Browsing by Author "Berhe, Aster"

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Assessment of the Implementation of Focused Antenatal Care in Public Health Centers in Addis Ababa, Ethiopia
    (Addis Abeba University, 2014-06) Berhe, Aster; Prof.Fantahun, Mesganaw (MD, MPH, PhD)
    Background- Antenatal care (ANC) is a widely used strategy to improve the health of pregnant women and to encourage skilled care during childbirth. In 2007, the Ministry of Health of Ethiopia developed a national adaptation plan based on the new model (Focused Antenatal care) of the World Health Organization (WHO). Although antenatal services are well utilized in Addis Ababa (100% first visit coverage), there are gaps in full implementation of all components of Focused antenatal care. Currently, there are limited studies on the implementation of Focused antenatal care in Ethiopia including in the study area. Objective-To assess the implementation of Focused Antenatal Care in public health centers of Addis Ababa. Methodology- Facility based cross sectional study using quantitative supplemented with qualitative data collection methods were conducted from July to August 2013. Eight hundred Sixteen sessions of Antenatal care were observed in ten health centers. Simple random and purposive sampling techniques were used for quantitative and qualitative components of the study respectively. A pretested semi structured interview guide and structured checklist was used to collect data. Data were entered with EPI-info version 3.5.1 and cleaned with, analyzed by SPSS version 20. Data was analyzed using descriptive and bivariate statistics and thematic analysis for in-depth interview. Results- The study revealed that the health care providers’ performance by five FANC components was as follows, on average comprehensive history taking had the highest performance (92%) and lowest performance was in clinical examination (54%). There was statistically significant difference (p<0.05) on the performance of health care providers where health officer and diploma midwives total average percentage performance scores were 79% and 75% respectively, while nurses scored 67%. Practice compared by visit and time spent showed that health care provider perform better in visit one (78%) and worse in visit three (62%). The average duration was 19 minutes for visit one and the time reduced during subsequent visits and was lower than WHO/National protocol. The qualitative data analysis revealed that there is variation among health care providers experience in implementing FANC and this may depend on their knowledge on FANC and work collaboration from their colleagues. Besides, Health care providers performed most of the procedures but also omitted certain procedures developed in the WHO / National protocol in all assessed health centers. Most of the assessed health centers have basic equipment’s and supplies while the National protocol on selected obstetrics topic including FANC was not found in all health centers and some procedures were not included in ANC card. Conclusion and recommendations- Health care providers did not spend adequate time as per the WHO/National protocol for each visit and their practice was not uniform. This affects the implementation of all components of Focused ANC and the desired outcome, it is especially prone to shallow health information and counseling which is at the center of Focused ANC. There were adequate equipment and supply to provide FANC in most of the assessed health center except few gaps. Implementation of Focused ANC may require assigning adequate staff and providing training, updating and disseminating the 2010 National Management Protocol on Selected Obstetric Guidelines for Antenatal Care to be in line with the new PMTCT guideline then revise FANC card accordingly.
  • No Thumbnail Available
    Item
    Infant Feeding Experience of Hiv Positive Mothers Utilizing Pmtct Services: The Case of Tikur Anbassa Hospital
    (Addis Ababa University, 2009-08) Berhe, Aster; Joshi, Sandhya (PhD)
    Mother to Child Transmission of HIV can occur during pregnancy, delivelY, and breastfeeding and it accounts for more than 90% of pediatric AIDS Various studies indicate that the rate of Mother to Child Transmission of HIV is high among infants who were on mixed feeding. UNICEF UNA IDS and WHO recommended that, all women have the right to choose exclusive breastfeeding or exclusive replacement feeding. However, numerous contextual factors can influence mothers in their choices and decisions related to what and how they feed their infants. An understanding of factors that influence women's adherence to the recommended infant feeding is critical in identifying ductile point's intervention. The study aims explore the experiences of infant feeding practices of HIV positive women who have used Prevention of Mother to Child Transmission service. Qualitative data was collected by the principal investigator using semi structured in-depth interview from 12 HIV Positive mothers who use PMTCT service at Tikur Anbassa hospital and was analyzed using principles of thematic content analysis. Most of the informants have opted for Exclusive breast-feeding due to economic reasons. Moreover, the long-standing community belief that aI/aches breast-feeding with motherhood also has an implication not to choose replacement feeding. Fear of disclosure and practicing exclusive infant feeding in an area where predominant breastfeeding is a norm are important challenge that affects mothers well being because of ostracization and stigma, which makes their lives difficult in the community. The velY basic essence of coping strategy is the mother 's ambition to have HIV free child. Most of the Study informants have appreciated the PMTCT services. The study has explored issues related to adherence to Exclusive infant Feeding practices. Hence, strengthening the counseling program, expanding PMTCT services, promoting exclusive breast-feeding by all mothers, continuous work on stigma and discrimination, linking the ANC and PNC with mother support group, are the major intervention areas that have been suggested in an effort to improve the effectiveness of P MTCT service. Key words: Exclusive Infant Feeding, AFASS, PMTCT