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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    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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    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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    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.