancy among adolescents aged 10-24 years have not been well documented in the country. A community based cross-sectional study was conducted in Awassa Zuria Woreda, southern Ethiopia from November to December 1994 G.C. A total of 1953 adolescents were included in the study. Data were collected using questionnaire by trained interviewers. The likelihood of substance (alcohol, Khat, Cigarette) use on average was at leas t two times higher (p<0.05) among adolescents who reported history of run away from their family and police arrest. Mental illness, suicidal attempt, STDs and teenage pregnancy were found to be more likely to occur among adolescents who use one or more of the substances than others.The older adolescents in general were found to be more likely to be exposed to all of the health related problems studied. Risk factors identified for substance use and association of substance use with the health related problems among adolescents were observed in this study. The levels and the interactions observed between the adolescent risk behaviors and health related problems indicate the need to set an immediate intervention programmers .
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    Determinant Factors That Influence the Use of Family Planning Among Eligible Couples in Rural Amhara: the Case of Bahir Dar Zuria Woreda
    (Addis Ababa University, 2001-06) Hassen, Mohammed; Berhane, Yemane (PhD)
    Rapid population growth is one of the major hindrances of societal development, which in most cases obse/ved in developing countries. Resource shortage, high rate of unemployment, high burden of dependency ratio, environmental degradation, etc, and an overall deterioration of the quality of life are sOllie of the outcomes of rapid population growth. Due to this governments of lIIany developing nations are unable to meet the social and economic needs of their people. In order to avoid problems caused by population growth, practicing of fclll1ily planning is one of the 1II0S/ papillar con/rolling methods used as a remedy. Limiting the number of children at household level is a first step to be taken that requires educating and encouraging rural eligible couples to have a Sill all family size. A cross-sectional survey was conducted all 140 couples, 70 currently users and 70 currently non-users in ten rural Kebeles using multi-stage stratify and random sampling techniques and the study was conducted to identify the influential factors for the use and non-use of modem contraceptives. Fac/ors identified as determinants were age of males, age during first marriage of females, education level of females, economic status of couples, knowledge about modem contraceptives and al/itude of couples, desired number of children of males, reasons given by males to have 1II0re children, decision making role of males and sex preference of children of couples. Providing consecutive education all fcUl1ily planning that enable to bring attitudinal and behavioral c/wnges of the rural couples would be much helpjitl to improve the pe/forl/wnce of falll it)! planning and thereby couples would have small family size, which is the main strategy to curb the rapid population growth that contributes to the achievement of development.
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    Determinants and Causes of Adult Mortality in Butajira
    (Addis Ababa University, 2000-12) Lulu, Kidest; Berhane, Yemane (PhD)
    Information on adult mortality is essentially non-existent in Ethiopia as in the rest of subSaharan Africa.This nested case-control study was conducted with the aim of assessing sociodemographic and behavioural factors associated with adult death in Butajira, Ethiopia. All deaths in the age-group 15-49 years during 1995-99 were taken as cases and unmatched controls of age 15-49 years were selected randomly from the computerized demographic surveillance database. Data were collected by lay interviewers using a simplified verbal --autopsy questionnai~e. Crude-and adjusted odds ratio-with-95%-confidence interval_were calculated to determine associations. Causes of death were diagnosed using an "expert algorithm" programmed into a computer.A total of 515 deaths and 1507 controls were interviewed. The major determinants of mortality identified are age-groups 30-39 and 40-49 years (OR 2.99, 95%CI 1.91-4.71 and OR4.01, 95%CI 2.49-6.46), male sex (OR 1.46, 95%CI 1.09-1.95), living in a rural lowland area (OR 1.54, 95%CI 1.03-2.31), single marital status (OR 1.63, 95%CI 1.13-2.35), having no educated person in the family (OR 1.91, 95%CI 1.11-3.29), being unemployed (OR 1.40, 95%CI 1.01-1.82), and poor and very poor perceived economic status (OR 1.97, 95%CI 1.31-2.94 and OR 2.98, 95%CI 1.73-5.13). The major causes of death observed were acute febrile illnesses (25.2%), liver diseases (11.3%), diarrhoeal diseases (11.1%), tuberculosis (9.7%) and lllV/AIDS (7.4%). Communicable diseases accounted for 60.8% of the deaths. The factors associated with mortality and the high level of mortality from communicable diseases reflect the poor socioeconomic development of the country and inadequate coverageas a whole in education, health and poverty alleviation. Therefore, efforts should be directed at planning and implementing cost-effective interventions to decrease morbidity and mortality particularly from communicable diseases. Emphasis needs to be given also to poverty alleviation programmed.
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    Exposure Assessment to Indoor Smoke Pollution in a Rural Ethiopia
    (Addis Ababa University, 1999-12) Eshete, Berhanu; Berhane, Yemane (PhD); Kumie, Abera (PhD)
    Very little effort has been made in Ethiopia to assess the effect of indoor air pollution at a community level. The aim of the study was to assess exposure to indoor air pollution at a household level and f ind out the feasibility of using questionnaire in determining exposure level for indoor air pollution . Crosssectional study design was utilized . Data were collected using structured questionnaire , in-depth interview with key informants and child movement recording . Data entry and analysis was done using Epi Info version 6 statistical software . A total of 600 households f rom the three study areas (rural high land , rural lowland and t own)were assessed . Three hundred thirty four(55 . 7%)of the households had high exposure level to indoor smoke . Rural households were less likely to have adequate smoke clearance compared to urban households (OR=O . 3 ; 95% CI=O . 16 , 0 . 54) . Being muslem, mar ri ed , Mother illiterate and and low economic status were less likely to be in the low exposure status with adjusted OR(95%CI) of 2 . 24(1.39 , 3 . 54) , 0 . 41(0 . 18 , 0 . 82) , 0 . 36(0 . 2 , 0 . 66)and 0 . 34(0 . 22 , O . ~4) , respectively . The main source of i ndoor Hlnoke wa s biomass fuel used by 98 . 5% for cooking and 29 . 6% for heating . The majority (94.9%) were using open type of stove wi thout flue or chimney . The median (SO) of exposure time by the interview and observation was found to be 180(202) and 125(148) minutes , respecti vely. From this we conclude and recommend that biomass fuels are the principal sources for the indoor smoke , the poor socio- demographic and environmental factors e xpos e children t o indoor smoke and collecting information about exposure time of under f ive c h ildren using interview and observation methods has no statistically significant difference . Using cleaner fuels , improving social , e conomic , cultural and envi ronmental conditions could improve the exposure level to indoor smoke .
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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 were 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 working hour for rural women in Butajira is 15 hours. Very high proportion (96.6%) women are victims ofFGM. The decision making power of women at a house hold level is low. Women have almost no access to information, about 88 percent of them never listened to the radio for the last six months. About 97 percent of women reported that 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 religious leaders to solve health problems. The women by large have no idea on how to promote health except that 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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    Infertility in Rural Ethiopia
    (Addis Ababa University, 1999-12) Haile, Ashenafi; Berhane, Yemane (PhD)
    Infertility is a world-wide problem aff ecting 8-12% of married couples. The prevalence of infertility in some areas of the sub-Sahara region reaches as high as 30% . Muc h of the literature on infertility deals with the problems of infertility for wome n in the western countries and l ittle is known as to what puts women in sub-Sahara Africa v ulnerable to infertility and as to how perceive the causes o f infertility. A cross-sectional survey was conducted in rural Buta jira, Ethiopia, in the period between the 13th of May and 23 rd of June, 1999 to determine t he magnitude and potential risk factors of infertility. A total of 901 women in the age group 20 to 29 years were e nrolled into the study from s urveillance reg ister. The prevale nce of primary and secondary i nfertility was 2.9% a nd 16.1% respectively. Comparison was made between cases of secondary infertility and fertile women about potential risk factors. pregna ncy wastage, age at first marriage less than 16 years, STDs occurring after t he last pregnancy, polygamous marriage, and low level education of the husbands were found significantly associated with secondary i nferti lity. Most women with the problem of infertility in the area visit the witc h-craft , more often than the health institutions. It is recommended that public health officials must i ncrease the access to and strengthen programs aimi ng at the reduction of post-partum a nd post- abortal i nfections a nd STDs. Due attention should be given for developing and impleme nting protocols for evaluating and managing infertility.
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    Magnitude and Determinants of Bottle Feeding in a Peri-Urban Community
    (Addis Ababa University, 1995-05) Bekele, Abeba; Berhane, Yemane (PhD)
    A descriptive cross-sectional sur vey was conducted in Butajira Woreda , south western Ethiopia, fo r a period of two months to determine the extent of bottle use in child feeding, fact ors associated with its use and the time of introduction of supplementary f eeding . A t otal of 1536 households with children 0-23 months were included in the study. The study found out the overall prevalence of bottle feeding to be 11.3% and the prevalence among children on suppl ementary feeding to be 16.7%. Only 6.3% of the bottle fed children were on bottle alone . Residence, maternal education and occupation were significantly associated with the practice of bottle feeding in the crude analysis and after adjusting for parental and child characteristics (P <0 . 05) . Only 53 .3% of the children received timely supplementary feeding, that is, between 4-6 months . Thirty four percent of children beyond the six months of age were found to be on exclusive breast feeding. Child bottle f eeding practice was significantly associated with early introduction of supplementary feeding, P<0.05. The extent of bottle feeding in the studied community is quite high and was found to be practiced more among the relatively well to do members of the community, a trend which was seen in the developed world at the beginning of the century. Improvement in maternal and child health services including health education are recommended.
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    Pregnancy Outcome in Rural Ethiopia With Emphasis to Prenatal Mortality
    (Addis Ababa University, 1997-12) Wolde-Michael, Kifle; Berhane, Yemane (PhD)
    A prospective communi ty-based study of pregnant women was conducted to assess pregnancy outcome with emphasis to perinatal mortality in rural communities of Meskan and Mareko district in Gurage zone in Southern Ethiopia, between March 22 and August 21, 1997. Pregnant women were identified by trained enumerators through house - to - house visit and were followed monthly till delivery, after which both the neonates and the mothers were visited at 7th and 28th days . Pretested questionnaires were used to obtain information on sociodemographic characteristics, past obstetric history , health problems during the index pregnancy and labour, and the condition of both the neonates and the mothers at the 7th and 28th days . Analysis made on 428 singleton births showed a perinatal mortality rate of 44.4 per 1000 birth s. The stillbirth and early neonatal mortality rates were 21.0 per 1000 births and 23.9 per 1000 live births , respectively. The rates were found to be relatively low as compared to figures reported for other sub-Saharan Africa. Both bivariate and multivariate analysis showed that maternal height and gestational age were significantly associated with perinatal mortality . The risk of death was significantly higher among neonates born to short statu red mothers . Si milarly the risk of perinatal death was higher in preterm babies than term babies. Continuation of this study for longer period , training of TBAs and provision of health education to the the community about clean and safe management of delivery and cord treatment and educating mothers on nutrition and appropriate utilization of MCH services are recommended.
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    Quality of Reproductive Health Services, with Emphasis on Structural Aspects, in South Central Ethiopia
    (Addis Ababa University, 1998-12) Wako, Getachew; Berhane, Yemane (PhD)
    Health care services in developing countries are reported to suffer from low quality. A descriptive cross-sectional stud y was conducted to assess the quality of reproductive health care, with emphasis all the structural as aspects in two administrative zones in somh central Ethiopia. Of the 79 health institutions in the stud y area, 74 were visited for a response rate of 94 %. Data were collected using a questiowlllire adopted from dIe WHO Safe Motherhood Need Assessment and dle WHO training modules for EP[ and STDs. Mult iple structu ral defi ciencies were identi fied in all components of reproductive l1ea1th care. Absolute minimlUll equipment for maternity and neonatal care were found 10 be complete and adequate in 20(27 %) and 3(4. 1 %) of the ins titu tions, respectively. Consumable supplies were avai lable adequately in 13(17.6%), ste ri lizer in 13(17 .6%), essential drugs iu 16 (21.6%), ergometrine injection i0 49 (66.2%), and alcohol in 22 (29. 7%) oftlle institutions. [n the EP[ section, steam steri lizer was available in 45(60.8 %), and adequa te vaccines in 57 (77 .0%) of the ins titutions . Only 1( 1.4%) health institution had a complete mix of contraceptives. Important laboralOry tests(syphilis test, hemoglobi nometer. urine atllllysis) were available fu lly in only one ( 1.4%) health ins ti tution. Only 9(12. 1 %) health insti tutions had adequate [EC materials on all reproductive health components. More than haH [44(59.4% )[ of tlle healtll institutionsilad no water source in tlle ircompound. Only 8(10.8 %) were found 10 have a telephone or two-way radio. A thi rd. 25(33.8%), of the heal III institu tions had no means of transport. ft is concluded that the Structural setring for reproductive health services is very poor in [he majority of [he bealth institu tions. Recolllmendations include that besides constructing new health instiru tions, strong emphasis should be given Oll revitalizing the existing health illStitutions by correcting stnlcrural deficiencies without delay.
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    Sanitary Condition of Catering Business Establishments in Addis Ababa
    (Addis Ababa University, 1995-05) Fisseha, Getachew; Teka, Gebre-Emanuel (PhD); Berhane, Yemane (PhD)
    A great majority of eating places are functioning in Addis Ababa under different denominations. The sanitary standards of these establishments was not clearly known since no systematic study had been conducted so far in the city. A cross-sectional survey was conducted to assess the sanitary condition of catering establishments in fifty randomly selected from 284 Kebeles in Addis Ababa proper from October to December 1994. Census identified 1485 catering establishments in these kebeles. Twelve randomly selected establishments were included into the study from each Kebele for the study. The response rate was 98.7%. Findings showed that 559(95 .2%) were privately owned. One hundred and seventy one (29.1 %) had no license. One hundred and fifty eight (26.9%) of the managers were not literate and only 7.2% had education above grade twelve. Poor repair condition of premises, inadequate sanitary faci lities, unsanitary utensils cleaning and handling , improper waste storage and disposal, poor personal hygiene of food handlers were the major findings. Seventy five (12.8%) of the studied estab lishments were found in good sanitary condition. Multi-sectoral approach of official control servIces by divulging the legislation to owners , managers , operators through regular supervIsIon and . increasing awareness of foodhandlers and the public in general , through training and health education are required to improve the current sanitary condition of catering establishments.