Browsing by Author "Mekonnen, Wubegzier (PhD)"
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Item The Assessment of Determinants of family planning use and unmet need among women of reproductive age group with disabilities in Addis Ababa(Addis Abeba Universty, 2016-06) Abera, Solen; Mekonnen, Wubegzier (PhD)Background: The 2007 Census of Ethiopia revealed 32630 of the 2739551 Addis Ababa population was persons with disability among which 7,835 are reproductive aged women. Persons with disabilities are the most marginalized groups concerning reproductive health services. Unmet need for family planning (FP) and Contraceptive Prevalence Rate (CPR) in Ethiopia was estimated at 25.3% and 29% in 2011 respectively. It may be difficult to achieve sustainable development goal without a focus on including people with disabilities. Objectives: This study is designed to assess levels and determinants of family planning use and unmet need among women of reproductive age group with disabilities in Addis Ababa. Method: Cross sectional study based on associations of persons with disabilities with stratified sampling was used to select 727 women’s with disability. Data were collected using structured questionnaire by eight trained females who completed grade twelve; two of which communicate by speaking and sign language. Data were cleaned and analyzed using Epi data and Stata 12. Descriptive statistics, binary and multivariate logistic regression analyses was employed to identify factors associated with contraceptive use and unmet need for family planning. Cut-off point for the detection of significance is p<0.05. Result: Current CPR among all reproductive age women and sexually active women with disability in Addis Ababa was 44.4% and 64.5% respectively. Unmet need of contraception was 20% among sexually active women with disabilities (10.6% for spacing and 9.4% for limiting) making percentage of demand satisfied 68.9%. Contraception was 6.8 (95% CI: 1.47, 31) times higher in women aged 30-34 compared to age group 45-49. Women whose partners attained primary education had about 3.1 (95% CI: 1.04, 9.5) times more likely to use FP compared with uneducated partners. Unemployed women were 0.8: (95% CI 0.3, 2.04) less likely to use FP methods compared with employed. Women discussing about contraception with partners were 3.3 (95% CI: 1.08, 10.34) times more likely to use FP. While unmet need is less likely among women aged 30-34, 0.05 (95% CI 0.04, 0.7) compared to age group 45-49. Besides women who discuss with their partner about contraception were less likely to have unmet need compared to counterparts 0.23 (95% CI 0.07, 0.7). Those women with number of living children above two are 3.3 (95% CI: 1.03, 10.7) times more likely to have unmet need compared to women with living children less or equal to two. Conclusion and recommendation: Unmet need is found to be high among women with disabilities in Addis Ababa, therefore public and private sectors should promote targeting programs for women with disabilities and their partner for the uptake of the family planning services. Focus should be given to women with disabilities who are unemployed and those whose partners have never been into school. ixItem Assessment of Intrauterine Contraceptive Device Utilization and associated factors for Low Utilization among clients of Family Guidance Association Clinics in Addis Ababa, Ethiopia(Addis Abeba Universty, 2016-11) Ali, Mohammed; Mekonnen, Wubegzier (PhD)Introduction: Although intrauterine contraceptive device (IUCD) method is the safest, very effective, long acting and reversible contraceptive method, it has been used at a very low rate in many developing countries compared to other modern contraceptive methods. Objective: The objective of the study was to assess the utilization of IUCD method and factors associated with utilization among women of reproductive age in Addis Ababa family Guidance Association of Ethiopia (FGAE) clinics. Methods: Facility based cross sectional study was conducted from March 1, 2016 to April 30, 2016, employing both quantitative and qualitative methods. Data for quantitative study was coded, entered and cleaned using Epi-info and transferred and analyzed by using SPSS version 21.0 for windows. Group comparison was assessed using Chi square analysis. Multivariate Logistic regression model was used to detect factors associate with IUCD utilization. All the tests were considered significant at p < 0.05. The qualitative data was analyzed using the qualitative thematic analysis approach. Results: A total of 108 respondents were currently using IUCD making the utilization rate 35.2%. The median duration of IUCD use was 33 months (Range: 1 - 120 months). Group comparison showed that marital status (p = 0.032), knowledge score (p = 0.010), and being told about IUCD duration (p = 0.044) had statistically significant association with current IUCD use. Thus, it was found that larger proportions of married women (66.9%), clients with good knowledge score (70.1%) and those who have been told about the duration of contraception of IUCD (67.3%) were not to using IUCD. Logistic regression analysis showed that clients with high knowledge score were about 1.8 times less likely to use IUCD (AOR 1.779: 95% CI = 1.087-2.913, p = 0.022). Qualitative study showed that rumors about IUCD from other users and clients' perception about IUCD such as its side effects, including bleeding and infection, as well its possible effect to cause infertility were important barriers affecting the level of use of IUCD in the study area. Conclusion and recommendation: The present study revealed that the proportion of IUCD use & duration of IUCD use was low in the study setup and clients with good knowledge level were less likely to use IUCD. The clients in this study population were much more influenced by the rumors and wrong perceptions about IUCD use, particularly towards side effects and other perceived untoward effect. Thus, Family guidance association of Ethiopia and other public and private health institutions should extend focused (method specific) education to their clients to remove misconceptions about IUCD use.Item Assessment of Men’ S Involvement In Long Acting and Permanent Contraceptive Use among Currently Married Men Aged 20-64 Years, in Mizan-Aman District, South Western Ethiopia(Addis Ababa University, 2014-06) Mulatu, Kebadnew; Mekonnen, Wubegzier (PhD)Introduction: Though women bear the physical, psychological and emotional strain of pregnancy and childbirth, it could not mean that fertility and contraception are based exclusively on the female population. Thus, the social roles of men who are dominant not only in decision making within the family, but also at community leadership levels have been overlooked. Most family planning programs give less attention to the understanding of men’s role in the effective and steadfast utilization of contraceptives. Objective: the main aim was to assess the role of men in long acting and permanent contraceptive use among currently married men aged 20-64 in Mizan-Aman District, South Western Ethiopia. Methods: Community-based cross-sectional study was conducted. A mixed method of quantitative and qualitative research was used. A total of 554 study participants were recruited for the study. The investigator prepared, pre-tested and structured questionnaire was used to collect data. Odds ratio along with 95% Confidence interval in Multivariate Binary Logistic regression was used to assess the strength and significance of the association. Thematic analysis has also been adapted for analyzing the qualitative data. Results: A total of 521 men were included in the analysis. Only 11.5% the respondent's wives used LAPMs though no study participant used any of these methods. Discussions between couples about LAPMs in the last 12 months (AOR=4: 95% CI.1.9-8.2) and on the number of children they want to have (AOR=3.1: 95% CI.1-9.2), going to health facilities with wives to discuss about FP with health providers (AOR=2.7: 95% CI. 1.3-5.6), and supporting the use LAPMS (AOR=4.5: 95% CI. 1.6-12.5) were significantly and strongly associated with utilization of LAPMs compared to their respective counterparts. Conclusions and recommendation: Discussion between couples on the use of LAPMs and on the number of children they should have; and men’s approval of LAPMs' utilization were factors that influencing utilization of LAPMs in the town. Health extension workers should enhance discussion between couples. Town level health programmers should advocate discussion between couples and men’s awareness on LAPMs. Further research, including both men and women is recommended in the Town and beyond.Item Assessment of Quality of Life among Children with Epilepsy and Associated Factors in Governmental Hospitals of Addis Ababa, Ethiopia,2021.(Addis Ababa University, 2022) Hailu, Samuel; Mekonnen, Wubegzier (PhD)Abstract Background: Quality of life (QOL) is increasingly recognized as an important patient-reported outcome in health care research. However, the use is still restricted. Epilepsy impact was far more frequently evaluated considering QOL but only focused on adult patients so this research focused on children. Objective: To assess the quality of life among children between (7-18) with epilepsy and associated factors in governmental Hospitals in Addis Ababa, Ethiopia 2021. Methods: A facility-based cross-sectional study design was employed and data was collected from 564 children using a face-to-face interview in Addis Ababa from November 2020 to January 2021 selected using multi-stage sampling method. Probability proportionate to size technique was applied to select children from each hospital. The data was cleaned, entered through EPI-INFO 3.1and exported to STATA version 15.0 for analysis. Frequency distributions of variables were tabulated. The raw numbers of the five-point Likert scale for QOLIE-CH-48 domain scores were converted into a 0-100-point response scale, with higher scores indicating better QOL.ANOVA was used to assess the relationship between quality of life and the independent variables. Multiple linear regression was conducted to identify factors predicting quality of life. The threshold for statistical significance was p<0.05. Result: -A total of 564 children participated with a response rate of 94.1%. The mean score of quality of life was 60.18±8.68 (95% CI: 59.05, 61.23). Self-depression (P= 0.0094 F=3.39), number of anti-epileptic drug (AED) (P=0.0021 F=4.97), types of seizure (P= 0.000, F=52.26) were statistically significant predictors of QOL.A score in quality of life increased by 5.03 for every unit increase in a score of seizure frequency per week with (β= 5.0395% CI:0.4 - 0.9).Quality of life of epileptic patients increased by 0.19 and 1.99 in every unit increase in a score of stigma and anxiety (β= 0.1995% CI: (-0.1 - 0.1) and(β=1.99, 95%CI: 0.007- 1.03) respectively. Conclusion: -The quality of life among children with epilepsy was low. Stigma, seizure, depression and anxiety, and AED side effects were statically significant for quality of life. Implementing interventions that focus on early detection like self depression and stigma in children with epilepsy should be of great concern for healthcare providers.Item Assessment of Utilization and Factors of Skilled Birth Attendance among Women of Childbearing Age in Ankasha Guagusa Woreda, Awi Zone, Amhara Regional State, Northwest Ethiopia, 2014(Addis Abeba Universty, 2014-05) Alemayehu, Mulunesh; Mekonnen, Wubegzier (PhD)Introduction; The Ethiopian Demographic and Health Survey in 2011 reported maternal mortality ratio of 676 maternal deaths per 100,000 live births which made our country among the 10 highest contributors’ of maternal death. Many Thesis results showed that properly equipped and supported skilled birth attendance reduce many of these complications. However, only 11.5 % of Ethiopian mothers were supported by skilled birth attendant during their labour and delivery. Objective: - To assess prevalence and factors to utilize skilled birth attendants among mothers who gave birth during the last one year in Ankasha Guagusa district. Methods: - A mixed study design employing a cross sectional household survey with in-depth interview and focus group discussion were employed. A total of 373 women age 15 to 49 years who gave birth in the past one year were asked. The sample size for the qualitative method was determined by saturation of ideas. Descriptive summary measures and associations between the various factors with skilled birth attendance were done employing Binary and Multivariate Logistic Regression. Thematic analysis was also used for the qualitative study. Result- The study showed that the prevalence of skilled birth attendance utilization among women who gave birth for the last one year in the study area were 70(18.8%). Main determinant factors associated to low utilization of skilled birth attendance in the study district were; women residence, educational status, ANC visit, type of health facility near to them, problem during labour and respondent’s attitude towards pregnancy and labour service. The odds of skilled birth attendance utilization among urbanites were AOR=5.5:195%CI (2.23, 13.57), educational status 2nd and above AOR=6.27 :( 1.31, 30.05), numbers of ANC visit 4th and above AOR=12.96:95%CI (3.20, 52.51) and women who encountered complications during their labour AOR=61.97:95%CI (19.83, 193.65) times higher than those counterparts. On the contrary mothers reside near to health post and unfavourable attitude of mothers towards maternal health care services were 83% and 65% less likely assisted by skilled birth professionals during their delivery than those the opposite parts respectively. Moreover, cultural practices, beliefs and barriers were other concomitant factors for low utilization of skilled birth attendance. Conclusion Skilled birth attendance utilization in the study area was very low due to different barriers. Hence, to bridge this gap especially women’s educational and awareness towards maternal health care services and cultural influences; sustainable awareness should be created by designing appropriate strategies including provision of targeted information, education and communication and integration among health care providers and other stakeholder at the community and health facilities. Key-words - Home delivery, skilled birth assistant, skilled birth attendance.Item Comparative study on the utilization of reproductive health services and factors affecting it among students with and without disabilities in public Universities in Addis Ababa, Ethiopia(Addis Abeba Universty, 2017-06) Meshesha, Selamawit; Mekonnen, Wubegzier (PhD)Background: Reproductive health services (RHS) and health education are fundamental human rights. However, utilization of reproductive health services among adolescents and youth is low. Particularly, people with disabilities have lower knowledge on reproductive health related issues and service utilization. Objective: The objective of this study is to compare reproductive health service utilization and assess factors affecting it among students with and without disabilities in public Universities in Addis Ababa, Ethiopia. Method: Institution based comparative cross sectional study was carried out in two public higher learning institutions in Addis Ababa from September 2016 to June 2017. Multi stage sampling was used to select a total of 548 respondents. The data analysis was done using STATA version 14 software. Odds ratio, 95% CI in conditional logistic regression was used to identify associated factors with RHS utilization. Result: The RHS utilization among students with and without disabilities were 40.52% & 69.1% respectively. RHS accessibility and awareness were the main reasons for not utilizing RHS among students with disabilities whereas religious and cultural barriers were reasons for students without disabilities. Those students without disabilities were (AOR=3.11: 1.86, 5.19) times more likely to utilize RHS than those students with disabilities. For students with disabilities those who knew RHS providing facilities [AOR=4.9: 1.47, 16.2], who ever had sex [AOR=30.1: 9.6, 94.4], who ever had discussed RH issues with any one [AOR=3.59: 1.6, 7.9], who were exposed to any type of mass media in the last 12 months [AOR=2.9: 1.03, 8.1] and who had a nearby health facility as other health facilities [AOR=4.36: 1.01, 18.7] were more likely to utilize RHS. For students without disabilities those students who were in the age group of 25 and above were [AOR=5.01: 1.19, 21.2] times and those students who had ever had a girl\boyfriend were [AOR=6.65: 3.2, 13.2] times more likely to utilize RHS than those who were in the age group 15-19 years and those who had never had a girl\boyfriend respectively. Conclusion and recommendation: reproductive health service utilization among students with disabilities is low compared with those students without disabilities. Awareness on RHS provision facilities, ever having sex, discussion on RH issues, mass media exposure in the past 12 months, availability of other HFs than University clinic were found to be significantly associated with RHS use among students with disabilities while age and having a boy/girl friend were the predictors of RHS use among students without disabilities. All stakeholders on RH working with people with disabilities should focus on awareness creation through mass media, discussion and training to increase the RHS utilization level.Item Designing an Integrated Vital Event Registration System in the Case of Federal Vital Event Registration Agency(Addis Ababa University, 2016-06-01) Mekonnen, Abdi; Ayalew, Elizabeth (PhD); Mekonnen, Wubegzier (PhD)Most people in Africa and Asia are born and die without leaving a trace in any legal record or official statistics. The inequalities in registration rates are large; developing countries account for 99% of the estimated 48 million unregistered births, with South Asia and sub-Saharan Africa together accounting for 79% of all unregistered births. Ethiopia is among the countries that have not installed national as well as regional civil registration and vital statistics systems. The overall objective of the proposed project is to design an integrated Vital Event Registration System (IVERS) for the Federal Vital Event Registration Agency so as to register, birth, marriage, divorce, notification, death and causes of death and certification at national level. This study employed Object Oriented methodology and qualitative cross sectional case study design methods. User requirement gathering were made through in depth interview and document analysis as major techniques to capture the core business process of the existing manual system. Accordingly, Unified Modeling Language was applied to specify, visualize, construct and document the architecture of a software system. The designed civil registration and vital statistics system registers all births marriage, divorce and deaths, issues birth and death certificates, notifies the authority birth and death from facilities/communities and compiles and disseminates vital statistics, including cause of death information. The proposed project will have significant impact on the healthcare system, policy makers, legal and administrative users as it is intended to systematically lay a foundation for the implementation of a Civil Registration and Vital statistics system that enables access to easy and much flexible vital event information.Item The Effect of youth Centers on Reduction of Risky Sexual Behaviors among Youth in Addis Ababa, 2016(Addis Abeba Universty, 2016-06) Fetene, Nigusie; Mekonnen, Wubegzier (PhD)Introduction: Risky sexual behaviors negatively affect the health of adolescents and young adults putting them at high risk of sexually transmitted infections and unwanted pregnancy for females, which may cause serious health consequences, social and economic problems. In addition, unwanted pregnancies may lead to school dropout and end up with unsafe abortion. No attempt was done to assess the effect of youth centers in reduction of risky sexual behaviors. Therefore, this study was designed to assess the difference in engagement of risky sexual behaviors between users and non-users of youth centers among youth in Addis Ababa. METHODS: A comparative cross-sectional study design was employed among 524 youth in Addis Ababa from September, 2015 to June, 2016. Multi-stage sampling was used to select youths from randomly selected sub cities. The data was cleaned, entered and analyzed through EPI-INFO 7 and SPSS version 16.0. First distribution of variables was presented by using tables and descriptive statistics to calculate some statistical datas and then logstic regressin model were used to measure magnitude of risky sexual behaviors among users and non-users. Results: Nearly half 254 (48%) of the respondents ever had sexual intercourse. The mean age of first sexual initiation was 18.56 (±3.019) years and about 37% of those who ever had sexual intercourse started it before the age of 18 years. Among those who ever had sex 47% of them never used condom. The over all prevalence of risky sexual behavior was 43.1% and the prevalence of risky sexual behavior among users and non-users were 38.5% and 47.7% respectively (P-value = 0.042). Utilization sataus of the youth center and age of the respondents were significantly associated with risky sexual behavior. Non-users of the youth center RH clinic were 1.570 times more likely to engage in risky sexual behavior compared to users of the youth center (AOR= 1.570; 95%CI = 1.056, 2.333). Youth aged 15-19 years were 92.1% less likely to practice risky sexual behavior compared to youth aged 25-29 years old (AOR = 0.079; 95%CI = 0.041, 0.376). Conclusion: A significant number of youths had risky sexual behavior that might lead them to different reproductive health risks. Non-users of the youth center were at a significantly higher risk of sexual behaviors than users. Keywords: Youth, Risky sexual behavior, Youth center, Addis Ababa, EthiopiaItem Predicting Maternal Health Care Seeking Pattern Using Data Mining Techniques in Ethiopia.(Addis Ababa University, 2013-06) Ayele, Dawit; Jemaneh, Getachew; Mekonnen, Wubegzier (PhD)Background: Utilization of maternal health care services could save unnecessary severe complications and death among women during pregnancy, delivery and after delivery. Ethiopia is one of the countries with high maternal morbidity and mortality in sub-Saharan Africa which needs more public health care effort in the country. Objective: The general objective of the study was to construct a model that can predict the maternal health care seeking pattern of reproductive age in Ethiopia. Methodology: The study followed Hybrid methodology of Knowledge Discovery Process to achieve the goal of building predictive model using data mining techniques. Therefore, the overall research design was to build a model that can predict the maternal health care seeking pattern using J48 Decision tree and Naïve Bayes algorithms in Ethiopia from EDHS 2011 dataset. WEKA 3.6.8 data mining tools and techniques were employed as a means to address the research problem. Results: The result of the study showed that the J48 Decision tree algorithm outperforms Naïve Bayes on the three of the outcome variables. For antenatal care the model was selected with an accuracy of 74.78%. Then for the second outcome variable (delivery care) the model was selected with an accuracy of 91.23% and area under receiver operating characteristics of 0.89. Finally for postnatal care the model was selected with an accuracy of 87.5% and area under receiver operating characteristics curve of 0.80. The best attributes selected for each of the outcome variables are Place of Residence, Household Wealth Index, Women’s Educational level, Husbands Occupation, Region, Husbands Educational level, Total number of children, Media Exposure. Conclusion: In general, the results obtained from this study were interesting and encouraging; it can be used as decision support for healthcare practitioner. The finding shows that there is a regional difference in utilizing maternal health care service in the country, thus it is recommended that all the concerned parties should give due consideration for these regions, increasing maternal education at least up to primary level in all regions of the country, provision of opportunities for employment and poverty reduction especially in rural parts of the region.