Browsing by Author "Gebretsadik Shibre"

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    Assessment of Mothers ‘Experience of Mistreatment During Facility Based Child Birth and its Predictors in Hosanna Town, South Ethiopia, 2019.
    (Addis Abeba University, 2019-10) Azeb Getachew; Mesech Assegid; Gebretsadik Shibre
    Background: Provision of quality maternal health services has a paramount contribution for improving service uptake and reduction of maternal death. Mistreatment during child birth that affects women‘s interest towards health service utilization . Yet, there is paucity of evidence about the magnitude of various forms of mistreatments mother‘s experience during facility based childbirth. Objectives: This study aims to assess women‘s experience of mistreatment during facility based child birth and its associated factor in Hosanna town and its surrounding kebeles, south Ethiopia, 2019. Method: Community based cross sectional study was employed from March to April 2019 in Hosanna town, South Ethiopia .Mothers who gave birth two week prior to the study period were selected through systematic random sampling technique from the recorded contact address of the delivered mothers. Binary and multivariate logistic regression model was used to assess mother‘s experiences of mistreatment using certain predictors. Crude and adjusted Odds ratio (OR) was calculated with95% CI at p-value <0.05. Result :From a total of 596 mothers, 577 of them participated in the study. 487 (84.4%) of the study participants were experienced at least one form of mistreatment during facility child birth. The most commonly reported category of mistreatment were poor rapport between provider and women 462 (80.1%), health system failure and constraints 453 (78.5%) followed by failure to meet professional standard of care433(75%). Mothers with no formal education less likely [AOR=0.25 (95%CI; 0.10-0.64), mothers who gave birth at hospital [AOR=2.53 (95%CI 1.56-4.09)], and mother‘s being dissatisfied [AOR=3.39 (1.58-7.28)] were more likely reported experience of any form of mistreatment. Conclusion and Recommendation: In this study the prevalence of mistreatment during facility based child birth was found to be very high. Identified determinants were mother‘s educational status, mothers who gave birth at hospital and who reported being dissatisfied were reported more experience of mistreatment during facility delivery. Policy makers and program manager‘s needs to design strategies to promote effective client provider communication, encourage health providers adherence to the standard of care and building national awareness to addresses the right of all clients/mothers.
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    Assessment of the Prevalence and Associated Factors of Birth Preparedness and Complication Readiness among Pregnant Women in Public Health Centers of Addis Ababa, Ethiopia.
    (Addis Ababa University, 2019-10) Rediate Sileshi; Meselech Assegid; Gebretsadik Shibre
    Background: Ethiopia is one of the countries with higher maternal mortality in the world that was estimated 11,000 in 2015 alone. Birth preparedness and complication readiness (BPCR) is important measure to improve utilization of maternal health which contributes for reducing maternal mortality. BPCR is a comprehensive package aimed at promoting timely access to skilled maternal and neonatal services. But limited study was found in Addis Ababa on BP/CR Objective: To determine the prevalence and associated factors of birth preparedness and complication readiness among pregnant women in public health centers in Addis Ababa Method: Facility based cross-sectional study was done in selected ten health centers in Addis Ababa. Multistage sampling technique was used to select health facilities by taking clients flow chart into account. Training was given to the data collectors prior to data collection. There were ten data collectors and two supervisors. Data was collected from March to April 2019 using structured questioner which was pretested in other health center. Then data was entered to Epi-data software version 3.1 by the principal investigator and SPSS 20 software program was used to analyze the entered data. OR were used to measure association and 95% CI and P-Value<0.05 were used as predictors of significant association. Binary and multivariable logistic regression was tatted. Result: A total of 633 pregnant mothers were participated in the study. 322 (50.9%) of the participants were prepared for birth and ready for complication management. Mothers who came for ANC follow up and have ultrasound were found to be 98.3%. Government employee mothers (AOR=2.29 1.03, 5.09), educated mothers secondary (AOR=2.459; 1.002, 5.038), preparatory (AOR=3.254; 1.245, 8.506) and tertiary (AOR= 3.001; 1.173, 7.679), decision making power (AOR=0.56: 0.33, 0.95), and counseling on danger sign (AOR=1.78; 1.196 2.65), and counseling on birth preparedness complication readiness during ANC visit (AOR=1.395; 1.90, 2.16) had found significantly associated with birth preparedness complication readiness. Conclusion and Recommendation: Birth preparedness and complication readiness was low among study participants. Even if there were higher prevalence of ultrasound, Most birth prepared and complication ready mothers were those who were counseled. I suggest health providers to give more attention on counseling on danger sign and birth preparedness and complication readiness
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    Assessment of the Prevalence and Associated Factors of Pneumonia in Children 2to 59 Months Old, Debreberhan District, North East Ethiopia.
    (Addis Abeba University, 2015-06) Gebretsadik Shibre; Mulugeta Betre
    Background: Childhood Pneumonia is the commonest cause of suffering worldwide among under- five children where it accounts more than one out of seven under- five deaths globally. It is the single leading cause of death in Ethiopia, accounting 18% of all under five mortality burden. Objective: The objective of the study was to assess the prevalence and associated factors of pneumonia in 2 -59 months old children in Debre-Brehan district. Methods: Community based cross sectional study was conducted in Debre-Brehan district from February 15 to February 25, 2015, 2015. Stratified, multi-stage sampling technique was used to proportionally draw households from each of the selected 6 kebeles- two from rural and four from urban strata, based on the number of kebeles in the strata - by taking in to account the number of households in each of these selected kebeles. Pre-tested Interviewer administered structured questionnaire was employed to collect data from randomly selected 458 households. Three diploma nurses and a public health officer were participating in the survey as data collectors and supervisor, respectively. The data was entered in to EPIDATA version 3.1 and then exported to Statistical Package for Social Science (SPSS) version 21 for analysis. Result: The prevalence of pneumonia in 2 to 59 months old children was estimated to be 5.5%. Past history of measles ( AOR = 2.676;95%CI 1.049, 6.830; p-value= 0.039) and diarrhea (AOR =5.293; 95%CI 2.107, 13.298; p-value= 0.000), use of improved latrine (AOR= 0.157; 95% CI 0.057,0.431; p-value =0.000)) and breastfeeding for 2 or more years (AOR=0.152; 95%CI 0.042, 0.553; p-value= 0.004) were found to be significant predictors of pneumonia among 2 to 59 months old children in this study. Conclusion and Recommendation : The present study identified a relatively low prevalence of pneumonia in 2 to 59 months old children. It also pointed out such modifiable risk factors of pneumonia in this age group as past history of diarrhea & measles, use of not improved latrine and breast feeding the child for less than 2 years. The Worerda Health Office, in collaboration with the health institutions in the district, should design and communicate strategies to the community to help them acquire knowledge on the importance of breast feeding ( for 2 or more years) and vaccinating ( for Rota and Measles vaccine) their child to prevent Pneumonia among them.
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    Association of Antenatal Depression with Anemia and Adherence to Iron-Folic AcidSupplement among Pregnant Women Attending Antenatal Care Services at Health Centers in Yeka Sub-City, Addis Ababa, Ethiopia, 2019
    (Addis Ababa University, 2019-10) Miraf Mesfin; Negussie Deyessa; Gebretsadik Shibre
    Background: Depression affects a large proportion of the global population. It is reported to affect about a quarter of pregnant women in Ethiopia. Some studies indicate that anemia might be a risk factor for depression. This underscores the need for an iron-folic acid supplement (IFAS). IFAS adherence by pregnant women is however not satisfactory. Studies again implicate that depression might affect adherence to IFAS. Nevertheless, this potential vicious cycle is not a well-explored area of research. The objective of this study is therefore to assess the association of antenatal depression with anemia and adherence to IFAS among pregnant women attending antenatal care (ANC) at selected health centers. Methods: a facility-based cross-sectional study was conducted among pregnant women who attended ANC service in Yeka sub-city, Addis Ababa. A total of 406 pregnant women were recruited in the study. Patient health questionnaire (PHQ-9), a validated tool in Ethiopia, was used to assess antenatal depression. IFAS adherence was assessed using pill count method. Bivariable and subsequent multivariable logistic regression were employed for data analysis. Results: it was found that anemic pregnant mothers had an increased odds of having antenatal depression [AOR=2.63; 95% CI (1.13, 6.14)] compared to non-anemic mothers. Having financial hardship, whether current pregnancy is planned and emotional abuse from an intimate partner also significantly associated with antenatal depression. Antenatal depression at cut-off (PHQ 9≥5) failed to show statistically significant association with IFAS adherence. Major depression (PHQ-9≥10) was however found to be significantly associated with adherence to IFAS [AOR=1.97; 95% CI (1.09, 3.56)] in pregnant women. Besides, factors significantly associated with IFAS adherence were parity, knowledge of the use of IFAS and current pregnancy complication. Conclusion: the study revealed a significant association that exists between two important public health problems, anemia and antenatal depression; and the association between antenatal depression and IFAS adherence. Further investigation of these associations is a warranted area of future studies. In the meantime, putting these underlying determinants into consideration is beneficial as they might complicate diagnosis and have a negative impact on treatment outcomes.
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    Investigating Inequalities and Assessment of the Determinant Factors in Postnatal Care Service Utilization in Ethiopia
    (Addis Abeba University, 2019-10) Asnakech Gizaw; Negusie Deyessa; Gebretsadik Shibre
    Background: Postnatal care is an important care which is given to the mother and her child to prevent and reduce maternal and child mortality. Despite the importance of the care for the mother and her child, there are considerable disparities in postnatal care utilization across many geographical locations, maternal socioeconomic, and demographic factors in many Sub-Saharan Africa. Objectives: To investigate inequalities and assess the determinant factors in postnatal care service utilization among reproductive women in Ethiopia using the 2016 Ethiopia demographic health survey data. Methods: The study utilized data from the fourth round Ethiopia Demographic and Health Survey (EDHS). The dataset was accessed from EDHS website upon registering to the website. Education and wealth-related inequalities were assessed by concentration curve and concentration index. The measured inequality also decomposed into its contributing factors using Erregers method of analysis. In addition to this, population attributable risk, difference, and ratio were used to assess the inequality after running Binary logistic regression and multi-collinearities were checked by using variance inflation factor (VIF=1.5). Result: PNC utilization within the first two days in Ethiopia in 2016 was only 16%. Complex summary measures suggest Maternal level of Education and wealth related inequalities in PNC were significantly high in 2016: with concentration indies of 0.166 and 0.2089 respectively. Simple summary measures also revealed wealth status, 4+ ANC visit, delivery by CS, use of internet and region were significantly predict inequalities in Postnatal care utilization. Conclusion: There is a significant inequality in Postnatal care utilization in Ethiopia. Maternal wealth status, maternal level of Education, frequency of ANC visits, use of internet, Region and C-Section delivery are the dominant inequality contributors in the utilization of PNC services within those critical hours after birth. Recommendation: Policy makers should focus on the implementation of the strategies to adequately address the observed inequalities in postnatal care utilization among women. Strategies should focus on the key population subgroups.
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    Long Acting Reversible Contraceptive Use and Associated Factors among Women Who Receive Abortion Service in Hawassa Public Health Facilities, Southern Ethiopia 2020.
    (Addis Abeba University, 2020-01) Kassahun Ketema; Meselech Assegid; Gebretsadik Shibre
    Background: One component of post abortion care is preventing repeat abortions by providing family planning counseling and contraception. Provision of long-acting reversible contraceptive methods has a higher potential to interrupt the continuous cycle between abortion and unplanned pregnancies that result in reduction of maternal morbidity and mortality. Objective: To assess utilization of long acting reversible contraceptive and associated factors among women who receive abortion service in Hawassa public health facilities, southern Ethiopia. Methods: Facility based cross-sectional study design using quantitative method was implemented in Hawassa public health facilities, southern Ethiopia. Three hundred ninety six study participants were included and proportionally allocated to the two public hospitals and 4 public health centers. The data was collected by interview using pretested structured questionnaire. Data entry was done using Epidata 3.1 version then data was cleaned and export to SPSS for data analysis. Frequency and median were displayed through tables and words. Bivariate and multivariable logistic regressions were used to analyze the association factors of the dependent variable using odd ratio and 95% confidence interval. P value < 0.05 during multi variable analysis considered as significance. Result: A total of 396 women came to the facility for abortion services were interviewed in this study with 96.4% of response rate. The overall utilization of long acting reversible contraceptive was 20.5% [16.4-24.8]. Decision making by both partners on long acting reversible contraceptive methods (AOR=3.3; 95% CI [1.56-7.09]), history of abortion (AOR=3.93; 95% CI [1.48-10.4]), counseling on family planning after abortion procedure (AOR=3.01; 95% CI [1.43-6.33]) and grand multiparous (AOR=6.68; 95% CI [2.28-19.5]) were associated with post abortion long acting reversible contraceptive utilization. Conclusion: Parity, previous abortion history, partners a companion decision making and time of counseling had significant association with post abortion long acting reversible contraceptive utilization. Programs that support male involvement should be supported and initiated to improve family planning utilization among abortion women.
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    Survival Status of Infants with Congenital Anomalies in the Selected Hospitals, Addis Ababa, Ethiopia: A Retrospective Cohort Study
    (Addis Abeba University, 2021-05) Mahdere Tsegaye; Wubegzier Mekonnen; Gebretsadik Shibre
    Background: Congenital malformations are a major health problem and highly contributed to neonatal and child mortality in all Sub-Saharan Africa. However, there are limited and inconsistent pieces of evidence on the survival status of congenital anomalies and their determinants in Ethiopia. Objective: to assess the probability of survivorship and its predictors in the first year of life among babies with congenital anomalies. Methods: A retrospective cohort study design was used among infants with congenital anomalies in Black Lion Specialized Hospital and Zewditu Memorial Hospital in Addis Ababa, registered from 2014 to 2017 which are referred from Addis Ababa region health facilities. Data were collected by reviewing the registration book and interviewing parents by visiting their homes using an electronic data collection tool. Data were analyzed using STATA version 14. The actuarial life table and Kaplan Meier survival curve were analyzed to estimate time to death with a log-rank test to compare survival time between groups. To identify independent predictors Cox-proportional model was carried out and crude and adjusted hazard ratios with 95% Confidence Interval (CI) were used to determine statistical significance. Results: The overall survival probability of infants with congenital anomalies to 7 days, 28 days, and 1-year was 70.3%, 50.0%, and 46.5%. Infant 1-year survival probability with nervous system congenital anomalies had (40.9%), digestive system (42.5%), circulatory system anomalies (43.3%),chromosomal system anomalies (60.0%), musculoskeletal system anomalies (50.0%), respiratory system anomalies (75.0%), and urogenital system (93.3%). The median survival time for those cases that died was 6 days. Survival of male infants and low birth weight infants was significantly poorer survival and those infants who had surgical intervention were significantly better survival. Conclusion: Survival of infants with congenital anomalies to one year is low. Effective interventions are required to focus on nutritional counseling, birth weight, and early surgical intervention to improve the survival probability of infants with congenital anomalies.
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    Trend and Inequalities in Neonatal Mortality and its Covariates; Analysis of the Ethiopia Demographic and Health Surveys Between 2000 and 2016.
    (Addis Abeba University, 2019-10) Yodit Hailemichael; Wubegzier Mekonnen; Gebretsadik Shibre
    Background: Neonatal mortality in low-and middle-income countries has shown slow decline and marked disparities across regions and countries. In Ethiopia, despite making overall progress in child survival, deaths among newborn babies still remain high at 29 deaths per 1,000 live births. Evidence on trend and inequalities in neonatal mortality in Ethiopia is scarce and yet, such evidence is important to contribute to the effort towards reducing neonatal mortality. Objectives: This study aims to assess the trend and inequalities in neonatal mortality by the five equity stratifiers, namely region, place of residence, wealth status, maternal education and composite coverage index (CCI) using the four Ethiopia Demographic and Heath Survey (EDHS) rounds. Methods: Using the four nationally representative survey conducted in 2000, 2005, 2011 and 2016, direct estimate of neonatal mortality rate were computed from birth history information provided by mothers. The trend in neonatal mortality were measured using annual rate of reduction and 95% CI to indicate the period when significant difference was observed. Once the data from the four rounds pooled together, we used both absolute and relative inequality measures to measure inequality in neonatal mortality. Concentration index was computed for the socioeconomic inequality and for area-based inequality, difference and ratio were calculated. We further did decomposition analysis for the wealth-based inequality to understand individual percentage influence to the observed inequality in neonatal death of the commonly known factors of neonatal death. A p-value of < 0.05 and 95% CI was reported as a measure of magnitude of significance. Result: Overall trend in neonatal mortality rate was slowly declining with the annual rate of reduction of 1.98 percent per annum between 2000 and 2016, and also great variation in average decline by selected equity stratifiers. Well served regions in reproductive maternal and child health service had comparatively lower mortality rate than underserved regions. In all the survey years there is wealth and education-based inequality in neonatal mortality, however the levels were not significant except for the 2011. An estimate of concentration index indicates (-.002, .009, -.012, .012) for wealth and (-.011, -.001, -.009, -.003) for education with p-value of (0.68, 0.07, 0.02, 0.05) and (0.00, 0.67, 0.00, 0.53) respectively. The absolute and relative inequalities in terms of regions showed greatest inequalities between regions with the highest mortality(Amhara) and regions with lowest mortality(Addis Ababa) with a difference = 0.0141, 95% CI (0.0059, 0.0222) and Ratio = 1.55 with 95% CI (1.1584, 2.0767) were as for place of residence (rural Vs urban) it showed non-significant, Difference = -0.0089 (-0.0222, 0.0045) and Ratio = 0.8054 (0.5972, 1.0863) respectively. The major contributors for observed wealth-based inequalities were different levels of wealth status, underserved regions and rural residence. Conclusion: Trend in neonatal mortality have showed slow decline and it was not uniform among the selected equity stratifies, progress in annual rate of reduction was also sluggish. Across the survey years, though mortality is concentrated among socioeconomically disadvantaged, the levels of wealth and education-based inequalities were significant only for the 2011 survey. Furthermore, estimates of absolute and relative inequalities for regions shows significant inequalities. It is recommended to maintain improvement in Reproductive, Maternal & Newborn Child Health (RMNCH) services and scaling up of interventions that directly act on leading determinants of neonatal mortality by focusing on the general population in addition to targeting the disadvantaged society, rural residents and underserved regions.
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    Trend and Inequalities in the Current Family PlanningUse Among Currently Married Reproductive Aged Women and the Family Planning Service Readiness in Addis Ababa Ethiopia.
    (Addis Ababa University, 2023-11) Hewan Berhanu; Wubegzier Mekonnen; Gebretsadik Shibre
    Background: Family planning use among reproductive aged women in Addis Ababa is declining from 56.9% to 49.9% according to Ethiopian Demographic and Health Survey (EDHS) data during 2005 and 2019. Urban health facilities had lesser availability of family planning services compared to rural facilities (87% Vs. 95%) according to Service Readiness Assessment 2016. Evidence on the trend, inequalities and service readiness in family planning services in Ethiopia is scarce and yet such evidence is important to contribute to the effort towards increasing family planning use. Objective: The objectives of this study is to assess the trend, and inequality in terms of age group, religion, parity, women empowerment, education of women and husband, employment and media exposure in family planning use among re productive aged women and health facilities that give family planning services in Addis Ababa, and, to assess the family planning service readiness of health facilities in Addis Ababa. Methods: The four Demographic and Health Surveys, the 8 Performance Monitoring for Action (PMA) was used to assess the trend and inequality among married women in Addis Ababa and Service Availability and Readiness Assessment (SARA) data set to assess the health facilities family planning service readiness. we used STATA software for the analysis. We used descriptive analysis to show socio demographic statuses and service readiness. We used logistic regression to show the trend. Concentration index was used for the ordinal equity stratifies, regression based predictive probability and odds ratio was used for others such as age, religion, employment and parity. And finally, regression-based decomposition analysis was used to identify contribution of socio-economic and demographic factors to inequality in FP use. Result: The overall trend of FP use is slightly increasing from 45% in 2000 (EDHS) to 60% in 2021(PMA). Primary and higher educational level of women and husband, 20-24 age group, having more than 1 child, being Christian and being employed were found to be significantly associated with high FP use. The largest contributors to education-based inequality are secondary and higher educational level of women (-0.63) in PMA 2019 and having 1 child (2.13) in PMA 2021. Among assessed health facilities, 2.1% provide 13 of the tracer items in 2016 and 1.3% provide all the 14 items in 2018. Conclusion: Trend in FP use showed a slight increase and was not uniform among the selected equity stratifies. Furthermore, estimates of absolute and relative inequalities show significant inequalities. FP service readiness of health facilities in Addis Ababa were low. It is recommended to maintain improvements in FP services and scaling up the interventions that directly act on leading determinants of FP inequality by targeting the disadvantaged group.
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    Trend, Disease Burden and Determinants of Mortality among Children 5-14 Years in South-Central Ethiopia: Analysis Using Butajira Health and Demographic Surveillance System Data (1987-2022)
    (Addis Ababa University, 2024-10) Hailemariam Negash; Wubegzier Mekonnen,; Solomon Emyu; Gebretsadik Shibre
    Background: Nearly, 0.9 million children aged 5-14 died globally in 2020. The death is especially unacceptable since the majority died of preventable or treatable causes. Although communicable diseases are still the leading causes, non-communicable diseases, and external causes account for half of all deaths, posing a triple burden. Objective: To assess the trend, disease burden, and determinants of mortality among children 5-14 years in Butajira, south-central Ethiopia from 1987 through 2022. Methods: The Butajira Health and Demographic Surveillance System open prospective cohort (1987-2022) and cause of death data acquired via verbal autopsy procedures (2007- 2022) were analyzed. Event history analysis was used to study mortality trends and the incidence of child death by covariates. The broad and specific causes of death burden for children aged 5-14 years were measured. The adjusted Incidence rate ratio (aIRR) with its 95% confidence interval in the Poisson regression model was used to measure strength, direction, and significance of the association between child mortality and exposure variables. Results: A declining trend in the incidence child mortality was observed (Kendall’s tau = - 0.83; P-value < 0.0001). The overall incidence of child mortality was 6.31 (5.99, 6.64) deaths per 1000 person-years. Communicable diseases (39.2%) were the major causes of death followed by non-communicable diseases (35.4%) and external causes (23.4%). HIV/AIDS (14.6%), severe malnutrition (13.1%), accidental drowning & submersion (8.5%) and RTA (8.5%) were the leading specific causes of death. The incidence of child mortality was higher among males with aIRR/95% CI (1.27 (1.15, 1.41)), older children (2.06 (1.84, 2.29)), ruralists (2.42 (1.88, 3.12)), lowlanders (1.37 (1.17, 1.60)), owned house (3.98 (2.33, 6.79)), small households (1.18 (1.05, 1.32)), uneducated mother (2.03 (1.80, 2.29)), lived 10 KMs away from hospital (1.34 (1.11, 1.63)), used unprotected water source (1.35 (1.18, 1.55)), had at least one ox [(1.36 (1.19, 1.54), or 2+ oxen (1.54 (1.32, 1.79))] and with a house without window (1.38 (1.18, 1.62)), latrine (1.96 (1.60, 2.40)) and media exposure (1.87 (1.60, 2.19)). Conclusion: During the 36 years of study periods in Butajira HDSS, a significant declining trend in the incidence of child mortality was found. Older children and young adolescents are suffering from triple burden of diseases. A comprehensive targeted interventions needs to be delivered at societal, household and personal level to avert the mortality burden.