Browsing by Author "Gebremichael, Bereket (MSc,Ass’t Professor)"
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Item Caregiver’s Knowledge and Utilization of Growth Monitoring and Promotion for under 2 years children in Debre Berhan, Ethiopia, 2020.(Addis Abeba University, 2020-09) Ahmed, Fuad; Gebremichael, Bereket (MSc,Ass’t Professor); Wondwossen, Kalkidan(MSc )Background: Growth monitoring and promotion is a prevention activity comprised of growth monitoring, linked with promotion that increases awareness about child growth and serves as the core activity in an integrated child health and nutrition program. Even though growth monitoring and promotion would appear to be a prerequisite for a good child health, several studies have shown that there is a “know-do gap” among caregivers. Objective This study was aimed to assess caregiver‟s knowledge and utilization of Growth monitoring and promotion services for children under two years old in Debre Berhan, Ethiopia 2020. Method Community based cross sectional study supplemented with qualitative design was conducted in Debre Berhan from February- May2020. Quantitative and qualitative methods were used. For quantitative part, from the 421 estimated sample size 402caregivers were selected by using a single population proportion formula with simple random sampling and data was collected using adopted, structured and pretested interviewer administered questionnaire. For qualitative 6 purposively selected health extension workers were interviewed (in depth interview) to supplement the quantitative study to find out the challenges. Quantitative data was entered into Epi data version 4.0.2 then exported to a Statistical Package for Social Sciences version 21.0for analysis. Bivariate and multivariable logistic regressions were computed to see the association of independent with the dependent variables. The results were reported as Odds Ratio and 95% Confidence interval. Qualitative data was analyzed using thematic analysis. Result with 402(95.4%) response rate, only 35% of the care givers were found to have adequate knowledge about GMP while utilization of GMP services was 13.4%.Illiterate caregivers were 3 times less likely to know about Growth monitoring and promotion than those with secondary or above level of education [AOR=3.54; (95% CI=1.22, 10.72)].Caregivers who didn‟t get an explanation about the weight status of their child were 5 times less likely to have adequate knowledge about Growth monitoring and promotion than their counterparts [AOR=5.02; (95% CI=2.626, 9.597)].Additionally, those who said there was no nutritional counseling and education sessions at the health facility were 2.4 times less likely to be knowledgeable about Growth monitoring and promotion than those that attended the session [AOR=2,4; (95% CI=1.356, 4.359)].Residents at rural area were more likely to utilize growth monitoring and promotion than urban area [AOR=0.128; (95% CI=0.035, 0.474)]. The odds of young child age group (0-5 and 6-11month) not to utilize Growth monitoring and promotion were lower by 87.7% and 80.7% respectively compared to the 18-23 months of age [AOR=0.123 and 0.193;(95% CI=0.029, 0.517 and 0.049,0.764)]. Children‟s with more than 5 family members were 3 times less likely to utilize Growth monitoring and promotion than those with less[AOR=2.97; (95% CI =1.171,7.536)].The odds of not utilizing the service were lower by 94% for those who travel less than an hour to reach the health facility [AOR=0.06 ; (95% CI=0.014,0.261))]. Care givers with poor knowledge were 2.4 times more likely not to utilize Growth monitoring and promotion than those who had good knowledge [AOR= 2.45 ;( 95% CI=1.125-5.332)].Qualitatively, workload, lack of materials, lack of training and supervision were among the major challenges faced by health extension workers. Conclusion and recommendation Both Knowledge and utilization of Growth monitoring and promotion were low. Thus, efforts should be made to deliver supportive supervision, trainings and materials to health posts. Additionally, promotional campaigns must be initiated to create awareness in both the rural and urban side of the city.Item Determinants of Low Birth Weight among newborns delivered at Addis Ababa public Hospitals (unmatched case control study),Addis Abeba,Ethiopia,2018/2019.(Addis Abeba University, 2019-02) Baye, Getaneh; Gebremichael, Bereket (MSc,Ass’t Professor); Wondwossen, Kalkidan(MSc )Background: Low birth weight is closely associated with fetal and neonatal morbidity, inhibited growth and cognitive development, and chronic diseases in life. Birth weight also predicts the child’s future health, growth, psychosocial development, and survival. Low birth weight can be defined as weight at birth less than 2,500 grams irrespective of gestational age. In developing countries, a birth weight below 2,500 grams is the leading cause of infant and child mortality and contributes to several poor health outcomes. In Ethiopia, the prevalence of LBW is as high as more than 13% according to studies from different regions of the country. Birth weight is a good summary measure of multifaceted public health problems that include long-term maternal malnutrition, ill health, and poor health care during pregnancy. Objectives: Main aim of this study is to identify determinant factors of low birth weight among newborns delivered in Addis Ababa public hospitals 2018/2019. Methods: A hospital based unmatched case control study will be conducted among 279 deliveries from March to April 1 2019 in Addis Ababa public hospitals, Ethiopia. The sample size is determined using double population proportion formula N=279. Consecutive sampling technique will be used to get cases and systematic sampling to get controls. Data will be collected by interviewing the mothers, reviewing medical records and measuring the anthropometry of the mothers and the newborns using structured and pretested questionnaire. Data will be entered using Epi-data 4.12 software and analysis will be done using SPSS 23. Variables that show significant association in the bivariate logistic regression analysis (p<0.25) will be entered in multivariable logistic regressions model. Adjusted odds ratio with 95% confidence interval (CI) and p value ≤0.05 will be used to claim statistical significance. Work plan: The study will be conducted from September to June, 2018/2019. Budget: The total budget required for this project is 35970 Ethiopian birrItem Determinants of preterm birth among newborns delivered in public hospitals of Hawassa Town,South,Ethiopia,2020:a case control study.(Addis Abeba University, 2020-09) Zewde, Ashenafi; Gebremichael, Bereket (MSc,Ass’t Professor); Tesfaye, Tewodros (BSc, MSc)Background Preterm birth is alive childbirth before 37 completed weeks or 259 days of gestation from the first date of a woman's last menstrual period. About 15 million babies are born preterm annually and more than a million died due to complications. Preterm birth rates appear to have increased over time and the exact cause of preterm birth is unknown with different risk factors are assumed to have an association. Objective The objective of the study was to assess determinants of preterm birth among newborns in public hospitals of Hawassa town, Southern Ethiopia, 2020.Method A Facility-based unmatched case-control study design was conducted from March 1 st to June 30 th , 2020.The sample size was determinedfrom previous studies by considering double population proportions formulausing r = 2 (ratio of cases to controls), 80% power and 95% confidence level and total sample size was270 mothers 90 cases and 180 controls. Consecutive sampling method for cases and systematic random sampling controls were used.Data was coded and entered into Epi data 3.1 and analyzed by using SPSS version 25.Variables that had (P- value <0.25) in the bivariate logistic regression analysis were entered in multivariable logistic regression model. Finally pvalue <0.05 was used to claim statistical significance. Result Out of the 270 mothers, a total of 266 participated in the study comprising 89 cases and 177 controls with a 98% response rate. Factors like sex of newbornAOR3.39, 95% CI (1.53-7.52), parity AOR4.25,95%CI(1.7010.59), pregnancy induced hypertensionAOR5.62,95%CI(1.10-28.71), antepartum hemorrhage hemorrhage AOR9.20,95%CI(2.09-40.32),premature rapture of membraneAOR4.69,95%CI(1.83-12.07), birth weight AOR6.2,95%CI(1.97-19.53), stressful lifeeventsAOR5.67,95%CI(2.16-14.91) and intimate partner violence AOR5.19,95%CI(2.0613.07)were found to predict preterm birth. Therefore interventions that target the identified modifiable risk factors should be developed by health professionals, professional associations, ministry of health in collaboration with non-governmental organization.Item Survival and predictors of mortality among HIV Positive Children on Antiretroviral Therapy at Public hospitals in East Gojjam, Ethiopia, 2019(Addis Abeba University, 2019-07) Biyazin, Yalemgeta; Gebremichael, Bereket (MSc,Ass’t Professor); Wondwossen, Kalkidan(BSN, MSC)Background: Human immunodeficiency virus and acquired immunodeficiency syndrome had created enormous challenges worldwide, continued to be the world’s serious health and development challenge. Globally, at the end 2017, there were 1.8 million children (<15 years) living with human immunodeficiency virus. The goal of antiretroviral therapy is to maintain maximal suppression of viral replication, to restore immune function, to reduce human immunodeficiency virus -related morbidity and mortality, and improve quality of life and prolong survival. The survival of HIV positive children treated with ART depends on a variety of factors, which might vary greatly with economic, socio- demographic, behavioral risk and health factor. Objectives: To assess Survival status and predictors of mortality among human immunodeficiency virus Positive Children on Antiretroviral Therapy at East Gojjam Zone Public hospitals, Amhara Regional State, Ethiopia 2019.Methods: An institution based retrospective cohort study was conducted in selected hospitals of East Gojjam zones among children aged less than 15years who were newly enrolled in human immunodeficiency virus care clinic from January1st 2014 to December 31, 2018. Data was collected using standardized check list. The charts were reviewed during March 1 to 22,2019. Data was entered Epi-Data version 3.1 and then exported to SPSS version 24 for statistical analysis. A Kaplan Meier curve and long rank test were used to estimate the survival time and compare survival curves between variables. Multivariable Cox proportional hazards model was fitted to identify predictors of survival status and variables having p value < 0.05 were considered as statistically significant. Result: In this study, a total of 251 HIV positive children on ART were followed up for a total of 60 months, with a mean (SD) survival time of 55.54(+ 0.83), (95% CI:53.90-57.17) months. The overall mortality incidence rate in the cohort during the 626 Child-year- observation (CYO) was 2.56/100 CYO. Kaplan- estimation Meier survival showed that overall estimated survival probability after starting ART was 0 .90 at 60 months of follow up. In this study age, hemoglobin level, CD4 count, cotrimoxazole preventive therapy (CPT), weight for height were statistically significant predictors of survival status (P <0.05). Conclusion and Recommendation: Age < 5 years, CD4 count, Hgb <10gm/dl, WFH (z<-3), not taking cotrimoxazole preventive therapy were an independent predictor of mortality. Therefore, concerned stakeholders should focus on above mentioned predictors of mortality and nutritional interventions to enhance survival of HIV-infected children on antiretroviral therapy.