Browsing by Author "Hailemariam, Damen"

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    Determinants of Community Health Agent Functionality in Arsi Region
    (Addis Abeba Universty, 1989-05) Hailemariam, Damen; Pickering, Joyce(PhD)
    A comparative case-control s tudy t o asses s the determinants of commun i t y hea 7th agent fun c t i ona Ii ty ~~as done in two Ars i Awrajas, in mid-southern Ethiopia. This was a census study which 'lias conducted by interviellling 347 CHAs from a structured questionnaire. The first objective was to describe the situation of the CHAs trained for the two Alvrajas up to the end of 1987. The other objecti\'e was to elucidate the determinants of CHA functionality by comparing the attributes of the functional CHAs (cases) with that of the non-functional ones(controls). An attempt was made to elucidate the determinants of these attributes. The findings revealed that only 25.8% of the CHAs interviewed were performing 50% or more of the activities mentioned in their job description . 45.6% of the CHAs were found to be performing no acti v ities at the time of the interview, i.e. a point prevalence of attrition rate of 45%. Comparing cases and controls showed that there was strong associations between CHA function and community support for the CHAs(RR = 72.4 with 95% CI 35 - 153). The other factor which was seen to be associated with function was supervision by health institutions (Odds of being functional when supervised being 28 with 95% CI of 15 - 53). Other factors ~'hich were found to be positively related to CHA functionality were: presence of hea lth post, provision of drugs and stationary to the CHA, and estab Ii shment of an act i ve hea I th commi ttee wi th the CHA be ing an execut i ve member • These f indings emphasize the importance of the prov i s i on of prope r commun i t y and hea I th system support for the success o f the community health services program.
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    The status of breast-feeding among mothers of children aged less than two years and implications for the occurrence of acute diarrhea, Jimma, Southwest Ethiopia
    (Addis Abeba Universty, 2002-03) Tselassie, Biruk k.; Hailemariam, Damen
    To assess the status of breast-feeding among mothers of children aged less than two years and implications for the occurrence of acute diarrhea; a community based cross-sectional study was conducted in Jimma town, Southwest Ethiopia. A multi-stage systematic sampling technique was applied. Experienced and qualified interviewers were employed and a pretested questionnaire was utilized for this purpose. A total of 412 mothers aged 15-49 with under-two years children were taken, after the calculation using the formula to estimate a single population proportions, to examine the status of breast-feeding and implications for the occurrence of acute diarrhea. It was found that out of the total study subjects, 407 (98.8%) of the children had ever breast-fed at any time after birth, and among children who have ever breast-fed, 339 (83.3%) have initiated breast-feeding early within 24 hours after birth. It was also found that out of the children aged four and above months (n=333), 207 (62.2%) of them were predominantly breast-fed, and from the same age group, 23 (6.91 %) have exclusively breast-fed for the first 4-6 months after birth. From the children who have exclusively breast-fed, 7 (30.4%) and from those predominantly breast-fed, 92 (44.4%) developed acute diarrhea. These differences were not statistically significant. However, out of the children who have initiated breast-feeding early after birth, 132 (38.9%) developed acute diarrhea as compared to those who have initiated late after 24 hours. Still the differences are not significantly associated with the occurrence of acute diarrhea (p<0.107). The over all practices of breast-feeding was found to be influenced by the state of attending postnatal care, which showed significant association (p<0.010). Mothers who have attended vi postnatal clinic are protected from having good practice of breast-feeding, as compared to the others [adjusted OR=0.50 (0.296,0.85)], which is a unique finding contradicts with the general truth. Maternal knowledge about the benefits of breast-feeding, on the other hand, were found to be influenced by variables such as maternal relations to the head of the household (p<0.029), attending of formal school (p<0.008), attending of antenatal care (p<0.015) and attending of health education (p<0.013). All these variables showed significant association with the outcome variable, which indicated mothers who have married, attended formal school, antenatal care and health education are in favor of having satisfactory knowledge about the benefits of breast-feeding. The occurrence of acute diarrhea was found to be influenced by some breast-feeding and health service related characteristics. For example, children from mothers who have unsatisfactory knowledge about exclusivity and duration of breast-feeding are protected from having the risk of acute diarrhea [(adjusted OR = 0.29 (0.12, 0.73)] as compared to those from mothers who have satisfactory knowledge. It is concluded that despite the rapid demographic shifts, maternal practices about breast-feeding is optimal except the practice of exclusivity. However, it can be concluded that mothers’ interacting with certain social, cultural, and economic variables, are important factors influencing their child feeding decisions. Finally, it is recommended that even in this population with free access to preventive medical care, greater efforts should be made to educate mothers regarding risk factors for diarrheal disease identification and the benefits of maintaining breast-feeding during acute diarrhea episodes.