Browsing by Author "Mulugeta Betre"

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    Assessing Child Immunization Coverage and Its Determinants in Sinana District, Bale Zone, Oromia Regional State, Ethiopia.
    (Addis Ababa University, 2013-04) Worku Dechassa; Mulugeta Betre
    Background: Immunization remains one of the most important public health intervention and cost effective strategy to reduce child mortality and morbidity associated with infectious diseases and is estimated to avert between 2 and 3 million deaths each year. The objective of this study was to assess complete immunization coverage and its associated factors among children age 12-23 months in Sinana district. Methods: A cross-sectional community based survey was conducted in 6 kebeles (PA) of Sinana District from 29, December 2012 –16, January 2013. A modified World Health Organization Expanded Program on Immunization cluster sampling methods was used for household selection. Data on 591 children aged 12-23 months and mothers pair were collected by using a pre-tested structured questionnaire through house to house visits from vaccination card and mother’s verbal reports. Bivariate and multivariate logistic regression analyses were used to assess factors associated with fully immunization coverage of children. Results: of 591 interviewed mothers’ of children, only 10.2% of the mothers have attended secondary and above level of education. Of children included in this study, only 33% of them had vaccination card at time of the survey and about 76.8% of the children aged 12-23 months were fully vaccinated by card plus history. Factors significantly associated with full immunization were antenatal care follow-up (adjusted odds ratio (AOR = 3.7, 95% CI: 2.3- 5.9), mother occupation being farmer (AOD=1.9, 95% CI:1.14-3.1), educational level of father being secondary and above (AOD=3.1, 95%CI:1.3-7.4), household family income greater than one thousand(AOD=3.2, 95% CI:1.4-7.4) , average walking time less than an hour(AOD=3.1, 95% CI:1.5-6.3), ever discuss about immunization with health service extension worker(AOD=2.4, 95%CI:1.32-4.2) and mother’s sufficient knowledge on immunization(AOD=2.5, 95% CI 1.5-4.2) , whereas area of residence , educational level of mother and child sex were not significantly associated. Conclusion: Even though, immunization coverage of children in sinana district gets improvement over national coverage, yet it is below governmental plan of 90%. Maternal Health care utilization and knowledge of mother about vaccine and Vaccine Preventable Diseases are the main factors associated with complete immunization coverage. It is vital that, local programmatic intervention should be strengthened to upgrade awareness of the community on the importance of immunization, antenatal care and working on advancing economical status of community is the way to optimize children’s immunization coverage
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    Assessment of Acceptability of Provider-Initiated HIV Counseling and Testing among Tuberculosis Patients in Addis Ababa.
    (Addis Ababa University, 2007-07) Ibrahim Nursien; Mulugeta Betre
    Introduction: Unless patients know their HIV status, they cannot benefit from the available care and treatment options. Therefore, various counseling and testing strategies are needed to identify more HIV infected patients. Objective: This study was conducted in March 2007 to assess acceptability of PIHCT and the factors influencing its uptake among TB patients in Addis Ababa. Methods: Institution-based, cross-sectional study was conducted and 423 TB patients interviewed. A two stage sampling method was used for the selection of study subjects. In the first stage of sampling, six health centers were selected by simple random sampling. In the second stage of sampling, patients were systematically selected in each selected health center. Results: Most of the patients were initiated for HIV testing by their TB treatment supervisor 402(98.5%). Among those who were initiated by their treatment supervisor for HIV testing, 266(66.2%; 95%CI= 61.6-70.8) had under gone HIV testing. Adjusted correlates of acceptability of PIHCT include younger age group (20-24) (AOR=3.0, 95% CI=1.2-8.1), primary education (AOR=2.0, 95% CI=1.04-3.8), secondary and above education (AOR=1.9, 95% CI=1.01-3.7), and recognition that any one should get tested for HIV (AOR=5.5, 95% CI=1.4-21.7). The reported barriers for acceptability of PIHCT include no risk perception for HIV infection 54(40.3%), tested before 53(39.3%), and fear of learning positive result 40 (29.8%) of the study participants. Conclusion and Recommendation: The wide spread support, and evidence of high acceptability of PIHCT in this study holds significant promise for the control, prevention and treatment of both HIV/AIDS and TB. Concerted efforts to consolidate, sustain, and scale up PIHCT, however, should be accompanied by intensive IEC on TB /HIV.
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    Assessment of Factors Affecting Safe Delivery Care Service Utilization In Brna Tsemay Woreda, South Omo Zone, SNNPR, Ethiopia.
    (Addis Abeba Universty, 2010-07) Firehiwot Haile; Mulugeta Betre
    Background: Every minute, at least one woman dies from pregnancy-related causes: 99% of these are in developing countries. The majority of these deaths occurs in sub-Saharan Africa, and is avoidable by using standard interventions and health care which all pregnant women and their newborns need. Objective: The main objective of this study is to assess factors affecting safe delivery care service utilization in Bena Tsemay Wereda. Methods: A cross sectional community based study which was supplemented by qualitative method was conducted in Bena Tsemay Wereda from August, 2009 to June, 2010. A multi stage sampling technique was used to select 426 women who had childbearing experience in the past five years prior to the study. To collect the quantitative data, well structured, pre-tested questionnaire was administered by data collectors. To supplement the quantitative information FGD and key informant interviews were conducted. Bivariate analysis of chi-square statistics and binary logistic regression is used to show the association of different variables with the dependent variable. Moreover, a multivariate analysis was implemented to identify factors that affect the utilization of safe delivery care utilization. Result: From the total of 426 mothers, 386 (90.6%) delivered their last child at home and only40 (9.4%) at health institution. Among the home delivery the distribution of birth attendants was25.4% TBA, 36.5% relatives and 22.8% their neighbors. Most of the respondents’ reasons for home delivery; 114 (29.2%), were reported that the HI was too far and there was no transportation and the other 93 (24.1%) due to their wish to deliver by nearby relatives. On the other hand, 52.5% of the respondents who deliver at HI were informed to deliver at HI. In multivariate analysis knowledge on DS, attitude towards institutional delivery, FP utilization, educational status of the mother, radio availability, walking distance of the HF, problem faced related to pregnancy or child birth and sex of health professional were found to be factors affecting safe delivery care utilization. Conclusion and Recommendation: The utilization of safe delivery care service was very low in the woreda. Most of the important factors influencing the utilization of safe delivery care services were socio economic, health service related factors and factors related to the mothers like attitude and knowledge on DS. So improving education for both groups especially girls, beyond the primary school, needs to be strongly encouraged. Health care providers should provide information on risks of pregnancy, benefits of giving birth at health facilities, danger signs during pregnancy and labor to mothers, family members and the community consistent to the focused ANC service provision.
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    Assessment of Health Care Service Working Mothers Exclusive Breast- Feeding Practice and Their Perception Towards the Breastfeeding Support Program at Work Place in Governmental Hospitals in Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-06) Tseganesh Tesfaye; Mulugeta Betre
    Background: In different parts of Ethiopia employed mothers wean breast feeding earlier than unemployed mothers due to early returning to work after child birth. A recent World Health Organization (WHO) internal employee's based study recommended that the employer should provide, prenatal/ postpartum services, which include separate rooms for breastfeeding, nursery childcare and provide flexible time and lighter job to working mothers. Objectives: To assess health care service working mothers exclusive breast-feeding practice and determining factors and their perception towards the breast-feeding support program at work place in Governmental hospitals in Addis Ababa, Ethiopia 2020. Methods: A mixed methods research of institutional based cross sectional quantitative study design supplemented with qualitative method was conducted in Addis Ababa Governmental hospitals. For the quantitative portion the sample size was estimated using a single population proportion formula and become 403. For the qualitative, in-depth interview was done for working mothers having child less than 2 years until information of interest is saturated. Simple random sampling technique was used for the cross sectional quantitative research design and purposive sampling for the qualitative. The data for the quantitative was collected using a face to face interview questionnaire and semi-structured interviews for the qualitative data. For the qualitative, during dada collection period, the obtained data through Interviews was audio taped by digital sound recorder. Descriptive statistics such as frequencies, proportions, and measures of central tendency and measures of variation used to describe the distributions of variables. The logistic regression model was used to assess the relation between dependent and explanatory variables. The qualitative data analyzed using content analysis. Result: Only 95(24.1%) continue EBF after returning to work and majority of them stop EBF before six months due to work related reason 270(89.9%) while the rest were due to different reasons 30(10.15%). The odds of discontinuing EBF after return to work is 8 times higher (OR: 7.98, 95% CI 1.64-38.90) among women who works in shift compared to women who works by the regular office hours. With all the importance that the mothers mentioned about the breast feeding support program but they prefer not to use the program due to cleanliness issues and transport related problems. Conclusion: Health care service working mothers discontinue EBF before 6 month due to different reasons but mainly due to work related reason and mothers intention to use the breast feeding support program which helps mothers to continue EBF is affected due cleanliness issues, transport difficulties, hospital acquired infections and work overload.
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    Assessment of Magnitude and Factors that Affect Care Givers’ Disclosure of HIV Diagnosis to their HIV Infected Children in Addis Ababa Ethiopia 2013/2014.
    (Addis Abeba Universty, 2014-05) Roman Negewo; Mulugeta Betre
    Background: Most studies conducted on HIV disclosure to infected children report on the challenges experienced by caregivers to disclose HIV status to their HIV infected children. Therefore it‟s essential to look for factors that affect care givers' disclosure of HIV diagnosis to their HIV infected children in these settings. Objective: To assess magnitude and factors affecting care givers' disclosure of HIV diagnosis to their HIV infected children in Addis Ababa Ethiopia. Methods: A facility based cross-sectional study was conducted. A study was conducted from February 2014 to April 2014 among 372 primary caregivers of HIV infected children aged 6-15 years in nine health facilities, Addis Ababa, Ethiopia. Data were collected through structured pre tested questionnaire. It consisted of both closed- and open-ended questions. Data were entered into EPI Info version 3.54 and analyzed by using SPSS version 21 for windows. Descriptive statistics such as frequency, mean, median, standard deviation, and range were used to summarize the results. Bivariate and multivariate logistic regression analyses were done. Qualitative study were used to support the quantitative study. Data were summarized by using tables. Results: Based on caregivers reports, 111 (29.8%) of the children knew about their HIV positive status. Marital status of caregivers, age of the child, Caregiver's HIV status, those caregivers discuss about disclosure issue with healthcare providers and children who get aid or support from charity organizations. were found to have statistically significant association with disclosure of HIV positive status to HIV infected children at p<0.05 in multivariate analysis. Conclusion: Parents or guardians may have a critical need for health education and counseling in order to develop a plan for disclosing to their children. Addressing and scaling up efforts on stigma and discrimination in neighborhoods, communities, and school settings; and developing guideline for disclosure of children with HIV/AIDS in Ethiopian context will increase the rate of disclosure of children's HIV positive status.
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    Assessment of Menstrual Hygiene Management (MHM) Practice, Associated Factors and its Effects among School Girls of Northern Shewa, Ethiopia
    (Addis Abeba University, 2021-09) Engidashet Tsedeke; Mulugeta Betre; Solomon Emyu
    Background: Menstrual hygiene management (MHM) is a process of managing menses wi necessary supplies and conditions by health and development promoted. Adolescents and youte specially school girls in the rural area are the prime victims of MHM problems. MHM challenge in low and middle income countries gain global attention recently. Generating context specifevidences would have paramount importance to design proper interventions. Objective: To assess menstrual hygiene management practice, associated factors and its effecamong school girls of Mida Woremo District in North Shewa, Amhara Region, Ethiopia, 2019/20. Method: School based cross-sectional study design with stratified sampling procedure waapplied. Samples were selected by lottery method from each stratum. Data was collected by sel administered questionnaire, FGDs and observation. Data was entered to Epidata version 4.6.2 anexported to SPSS version 25 for analysis. Both descriptive and binary logistic regressioconducted for quantitative and thematic analysis for qualitative part. Association expressed terms of COR and AOR with 95% CI by using p-value<0.05 as cutoff point. Result and Conclusion: Response rate of the study was 98%. MHM practice among schogirls was 39% (95%CI: 35%, 44%). Good knowledge, father’s occupation (government emplo other), family income ≤3350, have no pocket money, having TV and having private water line were significantly associated with MHM practice. Both health related (depression, illness/pain and development related (absenteeism, distraction of concentration etc.) problems were commoamong school girls. Improving knowledge of school girls and the general public, strengthening existing intervention and its monitoring and evaluation and cooperation and integration wouhave benefit of in improving MHM practices among school girls.
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    Assessment of Parent-Adolescent Communication on Sexual and Reproductive Health Matters in Awassa Town, Snnpr, Ethiopia.
    (Addis Abeba Universty, 2009-07) Martha Fikre; Mulugeta Betre
    Introduction :Sexual and reproductive health problems of adolescents in Ethiopia are rising from time to time. This may be associated with early sexual initiation. Different researches done in different countries had showed that good family communication regarding sexual risk behavior has been positively associated with a delay in sexual activity. There are different factors affecting communication between parents and adolescents regarding SRH issues which are uncovered. Objective: The study is done in an attempt to identify those factors and the influence of parent-adolescent communication on sexual and reproductive health of students Methodology- A cross-sectional descriptive study involving 694 randomly selected students among four high schools in Awassa, Ethiopia. A pretested structured anonymous questionnaire was used to collect quantitative data, which was entered, cleaned and analyzed using SPSS version 11.0 statistical package. Qualitative information was obtained from four focus group discussions and sixteen peer-to-peer interviews segregated by gender. A binary logistic regression analysis was used to asses the impact of determinants. Results: Two hundred five (30.4%) of the students discussed with either of their parents in at least two topics of SRH. Nevertheless, most of the respondents preferred to discuss SRH issue with their peers/friends than their parents. Mother being literate [OR=1.63; 95%CI=1.17, 2.27], adolescents’ having knowledge on STI, contraceptive, fertile period during menstrual cycle and emergency contraceptive [OR=2.56; 95%CI=1.51, 4.62, OR=2.17; 95%CI= 1.32, 3.53, OR=1.57; 95%CI=1.13, 2.18 and OR=2.58 95%CI=1.84, 3.63 respectively] were associated with communication of parent and adolescents on SRH. The most reported factor that affects communication between parents and adolescents on SRH issues were shamefulness, parents’ lack of knowledge and that the issue is culturally unacceptable. Both males and females were more comfortable to discuss sexual and reproductive health issues with mother. There is significant difference across gender where more females being comfortable discussion with mother [OR=2.37; 95%CI= 1.60, 3.49]. Conclusion and Recommendation: The overall research finding shows that communication on SRH issues promotes healthy behaviors of adolescent. Nevertheless, there is low communication between parent and adolescent on different SRH issues with different reasons for not discussing. Hence, based on the findings obtained in this study it is recommended that comprehensive family life education (FLE) should be initiated for the students and parents in school, home, religious institution, and health facilities for effective communication to occur on SRH. In addition programs working in ASRH should include parents to address parental influences on adolescents’ reproductive health and work to alleviate those factors which affect communication between parent and adolescents. Additional research needs to explore the influence of parent –adolescent communication on SRH issues on adolescent reproductive health especially using analytical studies.
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    Assessment of Parental Influence on Pediatrics Highly Active Antiretroviral Therapy (HAART) Adherence in Addis Ababa, Ethiopia, May 2010
    (Addis Abeba Universty, 2010-05) Frie Hailu; Mulugeta Betre
    Back ground: Ensuring good adherence is critical to the success of highly active anti-retroviral therapy (HAART). Failure to adhere very closely to the regimens results in continued viral replication, treatment failure and the emergence of drug resistant strains of human immune deficiency virus (HIV). Although parents and caregivers may have primary responsibility for their children's medication-taking, there is no single study that examined parents influence on pediatrics highly active anti-retroviral therapy (HAART) adherence in our set up. The result of the study is expected to help device intervention strategies to improving children’s adherence on highly active anti-retroviral therapy (HAART). Objectives: To assess the status, determinants of adherence and identify parental factors influencing pediatrics highly active anti-retroviral therapy (HAART) adherence in Addis Ababa. Methods: An observational: descriptive, cross sectional study was conducted in 9 Health institutions: public, private and Non-Governmental Organizations (NGOs) in Addis Ababa. Multi-stage sampling procedure was used to select a total of 586 children: age 0 - 14 years, Human Immune Deficiency Virus (HIV) infected and started anti-retroviral therapy (ART) 12weeks ago. Primary care givers of the children were enrolled after the nature of the study was explained that allowed informed decision to be made and written consent obtained. Data was collected from February 8- May 10, 2010 on socio demographic, parent factors, clinical markers, care givers to provider relationship and regimen variables. Structured questionnaire and focus group discussion were used. Univar ate, bivariate and multivariate analysis was carried out. Result: The parental factors were strongly associated with non-adherence; children who had non biological parents [OR=9.805(95%CI= 2.198, 43.736)], parents who didn’t communicate about HIV and ART adherence to their children [OR=3.915 (95%CI= 1.273, 12.036)], and parents who hadn’t good relationship with health care providers [OR=29.592(95%CI= 1.326, 660.333)] were more likely non adherent. Children who had more than four siblings [OR= 5.676 (95%CI=2.100, 15.339)] were also significantly associated with non-adherence Conclusion: The parental factors were strongly associated with non-adherence. The need for providers to have smooth relationship with the care givers of the HIV infected children on antiretroviral therapy, support caregivers to communicate with their children about the disease and antiretroviral therapy adherence is critical. Further research is recommended to explore the validation of self-report adherence using longitudinal study designs.
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    Assessment of Parental Influence on Pediatrics highly Active Antiretroviral Therapy (HAART) Adherence in Addis Ababa, Ethiopia, May, 2010.
    (Addis Ababa University, 2010-05) Frie Hailu; Mulugeta Betre
    Back ground: Ensuring good adherence is critical to the success of highly active anti-retroviral therapy (HAART). Failure to adhere very closely to the regimens results in continued viral replication, treatment failure and the emergence of drug resistant strains of human immune deficiency virus (HIV). Although parents and caregivers may have primary responsibility for their children©s medication-taking, there is no single study that examined parents influence on pediatrics highly active anti-retroviral therapy (HAART) adherence in our set up. The result of the study is expected to help device intervention strategies to improving children’s adherence on highly active anti-retroviral therapy (HAART). Objectives: To assess the status, determinants of adherence and identify parental factors influencing pediatrics highly active anti retroviral therapy (HAART) adherence in Addis Ababa. Methods: An observational: descriptive, cross sectional study was conducted in 9 Health institutions: public, private and Non Governmental Organizations (NGOs) in Addis Ababa. Multi-stage sampling procedure was used to select a total of 586 children: age 0 - 14 years, Human Immune Deficiency Virus (HIV) infected and started anti-retroviral therapy (ART) 12 weeks ago.Primary care givers of the children were enrolled after the nature of the study was explained that allowed informed decision to be made and written consent obtained. Data was collected from February 8- May 10, 2010 on socio demographic, parent factors, clinical markers,care givers to provider relationship and regimen variables. Structured questionnaire and focus group discussion were used. Univariate, bivariate and multivariate analysis was carried out. Result: The parental factors were strongly associated with non adherence; children who had non biological parents [OR=9.805(95%CI= 2.198, 43.736)], parents who didn’t communicate about HIV and ART adherence to their children [OR=3.915 (95%CI= 1.273, 12.036)], and parents who hadn’t good relationship with health care providers [OR=29.592(95%CI= 1.326, 660.333)] were more likely non adherent. Children who had more than four siblings [OR= 5.676 (95% CI=2.100, 15.339)] were also significantly associated with non adherence. Conclusion: The parental factors were strongly associated with non adherence. The need for providers to have smooth relation ship with the care givers of the HIV infected children on antiretroviral therapy, support caregivers to communicate with their children about the disease and antiretroviral therapy adherence is critical. Further research is recommended to explore the validation of self report adherence using longitudinal study designs.
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    Assessment of Quality of Care in Tikur Anbesa Specialized Teaching Hospital Neonatal Intensive Care Unit, Addis Ababa, Ethiopia
    (Addis Abeba Universty, 2015-06) Redeat Workneh; Mulugeta Betre
    Background: Despite the increasing population and unsatisfactory decline of neonatal mortality rate (NMR) less attention was given to Neonatal Intensive Care Unit (NICU) until recent years where a little effort is being made to improve the services provided. Currently there are 27governmental NICUs; Tikur Anbessa Specialized Teaching Hospital (TASTH) is one of these hospitals which serve as the main referral center. Regardless of the few number of NICUs there is complaints on the quality of care provided which might be due to a variety of reasons that are crucial for the survival of the neonates. Objectives: To assess the quality of care in TASTH, NICU in Addis Ababa, Ethiopia. Methods: Hospital based cross sectional study was used. The study has two categories of participants; primarily mother of the neonates who were available in the NICU during the data collection period and health professionals (n=35) working in the NICU. Sample size of the study on mothers was calculated using single population formula considering 50% prevalence which gives a total 384 participants. The unit was observed using inventory checklist from WHO Hospital Care for Mothers and Newborns: Quality Assessment and Improvement Tool. For the qualitative portion head of the unit (neonatologist), practicing neonatologist and the head nurse were included. Structured questionnaire was adopted from WHO Hospital care for mothers and new-born babies: quality assessment and improvement tool, and they were filled by the date collectors after obtaining an informed consent. Data was analyzed using SPSS version 20. P value of 0.05 was the cut off point for the level of significance. Adjusted odds ratio was used to show strength of association. Result: The study found that the quality of care that is provided in the neonatal intensive care unit in TASTH is inadequate. Overall service satisfaction was found to be 96.4% and 47.1% for the clients and health professionals respectively. Clients whom their neonates shared bed with others were 6.6 times not satisfied than those clients whom didn’t, AOR (95%CI) 6.612[3.604, 10.109] Health professionals who don’t think that there are a sufficient number of staffs were dissatisfied 3.15 times compared to those who think the number of staff is sufficient. AOR (95%CI) 150[0.050, 5.611] Conclusion and Recommendation: Quality administration demands several strategies thus, it is fundamental to identify the problems, aiming at implementing effective actions, and monitoring the processes. The findings from this assessment would assist in scaling up of such units. More over the presence of national guideline which is specific to NICU would be a key to solve the problems associated with quality of care in NICUs.
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    Assessment of Sexual Risk Perception and the Determinants of Protective Behavior of STIS/HIV/AIDS among Female College Students, in Debere-Markos Town, Amhara Regional State, Ethiopia.
    (Addis Abeba Universty, 2010-06) Daniel Alemu; Mulugeta Betre
    Background: Young people between the ages of 15 and 24 years are both the most threatened globally, accounting for half of all new cases and the greatest hope for curving the epidemic of HIV/AIDS. Young populations, especially never-married sexually active females have the greatest risk of HIV infection. They may not be aware of their vulnerability to it or of how bestto prevent it. There is a great gap between knowledge and practice which needs detailed research that address determinants. Objective: To assess female college student’s knowledge, sexual behavior, risk perception and determinants of protective behavior of STIs/HIV/AIDS in Debre Markos town. Methods: A descriptive cross-sectional institution based survey was conducted from February to April, 2010 and was complimented by qualitative study. Result: 340 students interviewed and four focus group discussions were conducted. Students’ comprehensive knowledge was (15.5%). Only 7.4% perceived risky sexual behavior that can exposed them for HIV. Among the study subjects 25% were sexually active. Sixty percent of the respondents had used condoms consistently during their last sexual exercise. Ten percent of never married respondents had experienced sexual intercourse. 75.4% did not used condoms during their last sexual contact. Of all participants 61% of the study group had ever tested for HIV in the last 12-months. Among those respondents who had sexual intercourse in the last one year 6.8% had symptom of STI as foul smelling genital discharge and/or genital ulcer. Thirteen percent of respondents had ever forced by their sexual partners and 5% of sexually active students had more than one sexual partner. Conclusion: Though awareness of HIV/AIDS/STIs among female college students was relatively high, they had low comprehensive knowledge that capable of them to prevent infections of STIs and HIV. Regarding risky sexual behavior and self-risk perception, most of the study subjects had involved in risky sexual behaviors but the great majority of them considered themselves having low or no risk for HIV infection. Protective behavior such as utilization of condom use was found to be inadequate but self-recognition of HIV status in the last 12 months was relatively higher. Recommendation: Continuous IEC/BCC intervention programs paying attention on the misconceptions and protective behaviors against HIV/STIs; creating a positive youth friendly environment to address sensitive gender-related issues and access protective means like condom provision within the institution and the community; Emphasis should be given to ensure access for young people to sex education, HIV/STIs, including information about contraceptives. Students have to be further promoted to HIV counseling and testing services.
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    Assessment of Status of Commercial Sex in Females Selling Local Beverage, their Risk Perception towards HIV Infection and Condom Use in Towns of Gojjam.
    (Addis Ababa University, 2007-07) Tenaw Bawoke; Mulugeta Betre
    Background (problem statement): - Selling local beverages like Araki, Teji and Tella by females is of back long and widely practiced activity in Ethiopia in general and in most towns of Gojjam in particular. And some of these females are practicing commercial sex with their beverage customers most of whom are farmers presumably with low awareness level towards HIV/AIDS compared to urban people. It is assumed that commercial sexual transaction between these females and farmers play significant role for the steadily growing rate of HIV transmission to the rural area. Objective: To assess the status of commercial sex among local beverage selling females and to identify their risk perception towards HIV/AIDS and condom use in selected Gojjam towns. Methods: a cross sectional survey assisted by focus group discussion (FGD) was conducted on 354 randomly selected local beverage sellers in Debre Markos, Dembecha and FinoteSelam towns from March 3 – March 10, 2007. A pre-coded, pre-tested and structured questionnaire was used for the quantitative method and FGD was conducted in the three towns for the qualitative method. Results: Fifty nine percent of the studied local beverage selling females (LBSFs) were older than 35 years and all of them were above 15 years old at the time of interview. About 46 % of the respondents were illiterates. More than one-fourth of the females studied were married before 10 years old, 76 % of them before 18 years old and most (72.3 %) females had no knowledge and consent of their first marriage. Out of the studied 354 LBSFs, 38.7 % (n=137) have ever practiced commercial sex work(CSW) of which 28.5 % (n=39 of the 137 ever practicing CSWs) have interrupted it at the time of interview and 27.7 % (n=98) are still practicing. Educational status before local beverage selling, duration of engagement in local beverage selling, age and lack of additional means of income other than local beverage selling have positive significant associations with engagement to commercial sex work. Family, marriage and other socio-economic factors before being engaged in local beverage selling are found to be statistically significant factors for commercial sexual engagement. Ninety nine percent of the study participants and especially 100 % of the FSW participants have knowledge of HIV/AIDS. Sixty five percent of the respondents have described all the three basic programmatically important prevention methods (Abstinence, Be faithful and use Condoms consistently).Thirty eight percent of the participants have comprehensive knowledge about HIV/AIDS. But 39.6 % of them had at least one misconception (incorrect belief) about HIV transmission. Twenty nine percent of the interviewed females have ever been tested for HIV of which 88 %have taken their results. About 43 % of the studied females have moderate/high and 55.8 % have nil/low risk perception towards HIV infection based on their past risk behaviors. Eighty eight percent of the studied LBSFs (100 % of FSWs) and 63 % of them have knowledge of male condoms and have ever used it respectively. And 65.8 % of the FSWs who have ever used male condoms have used it during their recent sexual contact with their paying clients. Within 30 days prior to the day of interview, about half of the commercial sex practicing LBSFs studied have used condoms persistently. Conclusion and Recommendation: several families, marriage and other socio-economic related factors before being engaged in local beverage selling are observed playing significant roles for LBSFs to start commercial sex work. And there is high level of unprotected commercial sexual transaction between these CSWs and farmers and other rural community members aggravating the speed of dissemination of HIV infection to the rural Ethiopia. These situations need due attention and rapid remedial intervention by joint efforts of the local government, civil societies and the community itself.
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    Assessment of the Extent and Determinants of Functionality of Health Extension Workers in East Gojjam Zone, Amharra Regional State, Ethiopia.
    (Addis Abeba University, 2009-06) Getachew Hailu; Mulugeta Betre
    Background :Previous studies have identified factors affecting Health Service Extension Program implementation as well as working conditions of Health Extension Workers in Ethiopia. Most of the studies conducted were qualitative and none of them raised the question to what extent HEWs are functional and what are its determinants. The present matched case control study was conducted to evaluate risk factors for functionality of HEWs after a cross sectional census survey determination of extent of HEWs functionality. Objective: A study was undertaken to determine the extent of HEWs functionality and to evaluate determinants of functionality of HEWs in East Gojjam Zone, Amharra National Regional State. Method: A population based matched case control study after a cross sectional preliminary census survey was conducted in East Gojjam Zone from March to May 2009. A total of 632 health extension workers were included in the cross sectional census survey. All of the (n=25)eligible cases (nonfunctional HEWs) in the zone were included in the study. Two randomly selected controls [(n=50)(functional HEWs)] working from 2003 to 2008 in the same zone from which the cases were enrolled were matched for each case for age, service year, marital status and woreda of the case. Data collection instruments of separately designed self administered and interview based structured questionnaire were used for the cross sectional and matched case control studies respectively. Result: Over all non functional prevalence of HEWS in East Gojjam Zone was 4 %( n=25) The final multivariable model identified health institution support (adjusted matched odds ratio [Adj.mOR=40, 95% CI=4.5_360]), selection pattern [Adj.mOR=11.2, 95% CI=1.3_98.9], and Future aspiration,[Adj.mOR=2.1 95% CI=1.3_57], as independent determinants of functionality of HEWs after adjusting for other variables in the model. Conclusion: In general functionality of HEWs was found to be encouraging. The majority (96% n=607) were functional where as 4 %( n=25) were non-functional. HEWs are doing better the family health, personal hygiene and environmental sanitation and health education services but communicable disease prevention and control service needs more effort. Health institution support, selection pattern and future aspiration had been identified as independent determinants of HEWs functionality. The program need to employ many qualified HRH for training, supervision and support. Therefore, the real cost of scaling up HEP, including the additional qualified HRH for supervision and training, should not be neglected. Moreover the need for career structure for HEWs is a high concern.
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    Assessment of the Magnitude and Factors Associated With Low Birth Weight among Newbors in Public Hospitals of Addis Ababa.
    (Addis Ababa University, 2015-06) Hirut Mulatu; Mulugeta Betre
    Background: Low birth weight is a public health problem in almost all countries of the world of which Ethiopia is one. The empirical literature provides mixed results on the relationship between many of these factors and LBW. Some of the variables that are found to be predicator of LBW in one study may not necessarily be a risk factor in another study. Objective: The main objective of this study is to assess the magnitude and factors associated with low birth weight at public hospitals of Addis Ababa from August 2014 to June 2015. Methods: Hospital based cross-sectional study was conducted in Addis Ababa. The study was conducted among three selected hospitals. A total of 457 samples were drown proportionally from the selected hospitals. Pre tested structured interviewer administered questionnaire was used. The collected data was cleaned, coded, and entered into EPI INFO and then exported to SPSS version 21.0 for analysis. Result: The magnitude of low birth weight was 8.8%. Low birth weight was more likely associated with timing of ANC visit (AOR=7.407, 95% CI=1.148, 47.794), taking extra meal during pregnancy (AOR=0.249, 95%CI=0.064, 0.960), type of pregnancy (AOR=0.302, 95% CI=0.094, 0.972) and iron/folic acid supplementation (AOR=0.30295%CI=0.092, 0.972). Conclusion and recommendation: Low birth weight was substantial and strengthening the public health intervention that put into consideration the factors identified here are essential.
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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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    Assessment of Use of Information Technology in Pharmacies and Drug Stores in Addis Ababa, Ethiopia
    (Addis Ababa University, 2010-06-01) Tadesse Gebre; Mulugeta Betre
    Back ground: Advance In information technology (IT) provides easy use and access to exploit its benefits. Information technology is currently important in improving healthcare delivery system. They improve efficiency, effectiveness, and reduce medication errors . However, the use and access of this in formation technology at pharmacies and drug stores level among d rug dispensing professionals is little known in Ethiopia, particularly in Addis Ababa. Objective: To assess the u se and access of information technology among pharmacists and druggists in pharmacies and drug stores in Addis Ababa and to identify the factors that affecttheusc of this technology. Method: A cross sectional survey was conducted in pharmacies and drug stores in Addis Ababa. The quantitative data were collected using pretested and self Administered questionnaire. The study Vas complimented with in-depth interview. Data were entered and analyzed by SPSS version 15.0. Result: A total of 257 pharmacist and druggists pa reticulated the study. The current means of giving service to customers .in pharmacies and drug stores was about t 93.0% paper -based (manual ) system and 7.0% were u sing computer system. Only 30(1 2.0%) professional had in tenet access in pharmacy/drug s tore. The most preferred source to obtain drug information was combination of printed sources and d rug inserts (manual system) 169(68.1%). Use of IT in pharmacy/drug store was poor. Conclusions and recommendations: The study indicated poor utilization status of IT for pharmacy practice service. The findings indicated the need for creating awareness among professionals In giving more skill oriented and also forma l in service IT re la ted trainings for the professionals. Further, the drug profess Iona t raining centers as well as other stakeholders should cons id reapproving the IT facilities for drug dispensing professional is to achieve better universal access and see of IT so as to improve healthcare delivery system, particularly pharmacy practice
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    Association Between Women’s Empowerment Stunning among Children Aged 6to59 Months: from 2016 Ethiopian Demographic and Health Survey.
    (2019-11) Yirgalem Shibiru; Mulugeta Betre; Mengistu Yilma
    Background : Stunting is predominantly irreversible nutritional deficiency disorder of children. Evidences on the impact of women empowerment to reduce child stunting are limited in Ethiopia. Objective: To determine the association between women empowerment on stunting among childrenaged6to59 months from the2016 Ethiopian Demographic and Health Survey datasets. Methods: The study used the Ethiopian Demographic and Health Survey 2016 dataset, which is a cross sectional study. The study participants were current married women of there productive age(15– 49years) group living with their husbands or partners whohavechildrenaged6-59monthsinthehousehold who were alive at the time of the survey. Data selected and exported to SPSS version 22foranalysis. Complex sample binary logistic regression analysis was employed to determine the association between children stunting aged 6-59 months and the predictor variables. In addition, multivariable logistic regression model was performed using variables that are significant at Pvalue ≤.05with95%ofconfidencelevel. Result: The prevalence of stunting among children aged 6- 59 month with 95% confidence interval was 41%(3,318) (95%CI: 39% - 43.3%). Around 45 %( 3806) of mothers employed in the last 12 months before the survey. Among mothers who had a job, 2072(54%) had seasonal jobs and the rest 1734(45%) had jobs throughout the year. About 50.5 %( 1921)of the mothers have been not paid for the job they were engaged with. Approximately 5855(69%) of mothers have had a positive attitude towards the husband justifying hitting or beating his wife. Maternal attitude towards wife beating (AOR [95% CI]) = 1.057[0.889, 1.256]), decision on large household purchase (AOR [95% CI] = 1.001[0.807, 1.243])had no association with child stunting .In contrast, Household wealth index (AOR [95% CI]) = 1.98 [1.44, 2.726]), Maternal height (AOR [95%CI] = 1.9[1.280, 2.82]), child sex (AOR [95% CI] = 1.255[1.077, 1.463]) were significantly associate with child stunting. Conclusion and Recommendation: The study indicated very high child stunting among children age 6-59 month. It also identified low women’s economic and socio-familial empowerment. Thus, it is recommended that Ministry of Health up to local health service authority should strengthen their effort on the implementation programs which aim to improve childhood undernutrition. Advocacy programs should be introduced to strengthen the practice on implementation policies and proclamation that enshrines women’ right so as to support women empowerment and thereby improve young childhood nutrition in Ethiopia.
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    The Association of Intimate Partner Violence During Pregnancy With Preterm Birth in Addis Ababa, Ethiopia
    (Addis Abeba University, 2019-11) Genet Melak; Mulugeta Betre ; Abiy Seifu
    Background: Preterm birth is a significant and growing public health problem leading to increased neonatal morbidity and mortality. Intimate partner violence during pregnancy is one of the factors that affect not only women’s health but also the health of the newborn. However, the association between intimate partner violence during pregnancy and preterm birth was not adequately studied in Ethiopia. Objective: To assess the association between intimate partner violence during pregnancy and preterm birth in Addis Ababa, Ethiopia. Methods: A facility-based age-matched case-control study was conducted among 420 women [140 cases (women who had preterm births) and 280 controls (women who had term births)] in six public hospitals in Addis Ababa, Ethiopia. Data was collected using a structured, interviewer administered questionnaire. A woman who reported the experience of at least one act of violent act, either physical or sexual or emotional or controlling behaviors by an intimate partner during the index pregnancy period was considered exposed to intimate partner violence during pregnancy. Descriptive statistics were computed to describe the characteristics of study participants. Additionally, the association between intimate partner violence during pregnancy and preterm birth was analyzed using multivariable conditional logistics regression model. Statistical significance was declared at P<0.05. The analysis was performed using Stata 14.0. Results: The odds of preterm birth was four times higher among women who experienced physical violence (AOR: 3.98, 95% CI: 1.03, 15.32), three times higher among women who experienced emotional violence (AOR: 3.64, 95% CI: 1.01, 13.06) and four times higher among women who reported controlling behaviors of their husbands/partners (AOR: 4.32, 95% CI: 1.10, 16.89) during their pregnancy. Conclusion and Recommendation: The study identified that women who experienced physical and emotional violence and whose husbands/partners demonstrated controlling behavior during pregnancy have a higher risk of preterm birth. To reduce the risk of preterm birth, prevention of physical and emotional violence during pregnancy and improving women’s autonomy should be integrated into perinatal care interventions.
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    Current Utilization of Reproductive Health Services and the Role of Peer Influence among Undergraduate Students of Wachamo University, Hosanna, SNNPR, Ethiopia
    (2017-11) Tsegaab Temesgen; Mulugeta Betre
    Background: Youth health is dependent on several complex and interdependent factors such as socio-cultural influences, social support structures (such as families, peers and communities), access to health services, education and employment opportunities. Objectives: To assess current utilization of reproductive health service and role of peer influence among regular undergraduate students of Wachamo University, Hosanna, SNNPR (Southern Nations and Nationalities People Region), Ethiopia. Methods: An institution based quantitative cross sectional study supplemented by qualitative method was conducted in Wachamo University, Hosanna, Hadiya zone, SNNPR, Ethiopia March, 2017. Multistage sampling method was used to select study subjects. A total of 389 study participants were selected for quantitative part. The data from the quantitative part of the study was entered in Epi info version 7 and analyzed using SPSS version 21. Whereas purposive sampling technique was used to select2interviewees for indepth interview which were health care providers and 40 regular undergraduate students in Hosanna campus of Wachamo University for 4 focus group discussions (FGD) . For the qualitative component, recorded data was transcribed and open code software was used to carry out content analysis, then results were triangulated with the quantitative findings. Results: From the total of 385 respondents, 227 (59%) utilized at least one of the reproductive health (RH)services in the past 6 months. sex(AOR=3, 95% CI: 1.15, 8.37), friend mentioned about importance of utilization of RH services(AOR=3.02, 95% CI: 1.19, 7.64), attitude of peer /friend on utilization of RH services(AO R=2.97, 95% CI: 1.11, 7.89), experience of discouragement not to use RH services(AOR=4.38, 95% CI: 1.44, 13.28) remained significantly and independently associated with current utilization of Sexual and Reproductive Health (SRH) services (CI 95%, cut off point for significance level P<0.05). The main problems identified from the qualitative finding hindering the current utilization indicated were lack of awareness, fear of being seen and feeling ashamed ,shortage of equipment and skilled provider as well as small service provision rooms of the facility. Conclusion: In general, it was found that current RH services utilization among youth in this study area was low. Interventions such as improving knowledge of the youth with regard to SRH issues, strengthening youth and RH centers in the campus with necessary supplies as well as training of the staffs and peer educators should be sought.
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    Demand for Long Acting Contraceptive Methods and Associated Factors Among Family Planning Service Users in Public Health Centers, Addis Ababa, Ethiopia, 2017
    (Addis Ababa Universty, 2018-07) Bahrnesh Debella; Mulugeta Betre
    Background: All individuals and couples have a basic human right to decide freely and responsibly the number, spacing, and timing of their child. However, the use of FP in Ethiopia has been limited to short-acting methods due to limited access to LAFPM, commodity shortages, and lack of skilled health care providers to offer services at the community level. The prevalence of LACMs use is 13% in the world and LACM use coverage is 2%, for Sub-Saharan Africa [6] and for Ethiopia, LACM use coverage is 3.7% [7] also the prevalence of implant in 2000, 2005, 2011 and 2016 show (0, 0.3, 3, 8) respectively but still the trend show slow improvement [8]. Objective: To measure the demand for long acting contraceptive methods and associated factors among family planning service users in public health centers, Addis Ababa, Ethiopia, 2017. Methods: Cross-sectional facility based descriptive quantitative study was conducted from July 1 - August 1, 2017 in selected government HCs in Addis Ababa, Ethiopia. Multi stage sampling technique was used to select the 848 study samples. A pre-tested and structured questionnaire was used to collect the data. The data analysis was performed using Statistical Package for Social Sciences (SPSS) version 20 software. Descriptive, bivariate and multivariable logistic regression analysis was done. Odds ratio from logistic regression was used to identify their association with demand of LACMs. P-value <0.05 was considered to show statistical significance. Result: The demand for LACM was 650 (76.7%). Among demanded LACM, 305 (36%) meet need and 345 (40.7%) unmet need. The multivariate analysis showed that being married [AOR: 0.562(0.335, 0.941)], primigravida [AOR: 0.402(0.228, 0.709)], ever heard about LACM [AOR: 2.762(1.529, 4.991)], knowledge on LACM [AOR: 2.210(1.298, 3.763)], attitude [AOR: 15.755 (9.628, 25.782)], perceived good quality service at health facility [AOR: 4.219(2.781, 6.40)] were found predictors of the demand for LACM in this study. Conclusion: the demand for LACM according to this study was high and the unmet need for LACM also high. Marital status, gravidity, information on LACM, knowledge on LACM, attitude on LACM and perceived quality of health facility service affect the demand for LACM in this study. Recommendation: Based on this study the demand and unmet need for LACM was found high so it is better to utilize the opportunity to provide the service to meet