Browsing by Author "Seifu, Abiy"

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    Assessment of Emergency Oral Contraceptive Use among Female Undergraduate Students of Addis Ababa University
    (Addis Ababa University, 2016-06) Deyas, Yared; Seifu, Abiy
    Background: - Unintended pregnancies are major public health concern in developing countries including Ethiopia. Female university students face unintended pregnancies because most of them are sexually active and exposed to unprotected sporadic premarital sexual intercourse. Emergency Contraception (EC) is a drug or a device that prevents unintended pregnancy and its consequences. Emergency Oral Contraceptives (EOC) are being increasingly used by unmarried young women to prevent unintended pregnancies following unprotected sexual intercourse. However, little is known about Emergency Oral Contraception (EOC) use among female students at higher education in Ethiopia. Objectives: - The aim of this study was to assess the proportion of Addis Ababa University undergraduate female university students who use Emergency Oral Contraceptive (EOC) Methods: - Institution based cross sectional descriptive study involving 635 undergraduate female students from Addis Ababa University (AAU) was done. Data was collected from January to February 2016. Study participants were selected using multi stage stratified sampling technique. Interviewer administer pretested structured questionnaire was used to collect the data. The data was entered into Epi info version 7 then exported to STATA version 12 for analysis. Descriptive analysis was applied to estimate the EOC use and describe the study participants. Results: - Overall, 78.74% were in the age group of 20-24, and 4.09% were married. Of the total respondents, 22.4% and 10.7% them reported previous use of EOC at least once and repeatedly, respectively. Among those who had unprotected sexual intercourse, 97.92 % have reported ever use of EOC. Non-consensual sex (37.32%), forgetting to take contraception (14.79%) and partner pressure (35.92%) were the main reported reasons for use of EOC. Conclusion and Recommendation: - There is very high level of EOC use among sexually active female undergraduate students who had unprotected sexual intercourse. This could be due to the fact that university students have relatively better information and access to the service. Therefore, it is highly recommended that the Federal Ministry of Health make regular contraceptive methods accessible for students in higher institutions
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    Assessment of Maternal Death and Factors Affecting Maternal Death Surveillance and Response System in Dire Dawa, Ethiopia
    (Addis Ababa University, 2015) Tesfaye, Tseyon; Addisie, Mesfin(PhD); Seifu, Abiy
    Background: Reducing maternal deaths is one of the key goals of Millennium Development Goals (NDGs). Programs and policies aiming to reduce maternal deaths need reliable and valid information. Maternal Death Surveillance and Response (MDSR) system is a method of collecting information on the level and causes of maternal death in order to provide accurate information to improve quality of maternal health care. Objective: The study aims to assess causes of maternal deaths and factors affecting MDSR system in public health facilities in Dire Dawa Methods: A cross sectional facility based study design including quantitative and qualitative methods was conducted in nine health facilities of Dire Dawa where an MDSR system was introduced. The quantitative method assessed maternal deaths and complications for causes and avoidable factors before the introduction of MDSR from 8 June 2013 to 7 June 2014 and after the introduction of MDSR from 8 June 2014 to 9 March 2015 by reviewing patient and facility records and interviewing with health care providers. Factors which affect the implementation of MDSR assessed qualitatively through in-depth interview with 24 purposively selected health care providers working in the nine public health facilities. Results: A total of 45 maternal deaths, 247 maternal complications and 8,857 deliveries were recorded during the two study periods. Maternal mortality ratios for the two periods were 511 and 505 per 100,000 live births in the baseline and implementation period respectively. Of the total maternal deaths 33 (73.3%) were avoidable. The direct obstetric causes were responsible for 41 (91%) of the deaths, of which hemorrhage 27%, hypertension during pregnancy 22% and obstructed labour 18% are the leading causes. MDSR is implementing in the nine public health facilities. Knowledge, attitude, support and supervision, training, staff turnover, and community participation are the main factors which affect the program implementation. Conclusions and recommendations: The identified maternal death is very high and most of them are avoidable and caused by direct obstetric causes of maternal death. MDSR system is implementing and accepted by most of the care providers. Improving care, capacity building, support and supervision and community awareness is crucial to reduce the number of maternal death and to strengthen and sustain the program implementations
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    Effect of Topical Application of Human Breast Milk, Chlorhexidine and Dry Cord Care on Neonatal Umbilical Cord Separation Time and Rate of Cord Infection in Butajira, Ethiopia 2017/2018: Cluster Randomized Trial
    (Addis Abeba University, 2019-08) Mesfin, Melat; Seifu, Abiy; Dr.Betre, Mulugeta
    Background- Annually 1 million newborns worldwide die of infection caused by bacteria that enter the body via the umbilical cord. Regarding this the Ethiopia national strategy of new born and child survival identified chlorhexidine (CHX) as one of the high impact intervention to minimize neonatal mortality. Whereas, studies have shown Human breast milk (HBM) application to the neonatal umbilical cord has a shorter cord separation time and lower rate of infection than CHX or the standard dry cord care (DCC). To the best of the investigators knowledge on to assess cord separation time and rate of cord infection, studies were not conducted comparing the standard DCC with that of CHX or HBM. Objective: - Compare the effect of topical application of HBM, CHX and DCC on neonatal umbilical cord separation time (CST) and assess the rate of cord infection at the Demographic and Health Surveillance Site, Butajira, Ethiopia, 2017/18. Method- From May to November, 2018, a three arm, non- masked, community based, cluster randomized controlled trial was conducted at Butajira Demographic and Health Surveillance site (BDHSS) located in Gurage Zone of the Southern Nations, Nationalities and Peoples´ Region (SNNPR) of Ethiopia. Nine kebeles of the BHDSS were randomized into two intervention groups i.e. HBM and CHX and a control group which is the standard DCC using a lottery method. From a sample size of 337, data were entered and analyzed for 302 term singleton newborns. Baseline characteristics across the groups were compared by ANOVA for continuous variables and Chi square for categorical variables. Mean CST was compared among the groups using one way ANOVA whereas the secondary outcome i.e. rate of omphalities was expressed in terms of frequency and was compared among the groups using Chi square. Level of significance was set at p <0.05 with 95% CI. Result- The mean cord separation time was 5.6 days in HBM group, 5.9days in CHX group, and 5.7days in DCC group but this difference was not statistically significant among the study groups (p value=0.40). The highest signs of cord infection rate were observed in dry care group and this was significant regarding the redness on the base of the cord stump (P<0.001). Conclusion and recommendations- Topical application of HBM is related with shorter cord separation time compared to CHX or DCC. It also has reduced incidence of infection, as much as topical CHX application. Generally the readily available human breast milk should be given further emphasis.
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    Impact of Food and Nutrition Security on Adherence to Anti-Retroviral Therapy (ART) and Treatment Outcomes among Adult PLWHA in Dire Dawa Provisional Administration
    (Addis Ababa University, 2007-06) Seifu, Abiy; Tesfaye, Fikru(PhD); Shiferaw, Solomon(PhD)
    Background: Adherence to Anti-Retroviral Therapy (ART) is critical for optimal virologic suppression and improved CD4+ cell count that in turn determines the survival of People Living with HIV/AIDS (PLWHA) on ART. So far a range of predictors of adherence to ART in many different social and cultural settings have been identified. However, household food and nutrition security as predictor of adherence to ART is less understood. Objective: The main objective of this research project is to assess the effect of household food and nutrition security on adherence to ART and treatment outcomes. Method: A cross-sectional study was conducted to assess the effect of household food and nutrition security on adherence to ART and treatment outcomes. Both quantitative and qualitative research methods were applied to triangulate the findings of one with another. Adult PLWHA on ART for at least 3 months were the study participants. Availability of enough food/money to buy one, behavioral and subjective questions, meal frequency, dietary diversity, food aid and BMI were used as indicators to measure the household food and nutrition security situation of PLWHA and self-reported adherence as an indicator to measure adherence to ART. Change in CD4+ cell count, body weight, functional status and frequency of opportunistic infections were used to measure treatment outcomes. Result: Based on food security assessment core module close to 90% of PLWHA on ART in Dire Dawa were food insecure and 30.1% had at least mild malnutrition. On patient self report of adherence 96.6% of them were adherent to 95% of the ART drugs prescribed. The median change in CD4 count after 6 months and the median change in weight after 3 months of ART were 116 (IQR 82-182) and 3kg (IQR 1-6kg) respectively. Reported diarrhea and lung disease among the study participants were 17.9% and 54.1% respectively. Food and nutrition security indicators were associated with treatment Impact of food and nutrition security on adherence to ART and treatment outcomes AAU, FM, DCH, RH specialty track IX outcomes. Food aid contributed to functional improvement (OR 1.89, 95% CI 1.20-2.97). Dietary diversity and meal frequency were significantly positively correlated with change in weight and change in CD4 count respectively (p<0.05). Pre-ART nutritional status was significantly negatively correlated with change in weight after 3 months of ART (p<0.001). Discussion: Food and nutrition insecurity is a serious problem of PLWHA on ART. Overcoming all the odds to adhere to the treatment PLWHA in the present study were adherent to ART more than any documented adherence findings. But food and nutrition insecurity was silent factor that impede treatment outcomes. Food aid, dietary diversity and meal frequency were positively associated with functional improvement, weight gain and CD4 increase. Pre-ART nutritional status was negatively correlated with weight gain indicating better improvement among severely malnourished. Current malnutrition was significantly associated with reported opportunistic infections. Conclusion and recommendations: The mere success in achieving high level of adherence among PLWHA taking ART should not undermine the impact of food and nutrition security on the treatment outcomes which is the ultimate goal of the program. Lack of food to take with medication is the main reason for those few non-adherents and food ration improved functional status of PLWHA on ART. Food aid as relief together with a sustainable income generating activities need to be included in ART program.
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    Impact of Food and Nutrition Security on Adherence to Anti-Retroviral Therapy (ART) and Treatment Outcomes among Adult PLWHA in Dire Dawa Provisional Administration
    (Addis Abeba University, 2007-06) Seifu, Abiy; Tesfaye, Fikru (PhD)
    Background: Adherence to Anti-Retroviral Therapy (ART) is critical for optimal virologic suppression and improved CD4+ cell count that in turn determines the survival of People Living with HIV/AIDS (PLWHA) on ART. So far a range of predictors of adherence to ART in many different social and cultural settings have been identified. However, household food and nutrition security as predictor of adherence to ART is less understood. Objective: The main objective of this research project is to assess the effect of household food and nutrition security on adherence to ART and treatment outcomes. Method: A cross-sectional study was conducted to assess the effect of household food and nutrition security on adherence to ART and treatment outcomes. Both quantitative and qualitative research methods were applied to triangulate the findings of one with another. Adult PLWHA on ART for at least 3 months were the study participants. Availability of enough food/money to buy one, behavioral and subjective questions, meal frequency, dietary diversity, food aid and BMI were used as indicators to measure the household food and nutrition security situation of PLWHA and self-reported adherence as an indicator to measure adherence to ART. Change in CD4+ cell count, body weight, functional status and frequency of opportunistic infections were used to measure treatment outcomes. Result: Based on food security assessment core module close to 90% of PLWHA on ART in Dire Dawa were food insecure and 30.1% had at least mild malnutrition. On patient self report of adherence 96.6% of them were adherent to 95% of the ART drugs prescribed. The median change in CD4 count after 6 months and the median change in weight after 3 months of ART were 116 (IQR 82-182) and 3kg (IQR 1-6kg) respectively. Reported diarrhea and lung disease among the study participants were 17.9% and 54.1% respectively. Food and nutrition security indicators were associated with treatment Impact of food and nutrition security on adherence to ART and treatment outcomes AAU, FM, DCH, RH specialty track IX outcomes. Food aid contributed to functional improvement (OR 1.89, 95% CI 1.20-2.97). Dietary diversity and meal frequency were significantly positively correlated with change in weight and change in CD4 count respectively (p<0.05). Pre-ART nutritional status was significantly negatively correlated with change in weight after 3 months of ART (p<0.001). Discussion: Food and nutrition insecurity is a serious problem of PLWHA on ART. Overcoming all the odds to adhere to the treatment PLWHA in the present study were adherent to ART more than any documented adherence findings. But food and nutrition insecurity was silent factor that impede treatment outcomes. Food aid, dietary diversity and meal frequency were positively associated with functional improvement, weight gain and CD4 increase. Pre-ART nutritional status was negatively correlated with weight gain indicating better improvement among severely malnourished. Current malnutrition was significantly associated with reported opportunistic infections. Conclusion and recommendations: The mere success in achieving high level of adherence among PLWHA taking ART should not undermine the impact of food and nutrition security on the treatment outcomes which is the ultimate goal of the program. Lack of food to take with medication is the main reason for those few non-adherents and food ration improved functional status of PLWHA on ART. Food aid as relief together with a sustainable income generating activities need to be included in ART program.
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    The Influence of Living Arrangement on Adolescents’ Risky Sexual Behavior in Sebeta Town, Oromia Regional State, Ethiopia: School Based Comparative Cross-Sectional Study.
    (A, 2016-06) Desta, Biruk; Seifu, Abiy
    Background: - Adolescence is an important period in human development where a person reaches sexual maturity, manifest in sexual engagement; thus encountering the possibility of contracting sexually transmitted diseases such as HIV/STIs. Living arrangement of adolescents can expose them to risky sexual behavior increasing the chances of acquiring HIV/STIs. However, the effect of living arrangement of adolescents on risky sexual behavior has not been adequately studied. Objective- To assess the influence of living arrangement on adolescents’risky sexual behavior among high school/preparatory students in Sebeta Town Oromia Regional State, Ethiopia Methods – School based comparative cross-sectional study was conducted in Sebeta secondary schools from Dec 2015 to june 2016.A sample of 361was taken for each group (those living with their family and those not living with their family).Students from governmental schools from grade 9 – 12 were included in the study. Data was collected using pretested interviewer administered questionnaire. Descriptive and summary statistics was done. Bivariate and multivariate analysis was done using logistic regression on STATA version 12.1 software to measure the association of living arrangement on risky sexual behavior and identify other factors associated with risky sexual behavior. Results:- Seven hundren twenty two participants responded to our invitation giving response rate of 99.31%.The overall prevalence of risky sexual behavior was 27.6% (95% CI: 24.33%, 30.89%) and it is predominant among adolescents lives away from their parents. Living away from family was significantly associated with risky sexual practice on bivariate logistic analysis OR= 2.02, 95% CI :( 1.45, 2.81) but the association disappeared on multivariate analysis AOR= 0.81 95%, CI: (0.49, 1.35). Drinking alcohols(beer) frequently(AOR=1.8, 95% CI:(1.22, 2.85), chewing khat(AOR=1.7, 95% CI:(1.10, 2.77),smoking cigarettes (AOR=2,95%CI:(1.07, 3.92) less parental monitoring (AOR= 6.1, 95% CI: (2.79, 13.52)),watching pornography movies/films(AOR=5.7, 95% CI:( (2.82, 11.10) and poor/less attachment to religious institutions (AOR=2.6, 95% CI :( 1.72, 3.91) were the factors that increase the odds of practicing risky sexual behaviour. x Conclusion and recommendation: The findings of this study showed that a substantial proportion of Governmental secondary school-going adolescents in Sebeta are engaged to risky sexual activities and that sexual activity among these adolescents aged 15-19 is influenced by multiple factors,including substance use, religiosity, perceived parental monitoring and watching pornography films. based on the finding of this study we suggest recommendation for programs works to improve adolescent reproductive health to work on upgrading sexuality education that goes beyond HIV/AIDS knowledge,to address risky sexual behavior in schools, to improve parental role.
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    Maternal risk factors for prematurity related neonatal mortality among preterm neonates admitted to Neonatal Intensive Care Unit of selected referral Hospitals in Addis Ababa
    (2017-11) Gemeda, Dirreba; Seifu, Abiy
    Background: The neonatal period is considered high risk period in terms of mortality. Globally, approximately 15 million infants are born prematurely each year, which is more than one tenth of all newborn infants. Mortality due to complications of prematurity is the leading cause of neonatal and children under five age death. Little is known about specific maternal risk factors for prematurity related neonate mortality. Objective: The aim of the proposed study was to identify risk factors for prematurity related neonate mortality. Methods: A facility based nested unmatched case control study design was employed to identify maternal risk factors for prematurity related neonatal mortality. Cases were preterm neonates who died and controls were preterm neonates who survived 28 days of neonatal period among those admitted to NICU ward. The study was conducted from July 25, 2016 to May 29, 2017 at neonatal intensive care units of three Referral hospitals in Addis Ababa city. The total sample size was 471 with 157 cases and 314 controls. Data was entered using Epi Info 7 and analyzed by STATA 12. Bivariate and multivariate logistic regression models were applied to measure the associations between the prematurity related mortality and maternal risk factors. Results: The mean/median gestational age of cases and controls were 30.6/30 and 33.6/34 weeks respectively. The mean (±SD) age of the mothers of cases was 25.8(±4.6) years and that of mothers of controls was 26.6(±4.7) years. Having no formal education [AOR (95% C.I): 6.586 (2.467, 7.582)], ANC visit [AOR (95% C.I): 2.791 (1.604, 4.857)], maternal anemia during pregnancy [AOR (95% C.I): 2.921 (1.396, 6.112)], urine test suggesting infection [AOR (95% C.I): 3.513 (1.261, 9.787)], and antepartum hemorrhage [AOR: (95% CI): 3.151 (1.509 , 6.577)] were found to be risk factors for preterm neonatal mortality. Conclusion and recommendations: Maternal education, poor antenatal care, maternal anemia, and ante partum hemorrhage have strong association with mortality among premature babies. Reduction of mortality among premature babies requires multi-sectorial response. The Ministry of Health (MOH) should give more emphasis to strengthening routine antenatal care and management of obstetric complications like antepartum hemorrhage. The Ministry of Education (MOE) on the other hand should pay special attention to women’s higher education; Promotion of proper maternal nutrition could be enhanced through joint effort of the ministries of education and health.
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    Utilization of long acting Contraceptives among reproductive age women in Addis Ababa Public Health Centers.
    (Addis Abeba University, 2014-06) Nigatu, Bizuayehu; Dr.Addisie, Mesfin; Seifu, Abiy
    Background: Long acting contraceptives such as intrauterine devices and hormonal implants are among the most effective methods that prevent unintended pregnancies. Long acting contraceptive is more convenient to clients who want to space or limit their births. Clients have better compliance to long acting contraceptive than the short acting methods, since they do not need to remember to use them or to visit family planning clinics frequently for method re-supply or administration. Objectives: To assess the utilization of long acting contraceptives among female family planning users at public health centers in Addis Ababa. Methods: A facility based cross sectional study that employed exit interviews with family planning clients and an assessment of the availability of the necessary resources was conducted in selected five public health centers, from March 11 –April 4, 2014 in Addis Ababa. Systematic sampling technique was used to select 447 study participants .Pre tested structured Amharic version questionnaire was used to collect the data through interview and inventory was carried out by using checklist. Both bivariate and multiple logistic regressions were used to identify associated factors. Result: Of 447 female family planning users interviewed 98.9% of them were aware of long acting contraceptive methods and 23.9% were using the methods. However, 48.3% respondents have negative attitude towards long acting contraceptive. Facility assessment showed that in the health centers assessed there were no shortages of resources for provision of long acting contraceptive including equipments and supply, trained health provider and contraceptives methods. Attitude of clients, previous use of long acting contraceptive, desire to have no children in the future and discussion with partners about long acting contraceptives were factors associated with long acting contraceptives use. Conclusion and recommendation: Knowledge about long acting contraceptive is high in contrary to the negative attitude for most respondents have towards the methods and low level of utilization. Providing appropriate counseling on long acting contraceptive, strengthening continuous education by model long acting contraceptive user, strengthening couple discussion and availing printed materials on long acting contraceptive are recommended.