Browsing by Author "Mitike, Getnet(PhD)"

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    Assessment of Community and Organizational Response Against the impact of HIV/AIDS in Tigray Region, North Ethiopia
    (Addis Abeba Universty, 2006-07) Abraha, Atakelti; Mitike, Getnet(PhD)
    AIDS is an extraordinary kind of crisis; it is both an emergency and a long-term development issue. In 2003, the Global PLWHA was 38 million out of which 2/3 (25 million) are in Sub-Saharan Africa. In Ethiopia, there are an estimated 1.5 million PLWHA with a prevalence of 4.4 % in 2003. In Tigray, Northern Ethiopia, the adult prevalence of HIV/AIDS is 4.4 % with an estimated 100,000 PLWHA in 1997 E.C. The Epidemic is reversing the social and development gains and deepening poverty. The Government of Ethiopia initiated the response in 1985. The response include the establishment of NTF, HIV/AIDS prevention and control department at MOH,HIV/AIDS prevention and control council and HAPCO ,development of HIV /AIDS policy and NSF. The objective of this study is to assess the community and organizational response against the impact of HIV/AIDS and to draw best practices and weaknesses in Tigray region. Data were collected from February –April 2006 in five districts of Tigray region using in-depth interview, FGD, document review and observation. Four zones were selected conveniently and from that five woredas were selected on lottery method .All available organizations in the five woreda were eligible for the study. viii Generally, the effort to curb HIV/AIDS epidemic is very poor. Absence of workplace HIV/AIDS policy, implementation guideline, misunderstanding of the concept and method of mainstreaming, lack of leadership commitment, lack of capacity and poor NGO and community involvement are among the major findings. Development of workplace HIV/AIDS policy and implementation guideline, repeated sensitization efforts to enhance high level commitment, rewriting of the role and responsibility of the FPP, financing mainstreaming and strengthening the capacity of coordinating organization.
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    Assessment of Knowledge of Diabetes, its Treatment and Complications Amongst Adult Diabetic Out patients in selected Health Institutions of Addis Ababa, Ethiopia
    (Addis Ababa University, 2012-04) Abeje, Yemesrach; Mitike, Getnet(PhD)
    Diabetes Mellitus (DM) is a clinical syndrome comprising a heterogeneous group of metabolic diseases that are characterized by chronic hyperglycemia and disturbances in carbohydrate, fat and protein metabolism secondary to defects in insulin secretion, insulin action or both. The findings of the study will help in identifying knowledge gap among diabetes patients. Objective: To determine the level of knowledge of diabetes, its treatment, complication and factors associated with adult diabetic patients attending in selected health facilities in Addis Ababa. Methodology: Facility based cross sectional study design was used among diabetic patients attending health facilities in Addis Ababa. The study was supplemented by qualitative method. The calculated sample size was 356. For calculation of mean knowledge score of diabetes; the correct answer was given one point, while incorrect and unsure answers were given zero. The interpretation of scores was performed by a Delphi panel of experts (A Survey of Knowledge on Diabetes in the Central Region of Thailand) and defined as poor (<50%), fair (50–80%), and good (>80%). Results: Three hundred twenty five DM patients participated in the quantitative study making the response rate at 91.3%. Mean age of respondents was 44.2 years (SD 15.5), with 52.9% being female. With a score range of 0 to 54, the mean (%) score of the respondents was 28.8 (54.4%) (SD11.4). Data showed that having high education seems to have positive effect on increasing knowledge about DM and those who are Amhara in ethnicity were nearly 2.4 times to have good knowledge (OR2.6; 95% CI 1.12 to 5.23). In addition data showed that, those who knew their last FBS level and patients who had glucometer were more likely to have good knowledge about DM. In qualitative study knowledge about diabetes was poor especially due to socio-cultural beliefs, personal etiology, communication barrier and by being self-oriented. Conclusion: In conclusion, knowledge about DM throughout the study was fair; these were associated with illiteracy, ethnicity, knowing last FBS level and having glucometer. It will be beneficial if a diabetic clinic and information center for teaching diabetic patients is established (In addition to the existing facilities) because they still need patient-specific education on diabetes and its management.
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    Assessment of Overall Quality of Prevention of mother-to-child Transmission of HIV Service in Adama Town, Oromia Region
    (Addis Abeba Universty, 2009-06) Assefa, Anteneh; Mitike, Getnet(PhD)
    Background: Sub-Saharan Africa in which Ethiopia is a part remains the most seriously affected region with AIDS in the year 2007. More than 60% of all new HIV infections are occurring in women, infants, and young children in this region. In 2005 alone, an estimated 540,000 children were newly infected with HIV, with approximately 90% of these infections occurring in this region. Objective: To assess quality of PMTCT services and client satisfaction in private and public health facilities in Adama city, Oromia Region. Methodology: A facility based cross-sectional study which involved quantitative and qualitative approach was conducted from September 2008 to June 2009. It involved 423 pregnant women and 31 health providers. Results: From all pregnant women interviewed, 74.7% of them were found to be fully satisfied with the PMTCT service they received. Only 39% of the clients understood the counseling on MTCT and PMTCT. Not more than 90% of the pregnant women were counseled and accepted HIV testing and partners of 6.34% of the pregnant women were tested for HIV. The average duration of stay of clients with their health care provider was 12.8 minutes where the standard is 15 minutes. The average clients' waiting time was 41.5 minutes and 21.5 minutes in private health facilities and governmental health facilities respectively. From women of reproductive age group who were infected with the virus, 18% of them were counseled on family planning and started to use family planning. About 97% of the HEIs had received ARV prophylaxis. Cotrimoxazole prophylaxis was started at two months of age for 87.4% of the HEIs. More than half (60%) of the pregnant women came to the center they visited after being recommended to come by their friends or partners. Clients gave more weight to the ethical approach of providers to express their degree of satisfaction. Only two third of the health providers who are directly involved in PMTCT services received training on VCT for PMTCT. From the providers’ side the most eminent problems were lack of training to update PDF Creator - PDF4Free v2.0 http://www.pdf4free.com viii themselves with current knowledge/skills, lack of feedback on job performance and lack of incentive for the additional burden added to them. The national PMTCT guideline was available and in use in only two among the eight health facilities assessed. Conclusion: About two third (74.7%) of the clients were fully satisfied with the PMTCT service they received. Little more than half (52%) of pregnant women were counseled on MTCT and PMTCT. Less stay of health providers with the clients, long waiting time of clients, unavailability of advanced medical equipments and laboratory tests, lack of conformation to the national PMTCT guideline, and poor infrastructure were the most significant factors which compromised the quality of PMTCT services. Lack of family planning service provision together with HIV/AIDS services and lack of male involvement in PMTCT services were also among the factors which compromised the achievement of the PMTCT program. Recommendation: Offering counseling on MTCT and PMTCT to all pregnant women, to deliver quality and comprehensive PMTCT interventions by reducing clients’ waiting time as much as possible, enabling women to communicate with their partners about HIV testing, offering strong supportive supervision to health facilities and capacity building, and creating a strong link between HIV/AIDS and reproductive health services are crucial to improve the quality of PMTCT services.
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    Assessment of Pregnancy Outcome with Emphasis on Perinatal and Neonatal Mortality in Dire Dawa Town, Ethiopia
    (Addis Ababa University, 2003-07) Yaekob, Tesfaye; Mitike, Getnet(PhD); Berhane, Yemene(Professor)
    The commonly used pregnancy outcome indicators in developing countries are maternal mortality, abortion, perinatal, neonatal mortality, low birth weight and preterm births. About eight million perinatal deaths are reported annually in the world of which 40-60% is neonatal mortality and almost all are in developing countries. Many hospital based studies were conducted on those problems, while community based are very few. Therefore this community based cross sectional comparative study was conducted to assess the pregnancy outcome with emphasis on peri and neonatal mortality by delivery place and its associated factors in Dire Dawa town. The study was conducted between November 2002 and April 2003. A total of 1462 mothers who had children or had been pregnant for the last five years were participated in the study. Pre tested standardized questionnaires were used to obtain information on socio demographic, obstetric history and the condition of the new born and mothers during labor and neonatal period. Analyses were made using EP INFO 4.6 statistical package and SPSS version 10. In the study the following findings were found: High perinatal mortality rate of 73/1000 live births with 38/1000 and 35/1000 live births being at home and in health institutions respectively. High neonatal mortality rate of 47/1000 live births with 28/1000 and 19/1000 live births at home and in health institutions respectively. Mothers who had 2-4 parity had more risk to perinatal mortality than primi Para mothers. (AOR 5.15, 95%CI 1.54, 17.23) and mothers who had 5+ parity had more risk to perinatal mortality than primi Para mothers. (AOR 4.38, 95%CI 0.65, 29.40) vi In this study it is found that very small and small (mother’s perceptions birth weight) neonates have more risk to neonatal mortality than neonates who had normal birth weight when they were born(AOR 3.61, 95%CI 1.75, 7.43) and also term babies had less risk to perinatal and neonatal mortality than babies born preterm it is statistically significant when it is entered into logistic regression model(AOR 0.28, 95%CI 0.11, 0.70) and (AOR 0.28, 95%CI 0.12, 0.63) respectively. Mothers whose income were <300 birr per month had more risk to neonatal mortality than mothers whose income were >601 birr per month. (AOR 4.64, 95%CI 1.53,14.01) and mothers whose income were 301-600 birr per month had more risk to neonatal mortality than mothers whose income were >601 birr per month. (AOR 4.29, 95%CI 1.27, 14.50). Based on the above findings of the study the following recommendations were made. Strengthening of the MCH/FP care unit at each level and encourage mothers to use FP services and improve quality of care , establishing and utilization of emergency obstetric care services with special emphasis of neonatal care and give special attention to empower of mothers and improve economic status and educational level of women
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    Assessment of utilization of Modern Child Spacing Methods
    (Addis Ababa University, 2003-04) Tafese, Zergu; Mitike, Getnet(PhD)
    Comparative Community-based cross sectional study conducted in Gambella Town of Gambella Regional State, which is 777 kms away from Addis Ababa to the South west of the country. The study populations were women of reproductive age group residing in the urban area of Gambella woreda during the study period. Multistage sampling procedure was carried out to reach at the 936 households to be included in the survey. Simple random sampling technique was applied to select the respondent women when more than one women of reproductive age group resides in the same household. Data was collected using pre-tested structured questionnaire complemented by focus group discussion. The finding of the study revealed that there is statistically significant difference between indigenous and non-indigenous study groups by educational status, number of co-wives, intended number of children and length of postpartum sexual abstinence. Ninety six percent of the non-indigenous women and sixty two percent of the indigenous women have heard about modern contraceptive methods. The most commonly known contraceptive methods were oral pills and injectables. More than 50.0% of the non-indigenous women were used modern contraceptive methods in their lifetime while only 20.2% of the indigenous have ever tried. Current contraceptive prevalence was 11.5% among indigenous study women while it was 36.4% among non- indigenous group. Desire for more children and use of natural method like prolonged postpartum sexual abstinence were the reasons for non use among indigenous women while desire for more children and not currently engaged in viii wedlock were the most commonly reported reasons for non-use of modern contraceptive methods for non-indigenous women while It was found that the tradition of indigenous population enforces male partners to observe for prolonged postpartum sexual abstinence and their culture allows them to have multiple wives. More over, it was noted in the qualitative finding that once a women is engaged in wedlock it is must that she has to produce as many children as possible because children particularly daughters were assumed to be the source of family income and women can not make any decision related to reproductive matters which consequently influenced their modern contraceptive utilization. The result of multivariate analysis showed statistically significant association between age, marital status, number of co-wive, previous attendance of PNC previous health institution delivery, and modern contraceptive utilization. Women empowerment through education and looking for alternative sources of family planning delivery system and involving male partner in reproductive health issues were recommended
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    HIV/STI Behavioral Survey among Male and Female Students in Axum University: A Comparative Study, Axum Town, Tigray, Northern Ethiopia
    (Addis Ababa University, 2010-06) Yetum, Tesfa; Mitike, Getnet(PhD)
    Introduction: Efforts to reduce the spread and impact of HIV/AIDS are very much related to changing high-risk sexual behaviors and environments facilitating high risk sexual behaviors. This can be done successfully if these efforts are supported by relevant studies that aimed at analysis of sexual behaviors among the potentially risk groups. Objective: To assess and compare High Risk Sexual behaviour among male and female university students Methods: A comparative cross-sectional study (both quantitative and qualitative methods) were conducted from April 20 to 30, 2010 to assess the risky sexual behavior among male and female university students in Axum town. A total of 640students, 320 males and 320 females were participated. A structured, pre-tested, and self-administrated questionnaire and FGD were used for quantitative and qualitative data collection respectively. Results: In multivariate analysis respondents’ age , drinking alcohol, chat chewing and cigarette smoking were statistically significant with high risk sexual behavior. The mean age of the study subjects was 20.65 +1.53. 234 (36.6%) of the study subjects had ever had sexual intercourse, and 107(33.4%). Among the sexually active students 160 (68.4%) had only one lifetime partner, 59 (25.2%) had 2-5 partners and 15 (6.4%) had more than 5 lifetime partners. The proportion of males reported having had more than five lifetime partners was higher than females 10(7.9%) and 5(4.7%) respectively. Males were more knowledgeable and had positive attitude than females. Fifty two (8.1 %) of the students claimed that their chance of contracting HIV/AIDS was high while 514 (80.3%) said there was no chance at all. Seventy four (11.6%) did not know their risk status. Conclusion: Age, drinking alcohol, cigarette smoking and chat chewing showed a statistically significant association with high risk sexual behavior, males were more knowledgeable and have positive attitude than females, in general the students had low risk perception and males had higher risk perception than females
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    Identifying Factors Associated with the Difference Between Sidama Development Program and family Guidance Association of Ethiopia supported CBD Programs in contraceptive prevalence rate, Sidama Zone, SNNPR.
    (Addis Abeba Universty, 2003-07) Alano, Abraham; Mitike, Getnet(PhD)
    A comparative cross- sectional study was conducted in Sidama Zone, SNNPR to identify reasons for the difference in contraceptive prevalence rate between the Sidama Development Program (SDP) and Family Guidance Association of Ethiopia (FGAE) supported CBD projects. Multi-stage sampling was employed to identify the study woredas. A total of 1058 reproductive age group women were interviewed from both project areas. Six hundred ninety eight from SDP and 360 from FGAE site were selected proportionate to population size. Households were selected from respective peasant associations using systematic sampling and woman from household selected randomly. Eight FGDs and four in-depth interviews were conducted in two project areas. Key informants and discussants were selected based on convenience and their position in the institution or community to participate in the study. Contraceptive prevalence rates were 40.7% and 51.6 % in SDP and FGAE areas, respectively. This showed significant difference between the two project areas (p-value, 0.01). Knowledge of at least one contraceptive method was also significantly different between the two areas with (p-value <0.01). Ninety three percent of SDP and 97% of the FGAE areas mentioned at least one modern contraceptive method. More women in FGAE (37%) than in SDP area 29.5% experienced contraceptive usediscontinuation. The main reasons were desire for more children followed by health related problems. Perception about the quality of FP services given by the CBD agents showed significant difference between the two project areas, particularly for possibility of getting method of their choice (OR=0.23(0.07,0.61)), information given about how to take the contraceptives (OR=0.18(0.07,0.49)) and methods that prevent HIV/AIDS (OR=0.54(0.30,0.94)). Standardized initial training and regular subsequent refresher training with occasional incentives given to the CBD agents showed significant association with variation in success of the agents’ performances and contraceptive prevalence rate in two project areas. The study concluded that variation in the CBD agents training, level of motivation and supervision given contributed for the difference in CPR. Therefore, it is recommended that sustained motivation of CBD agents, training and supervision (with using the successful model) in both areas is imperative. In addition, cost-effectiveness analysis research is recommended in order to identify the relative cost- effectiveness of the CBD projects.
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    The Role of Men in Family Planning in a Rural Community of Western Ethiopia
    (Addis Ababa University, 2004-04) Tolassa, Yohannes; Mitike, Getnet(PhD)
    In recognition of men’s influence on family life decision and actions, and the family planning needs of men, family planning programs are encouraged to involve men. To determine men and women factor that affect family planning utilization by the couples, a cross sectional, community based study was conducted in six Rural Kebeles of Bodji woreda of western Ethiopia; Between Dec24,2003-Jan3, 2004. Systematic random sampling was used to select the study subjects. A pre-tested questionnaire in Oromo language was used to collect information from the couples. Similar questions were posed to the couples simultaneously but at distance they couldn’t hear each other. A total of 365 married couples were included. Nearly 100% of them are Oromo and Christians, 96% are farmers, 79.1% of men and 63% of women had formal education. Eighty-four percent of men and 86.3% of women have information about family planning, 82-% men and 89.6% women believe that family planning is important. The majority, 90.6% of men approves contraceptive use by their wives, but only 70% of women reported perceived approval by their husbands. Both bivariate and multivariate analysis has shown that, age of the couples ,knowledge of family planning methods by men, men as advocate for contraceptive use, discussion about family planning, perceived approval by husband, women education, ,family size, are predictors of family planning use by women. On the other hand, husbands’ opposition was positively related to contraceptive use by women. The reason behind is not clear. In conclusion, in married couples, both women and men factors affect family planning service utilization by the women. Therefore all programs targeted to promoting family planning have to vi target both men and women, men should be considered as an important agent to expand family planning utilization Key words: role of men, family planning, rural community