Browsing by Author "Seme, Assefa(PhD)"
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Item Assessment of Concurrent Multiple Health Risk Behaviours among Youth in Yaballo Town, Borana Zone, Oromiya Region(Addis Abeba Universty, 2012-06) Shunu, Addisu; Seme, Assefa(PhD)Background: Multiple health risk behaviors among adolescents pose a threat to their health, including HIV/AIDS. Health risk behaviors such as Khat, alcohol use, smoking, substance use, and sexual risk behaviors among youth have been shown to co-occur with each others. Objectives: The aim of this study is to estimate the prevalence of single and concurrent health risk behaviors and to explore how health risk behavior is associated with socio demographic factors and peers’ behaviors among youths in Yaballo town. Methodology: A comparative cross-sectional study design was employed supplemented with qualitative study .The study subjects were systematically selected. Data were collected from 825 in in-school and out-of-school youths by using self-administered questionnaires. The data were analyzed using univariate for frequencies, bivariate analysis to see the association between independent and dependent variable and multiple logistic regressions to control confounding variables. Results: Out of total 65.2% were male and 34.7% female. Overall, out of the study participants 87 % (81.9% ISY, 92% OSY) youths ever had sex with an individual opposite sex. Disaggregated by sex, 66.6% of male had had sex compared to 33.4% of female. In logistic regression older age (AOR=2.82, 95%CI= 1.41, 5.65), school status (AOR=2.764, 95%CI=1.759, 4.345), Khat chewing (AOR=7.625, 95%CI=4.146, 14.022), Watching pornographic films (AOR=2.697, 95%CI=1.751, 4.153) and having sexually active peers (AOR=4.918, 95%CI=2.407, 10.046) were significantly and independently associated with ever having sex .Overall, 40.1% of out-of-of school youths had unprotected sex during the last sexual inter course prior to study compared to 37.1% of in-school youth. Of the 815 subjects, 10.9% reported no risks, 14.1% reported one risks, and 74.8% reported two or more risk behaviors. Among out-of-school youths having no education (AOR=4.445, 95%CI=1.450, 13.620) and grade level of 9-10 (AOR=3.170, 95%CI=1.517, 6.632) were strongly associated with two or more risk behaviors. Conclusion: majority of youth were engaged in multiple health risk behaviors. The influencing factors are socio-demographic characteristics and peer influence. Interventions should focus to encourage adolescents to complete the compulsory primary education as well as help them to establish friendships and follow peers with good behavior.Item Assessment of Factors Influencing Magnitude and Utilization of Institutional Delivery Service in Women of Reproductive Age in Nifas Silk Lafto Sub-City, Addis Ababa, Ethiopia(Addis Ababa University, 2016-05) Abdulkadir, Zubeida; Seme, Assefa(PhD)Back ground: -Every pregnancy is a risk which may end up with complication or death. Institution delivery is a good means to undertake this risk in providing the delivery service by skilled personnel and which will contribute to reduce maternal morbidity and mortality especially for developing countries like Ethiopia. Objective:-This study was designed and conducted with the aim of assessing factors influencing magnitude and utilization of institutional delivery in Nifas Silk Lafto Sub-city in Addis Ababa, 2014. Methods:-A community based cross sectional study using quantitative methods was conducted in Nifas Silk Lafto Sub city, Addis Ababa. A study population was all six ketena’s in Woreda two of the sub-city. The total sample size for the study was estimated by single proportion population formula. Data was collected from 794 women of reproductive age using structured questionnaire, EPI-info version 3.5.1 was used to enter the data and SPPS version 20.0 was employed for analysis. Logistic regression and odds ratio was calculated to ascertain association between dependent and independent variable. The result was present in tables and text. Result A total of 768 women of reproductive age participated in this study. Women who have higher level of education were about 3.6 times more likely to deliver at health institution compared to women with low level of education [AOR: 3.6, 95% CI: (1.1 , 11.8)].The study also showed that 92.9% of mothers gave birth in health institution. Conclusion: - This study highlighted institutional delivery is most favorable so that promoting institutional delivery and women education is crucial among women of reproductive age groupItem Assessment of Modern Contraceptive Utilization and Associated Factors among Female Anti-Retroviral Therapy Attendants in Arada Sub city, Addis Ababa, Ethiopia(Addis Ababa University, 2016-08) Alemu, Tewabech; Seme, Assefa(PhD)Background Preventing unintended pregnancy is one of the 4 pillars of prevention of mother to child transmission program. Counseling and provision of contraceptives to HIV infected women who are on ART is an important strategy to prevent unintended pregnancy and its complication among HIV positive women who wish to limit the number of their children or delay pregnancy. World Health Organization considers providing safe and effective contraceptive to HIV infected women as one strategy for preventing pediatric infections. Despite these adopted strategies very few HIV positive women who wish to delay or limit the number of children are using modern contraceptive methods. Objective: To assess utilization of modern contraceptives by women of reproductive age who are attending ante retroviral therapy(ART) clinic and associated factors in public health facilities in Arada sub city, Addis Ababa, Ethiopia. Methods: Institutional based quantitative cross-sectional study was conducted in selected 5 public health facilities in Arada sub city from February to March, 2016. A systematic random sampling technique was used to select study participants. Three hundred and forty eight eligible women of reproductive age who were on ART were interviewed by using a pre tested structured questionnaire to assess modern contraceptive utilization status. Data entry and cleaning was done using Epi Info version 3.5.1 and then exported to SPSS version 20 using stat transfer software version 12 for analysis. Bivariate analyses were done for each independent variable and the outcome variable to select variables for the multivariate analyses. Variables which showed p-value of less than 0.25 during bivariate analysis were entered into multivariate logistic regression model to identify their independent effects. Odds ratio was used to measure the strength of association between the dependent and independent variables while95% confidence interval was used to determine the significance of the association. Tables and figures were used to present the results of the study. Result: One hundred (28.7%) of the respondents used at least one method of modern contraceptives to avoid or delay pregnancy. Condom was the most utilized type of contraceptives. Out of one hundred contraceptive users 85.2% were using dual contraceptives. Marital status (currently married) (AOR 3.15, 95% CI 1.50-6.61),having open discussion with sexual partner about contraceptive use (AOR8.03, 95% CI 4.22 to15.28), peers’ positive influence (AOR 2.39,95% CI 1.09 to 5.22) and not having perception of being HIV positive affect their contraceptive use (AOR 0.2, 95% CI 0.11 to 0.37) were the major determinant factors identified to modern contraceptive utilization among ART attending women. Conclusion and recommendation: Utilization of modern contraceptives by ART attending HIV positive women of reproductive age in the study sub city was low (28.7%). Condoms were the most frequently used contraceptive method. The proportion of women with HIV using dual contraceptive were high (85.2%).Being currently married, having open discussion with sexual partner, peers’ positive influence and not believing about the negative influence of HIV on contraceptive use have positively affected contraceptive use by ART attending HIV positive women in the study area. Strengthening counseling on the importance of couple’s discussion as well as health education about HIV and family planning as part of ART care and treatment to avoid negative perception towards contraceptive use is recommended. Key words: contraceptive utilization, HIV positive, modern contraceptive, family planningItem Assessment of Sexual and Reproductive Health Problems among Prisoners aged 15-29 years in Addis Ababa.(Addis Abeba Universty, 2009-08-24) Agazi, Alem; Seme, Assefa(PhD)Death and disability caused by Sexual and Reproductive Health accounted for 18 percent of the total disease burden globally in 2001, though there is considerable regional variation. And STIs, excluding HIV/AIDS, accounted for 0.9 percent of all DALYs lost in this year. Prisoners aged 15-29 years are more vulnerable for STIs because of their high risk behaviours and Sexual Violence. Sexual violence occurs in every culture, in all levels of society and in every country of the world and it is a serious public health and human rights problem. In Ethiopia, though various researches have been made to assess SRH problems of youths, still there are no studies that address the SRH needs of youth in prison. This cross sectional survey conducted in 2008/2009, tried to investigate the magnitude and factors associated with SRH problems among youth prisoners in Kaliti Maremia-Bet, Addis Ababa, Ethiopia. This study was conducted among a total of 358 youth inmates participant, with a response rate of 99.7% and among 18 discussants in quantitative and qualitative part of the study, respectively. Among 306 sexually active respondents, 31 (10%) had consensual sex in prison, 28 (9.2%) reported symptoms of STIs in prison. History of STI before detention was positively associated with STI in prison [AOR) = 4.3 95%CI: (1.8, 10.2)]. And, among 357 respondents 15 (4.2%) reported sexual victimization. The prevalence of STIs and sexual victimization among inmates in Kaliti Maremia-Bet is considerable. Therefore, Sexual health programmes in prisons should include STIs screening, education about STI risk reduction and awareness raising program about sexual violence is needed for prisoners and prison staff.Item Assessment of Sexual Behaviour and Condom Use Among Married or Cohabiting Couples in Nekemte Town, East Wollega, Ethiopia(Addis Ababa University, 2010-06) Regasa, Tolesa; Seme, Assefa(PhD)BACKGROUND: Rates of human immunodeficiency virus (HIV) infection among married women or those in committed partnerships are increasing rapidly. Most HIV infection in sub-Saharan Africa occurs during heterosexual intercourse between couples in a relationship. The primary mode of HIV transmission in Ethiopia is via heterosexual contact. Over 90% of adult cases of HIV in Ethiopia are attributable to heterosexual activity. OBJECTIVE: The objective of this study was to assess sexual behavior and condom use among married / cohabiting couples in Nekemte town. METHODS: A community based cross sectional survey was conducted from February to March, 2010 in Nekemte town. The data was collected through quantitative and qualitative methods. Two multistage sampling techniques were used. In the first stage, simple random sampling technique was used to select the kebeles. In the second stage, systematic random sampling was used to select 768 couples (768 males and 768 females) and 1536 individuals from 768 households were interviewed. RESULTS: The prevalence of premarital sexual intercourse was 30.6% among married/cohabiting men and 19.7% among women. However, the transition of premarital sex to marriage among those who had premarital sex (235 men Vs 151 women) was low, 40 (17.0%) among men and 40 (26.5%) among women. About seven percent of males and 2.1% of females’ respondents reported that they had extramarital partners and about 4% of males reported having had more than one sexual partner in last 12 months. Despite this the prevalence of ever use of condoms was 5.4% (95% CI 4.3, 6.5%) and 4% (95% CI 3.0, 5%) in the past 12 months. In multivariate analysis, number of life time sexual partners, perceived risk of HIV infection, suspecting spouse having extramarital partner and discussion about condom had significant association with condom use in both sexes. CONCLUSION: Despite the fact that some married /cohabiting people engaged in risky sexual behaviors or extramarital partner, condom use among couples has remained very lowItem Assessment of Substance use and Risky Sexual Behaviour among Haramaya University Students(Addis Abeba Universty, 2011-05) Derese, Andualem; Seme, Assefa(PhD)Background: Substance use and problems arising from it are increasing all over the world, and currently together with HIV/AIDS epidemic, become one of the most threatening and challenging social and public health problems. University students are more vulnerable to wider sexual and reproductive health (SRH) and HIVAIDS problems due to new environment with poor protection, age and the need to explore life, peer pressure and absence of proactive programs. Objectives: This study assessed the prevalence of substance use and its association with risky sexual behaviour among Haramaya University students. Methods: A cross-sectional survey was carried out among 725 randomly selected Haramaya University undergraduate students from December 2010 to January 2011 using a self-administered questionnaire. Students are stratified first by campus and then by year of study. Sampling with probability proportional to size was used to select students from each year of study using students list as a sampling frame. Descriptive statistics was used to describe the study population and cross-tabulation was done to see the association between dependent and independent variables. Logistic regressions with 95% confidence intervals were calculated to determine independent predictors of risky sexual behaviour. Result: Among 725 participants, 390 (53.8%) reported having used at least one substance in their lifetime. The most commonly used substance was alcohol (41.7%), followed by khat (30.3%), cigarette (11.3%) and illicit drugs (3.9%). Of the total respondents, 243 (33.5%) had sexual experience in their lifetime. Among sexually active, 28(11.5%) had multiple sexual partners in the last three months and 29(16.3%) of males had sex with commercial sex workers. One hundred forty nine (61.6%) of sexually active students used condoms during the last sex but its consistent use was 55.7%. Use of khat, alcohol and cigarette was significantly and independently associated with risky sexual activities with AOR (95% CI) of 2.58 (1.58, 4.22), 2.46 (1.52, 3.98) and 2.22 (1.19, 4.14) respectively. Conclusion: The prevalence of substance use among Haramaya university students was high .Use of khat, alcohol and cigarette was significantly associated with risky sexual activities. Awareness raising about safer sex and consequences of substance together with taking the necessary disciplinary measure for those who break the rule and regulation set by the university is highly advisable. viiiItem Association between Comprehensive Sexuality Education and Adolescent Risky Sexual Behavior, Addis Ababa, Ethiopia(Addis Abeba Universty, 2017-06) Atnafseged, Bethel; Seme, Assefa(PhD)Background: Adolescents transit into adulthood with conflicting and confusing messages about sexuality and gender. They lack adequate information and preparation on sexual and reproductive health (SRH), which leaves them vulnerable to risky sexual behavior, coercion, abuse and exploitation which intern exposes them to unintended pregnancies and sexually transmitted infections (STIs) including HIV/AIDS. Objective: To assess the association between Comprehensive Sexual Education and Adolescents’ Risky Sexual Behavior among In School Adolescents in Addis Ababa, Ethiopia Method: The study used a cross sectional study design with internal comparison to assess the association between Comprehensive Sexuality Education and Risky Sexual Behavior. Gullelie sub city was purposively sampled as it was the only sub city that had Comprehensive Sexuality Education given to students. The study was conducted from November 2016-June 2017. Data were collected using structured self-administered questionnaires which was pre-tested on 30 students from non-selected but similar school in the sub city. The collected data were entered into Epi Info version 7 and cleaned before transferring the data to Stata Version 14 for analysis. Bivariate analysis was done to see the association of each independent variable with the outcome variable. Variables with P-Value of <0.25 were considered for multiple logistic regression analysis. In addition to text description, tables and graphs were used to summarize and present the data. Result: A total of 383 students participated in the study with a response rate of 98.2% The mean age (±SD) of the respondents is 16±1.4. From the total respondents, 61 (16.1%) adolescents had already started having sexual intercourse of which 48 (88.9%) had early initiation of sex. Prevalence of risky sexual behavior among respondents is 15%. From the total respondents, 27.4 % took Comprehensive Sexuality Education and it is found to be protective against risky sexual behavior putting those who did not take CSE at odds of [AOR=2.82 95% CI [1.02-7.75].The study revealed that gender, having friends with the experience of sexual activity, perceived parental control, watch pornographic movies, exposure to CSE were found to affect risky sexual behavior among the study participants Conclusion and conclusion: CSE has a positive effect on preventing adolecents risky sexual behavior. Watching pornographic movies and having friends with sexual experience were drivers of high risk sexual behavior while parental control, and exposure to CSE were protecting against risky sexual behavior development. According to the result of this research it is recommended that CSE be given on a larger scale.Item Awearness Attitude of Reproductive Age Women about Ethiopian Abortion Law and Service Utilization. Lideta Sub City, Addis Ababa Ethiopia(Addis Ababa University, 2011-06) Esayas, Tsigereda; Seme, Assefa(PhD)Back ground: Maternal mortality caused by unsafe abortion is a critical public health problem and a quiet pandemic. Worldwide 22 million unsafe abortions occur annually which result in 68,000 deaths of women, moreover millions suffer permanent complications. Almost 97% of unsafe abortion took place in developing countries. Unsafe abortion contributes 10 % of maternal death in Ethiopia. Awareness on the law leads women to utilize safe services, but it is common to misperceive the particulars of the law, which lead women to unsafe abortion and financial abuse. The abortion law has been in place on the penal code for the last 10 years. Despite the formulation of the law, nothing is known about the awareness, attitude and service utilization by women of reproductive age in Lideta sub city. Objective: The aim of this study is to assess the awareness, attitude of reproductive age women on the safe abortion law and abortion service utilization in Lideta sub city, Addis Ababa, Ethiopia. Methods: Community based cross-sectional study design of quantitative & qualitative methods was conducted among 633 reproductive age women in three woredas of Lideta sub city by using a pre tested structured interviewer administered questionnaire. Multi stage cluster sampling method was used to select three woreda and ketena. Data were entered in to EPI info version 7.0, and STATA 12.1 statistical software for analysis. To see the association between independent and dependent variables bivariate and multivariate logistic regression analysis were used .Qualitative data was audio taped, transcribed, translated ,and by open cod soft ware coded and categorized then thematic analysis was done to get result . Result: - 594 women participate and making the response rate of 93.8%. Generally 120 ((20.2%) participants have awareness on pre condition that permit legal abortion, and more than half, 323 (54.3 %) of the total 594 study participants were found to have negative attitude towards the law. being government employee [AOR 2.7 95% CI (1.2-6.2)], attaining technical level of schooling [AOR 3, 95% CI (1.5-6.0)] were significantly associate with women’s awareness on abortion law. Knowledge on complications of unsafe abortion [AOR 2.5, 95% CI (1.6-4.0)], awareness on Ethiopian abortion law [AOR 2.8, 95% CI (1.7-4.6)], attaining higher educational level [AOR 3.8, 95% CI (2.0-7.2)] were significantly associate with women’s attitude towards the ix law. Lacks of money, lack of awareness on the law and service availability, stigma were the major reasons raised by participants not to utilize abortion service by qualitative study. Conclusion and recommendation: Awareness and positive attitude towards abortion law was low and women who were unaware about the law would not utilize abortion service. So that stake holders like Addis Ababa city administration health bureau, health extension professionals, health facility should work jointly to create awareness in the communityItem Contraceptive Utilization and Associated Factors among HIV Positive Women Enrolled in HIV Care in Health Centers of Addis Ababa(Addis Ababa University, 2016-06) Sentayehu, Tsedale; Seme, Assefa(PhD)Background : Increasing access to family planning and reducing unintended pregnancies among human immune deficiency virus (HIV) clients has a number of economic benefits, including low costs for prevention of mother to child transmission (MTCT), lower costs for pediatric treatment and reduced costs for mitigating the consequences (such as low birth weights) of unintended births. For women with HIV who do not wish to become pregnant, family planning is proven, cost effective strategy for preventing vertical transmission of HIV. Yet there are limited studies conducted in health centers to assess contraceptive use and factors affecting its use among HIV positive women. Objective: To determine magnitude of contraceptive utilization and associated factors among HIV positive women that are enrolled for HIV care in government health centers in Addis Ababa. Methods: A facility based cross-sectional study was carried out on a sample of 682 HIV positive women in the anti retroviral treatment (ART) follow up units of selected health centers in Addis Ababa. A systematic random sampling procedure was applied to select study participants. Data was collected through interview using structured questionnaires. Data was analyzed using SPSS version 20.Multiple logistic regression analysis was done to see the association between the outcome and predictor variables Result: The magnitude of contraceptive use among sexually active study participant were 88.27%. The most commonly used method was injectable followed by implant. HIV positive women who had a higher chance of contraceptive use were those who have two children (Adjusted odd ratio (AOR): 2. 8; 95% CI: 1.2-6.3),those who have more than one sexual partner (AOR: 12.0; 95% CI: 3. 3- 44.4)and those who disclose their status to their partner(AOR: 3. 4 95% CI: 1.52-7.55); Whereas women who were Protestant (AOR: 0.403; 95% CI: .191-.852),not currently married (separated /divorced/widowed) (AOR: 0.221 95% CI: .097-.501)were less likely to use contraceptive. Conclusion and Recommendation: The study has shown that about two-thirds of participating HIV positive women use at list one contraceptive method. The most preferable contraceptive methods used were Injectables and implants. Among the long-term contraceptive methods, intra uterine contraceptive device (IUCD) were used in very low rate. Religion, marital status, number of living children, number of sexual partner and disclosure of HIV status to sexual partners were found to be related with current contraceptive use among study population. We would like to recommend that the regional health bureau has to work hard to increase coverage of contraceptive utilization by HIV positive women in order to prevent mother-to- child-transmission of HIV by strengthen the existing family planning services integration with ART clinics and particular emphasis should be given on encouraging women to disclose their HIV status to partners.Item Exclusive Breast Feeding Practices and Associated Factors among HIV Positive Women in Public Health Facilities of Adama Town, Ethiopia(Addis Ababa University, 2016-05) Ketema, Zelalem; Seme, Assefa(PhD)Background: Despite the benefit and promotion of exclusive breast feeding, the rate of excusive breast feeding is still low in Ethiopia. Thus, this study will assess factors that lead to nonadherence to exclusive breast feeding among HIV positive mothers. Objective: the main objective of this study was to assess the prevalence of exclusive breast feeding and factors that influence its practices among HIV positive mothers of infants aged 6-24 months old who are on chronic HIV care in selected health facilities of Adama town. Method: Institution based cross-sectional study was conducted among 193 HIV positive women with infant aged 6-24months in three health facilities (Adama hospital, Geda and Adama health centers) of Adama town in Ethiopia. Data was collected using structured and pre-tested questionnaires. Four data collectors and three supervisors were trained and involved in data collection process. Data were entered and analyzed using SPSS version 20 statistical software package. Univariate analyses were done to determine various proportions and bivariate analysis was conducted to measure the existence and the strength of an association between the dependent and the independent variables. Level of significance was set at a p value of ≤ 0.05. Variables that had less than 0.05 level of significance were further analyzed in multiple logistic regression models to control the potential confounding variables. Results: In this study the prevalence of exclusive breast feeding, exclusive replacement feeding and mixed feeding and factors associated with exclusive breast feeding was determined. The result showed that exclusive breastfeeding, exclusive replacement feeding, and mixed feeding were 84.7%, 3.2 %, and 6.3 %, respectively. Exclusive breast feeding was more practiced by mothers who had adequate knowledge on exclusive breast feeding (Adjusted OR = 6.84(2.54, 18.44)), mothers who disclosed their HIV status to their husbands/spouses (Adjusted OR= 3.80(1.28, 11.28)), and mothers who attained below primary level of education (Adjusted OR = 3.89(1.41, 10.70)). Conclusion and Recommendation: Despite more than three-quarters mothers who adhere to exclusive breastfeeding, the rate is still not satisfactory. More extensive and comprehensive approach of infant feeding counseling should be put in place in order to increase exclusive breastfeeding by HIV positive mothers. Moreover, both partners should be counseled properly on the issue to get the support from their male partners. Keywords: Exclusive breast feeding, replacement feeding, mixed feeding, HIV positive womenItem Facilitating factors for the Prevention of Mother-To-Child Transmission of HIV Service Utilization among Antenatal care attending Pregnant Women in Public health facilities in Dire Dawa(Addis Abeba Universty, 2014-06) Nuri, Aliya; Seme, Assefa(PhD)Background: Mother-to-Child Transmission of HIV has been identified as the greatest means of HIV infection among children. Studies related to PMTCT utilization has been done in other parts of Ethiopia. However, there were no studies that have examined the magnitude and factors for utilization of PMTCT despite high overall health service coverage in Dire Dawa. Objective: To assess the magnitude and facilitating factors for the prevention of mother-to-child transmission of HIV service utilization among Antenatal care attending pregnant women in public health facilities in Dire Dawa. Methods: A facility based cross-sectional study was conducted using face to face interviews with mothers attending antenatal clinics in public health facilities in Dire Dawa which was supplemented by qualitative study. For quantitative part of the data 389 pregnant women were recruited using systematic random sampling method. Trained data collectors conducted the data collection using a pretested structured questionnaire. The response was coded and entered into the computer using EPI info version 3.5.4 statistical packages. Cleaned data was exported to SPSS version 21.0 for analysis. Bivariate and Multivariate analyses were carried out. Six in-depth interviews were conducted with selected people working on PMTCT in their respective work places. The qualitative interviews were conducted by the principal investigator using the interview guides prepared by me. Results: A total of 389 pregnant women attending antenatal care in Dire Dawa were approached. Of the 389 participants, about 53.2% were between 25-34 years of age, 78.9% had formal education at primary level or above, 95.6% reported acceptance of HIV counseling and testing, 78.9% were aware about mother-to-child transmission of HIV, and 93.8% knew about prevention of mother –to-child transmission of HIV and 82.3% were aware of the availability of ART prophylaxis. Of the 372 tested pregnant women, 361 (97.0%) were negative and only eleven (3.0%) were positive for HIV. Out of 11 women who were positive for HIV 9/11 of them linked to ART care service, but two of them didn’t decide to be linked to ART care services. PMTCT service utilization was positively associated with high monthly income [AOR =3.7(95%CI) (1.2-11.5)], have information about VCT [AOR=4.4(95%CI) (1.1-17.6)], and prefer to have same counselor for discussion before and after the test [AOR=3.6(95%CI) (1.2-10.7)]. Conclusions and Recommendations In general the PMTCT service utilization in Dire Dawa was found to be high. Strengthening the level of PMTCT services in ANC settings and increasing mechanisms to promote involvement of men in PMTCT services is needed. Keywords: Utilization, PMTCT services, pregnant women, ANC, Dire Dawa.Item Fertility Needs Assessment among People Living With HIV/AIDS in Four Regional Hospitals, Addis Ababa(Addis Ababa University, 2010) Gossa, Tezeta; Seme, Assefa(PhD)Back ground: Despite the increased emphasis on ART and other health care services for HIV infected individual, issues of fertility and child bearing have received relatively little attention. In particular, little is known about actual fertility desire and determinants of fertility desires among HIV- infected women and men who are receiving ART. The desire of infected persons to have children in the future has significant implication for the transmission of HIV to sexual partners or newborns. Objective: To assess fertility needs of people living with HIV/AIDS who were on ART in four Regional Hospitals of Addis Ababa. Methods: The study was conducted in Addis Ababa from August 2009 to June 2010. It was a cross-sectional study supplemented by qualitative in-depth interview on a sample size of 444. Quota sampling technique was used to select the study participants. Data were entered and cleaned using EPI info version 3.4.3 and analyzed using SPSS version 15.0 for windows. Result: Nearly half of the study subjects (46.2%), female 101(49.3%) and men104 (50.7%) desired to have children. Multivariate analyses indicate that those respondents who were married/ in relation and single were significant associated with desire for children (adjusted OR: 2.60, 95% CI: 1.47- 4.59) and (adjusted OR: 2.93, 95% CI: 1.47-5.85), respectively and those who had one child or none were also more likely to desire children than those who had two or more children (adjusted OR: 18.31, 95% CI: 10.17-32.96) Conclusion: A substantial proportion of HIV-infected women and men receiving ART in the study would like to have children in the future. The fact that many HIV- infected adults desire to have children has important implication for the prevention of vertical and heterosexual transmission of HIV and the need of incorporating fertility- related counseling as well as advice regarding safe conception and child birth and services like PMTCT as appropriate, in to HIV treatment servicesItem Knowledge on Maternal Health Benefits of Donated Blood and Blood Donation among University Students(Addis Abeba Universty, 2016-06) Haileselassie, Amanuel; Seme, Assefa(PhD)Background-Access to a safe and sufficient blood supply could avert up to 150,000 pregnancy related deaths globally each year. At minimum, the World Health Organization estimates that a country needs 1% to 3% of its population to donate blood to meet its need.Yet, many African countries including Ethiopia are far below the minimum blood collection rate. This gap between blood supply & demand has a significant impact on maternal mortality in SSA countries where 26% (16–72%) of maternal hemorrhage related deaths were due to lack of blood for transfusion. Different studies in developed and developing countries show a knowledge gap on the benefit of blood donation, unfavorable attitude & poor practice of blood donation. In Ethiopia, however, there are few studies conducted on this important area. Objective- To assess knowledge on maternal health benefits of donated blood, attitude & practice of blood donation & associated factors among Addis Ababa Science & Technology University students. Methods- A cross-sectional study was conducted among 421 students in Addis Ababa Science and Technology University who were selected through a stratified random sampling technique. Pre-tested questionnaire was used to collect data through a face to face interview. The data was coded and entered into EPI info version 7.0, cleaned in SPSS version 20.0 and analyzed in STATA 12.1. Then, descriptive statistics and two step (bivariate and multivariate) logistic regressions analyses was applied. Result- Among 421 respondents, 245 (58.19%) respondents had good knowledge about maternal health benefits of donated blood & 221 (52.49%) respondents had favorable attitude towards blood donation. About a quarter of study participants (105, 24.94%) had donated blood. Studying in biological science [AOR, (95% CI), 2.95 (1.16, 7.49)], being from wealthier families [AOR, (95% CI), 2.85 (1.36,5.97)] , family history of blood transfusion [AOR, (95% CI), 3.49 (1.89,6.45)], good knowledge about maternal health benefit of donated blood [AOR, (95%CI), 3.94 (1.97, 7.89)] & favorable attitude towards blood donation [AOR, (95%CI), 5.03 (2.63, 9.62)] were significantly associated with blood donation. Conclusion/recommendation- Knowledge about maternal health benefit of donated blood, favorable attitude and practice of blood donation is low. So, NBBS of Ethiopia should work jointly with all stakeholders (Government institutions, NGO’s, Community Based Organizations, Media and Private organizations) to create more awareness and sensitization about the need of blood for maternal health & increase number of blood donors.Item Negative reproductive health (RH) outcomes appear to be associated with inadequate(Addis Abeba Universty, 2016) Akalu, Alemtshehay; Seme, Assefa(PhD)Negative reproductive health (RH) outcomes appear to be associated with inadequate use of RH services and difference in the use of RH services among different demographic and socioeconomic groups. Women beggars are at increased risk of RH problems because of multiple factors. Moreover, little is known about reproductive health service utilization by those disadvantaged section of the society. Assessing the RH problems of those women and their RH service utilization is critical for timely intervention. Objective: To assess reproductive health service utilization and associated factors among women beggars in the reproductive age group in Addis Ababa, Ethiopia. Methods: A quantitative cross-sectional based study was conducted from September 2015 to May 2016 in Addis Ababa. The study was conducted on 351 women beggars of reproductive age group using an interviewer administered structured questionnaire. Data were entered in to Epi-Info (version 7) then, exported to SPSS (version 20) for cleaning and analysis. Bivariate analysis was used to identify independent variables that are associated with the outcome variable (RH service utilization). Those significant variables in the bivariate analysis were taken to multiple logistic regression analysis to determine the independent effect of each variable on the outcome variable. Results: Among the study participants majority were 35 years or younger (80%), divorced/separated (40.5%) and illiterate (64%). About 72% and 29% of women beggars had the first sexual encounter and the first pregnancy, respectively, at the period of adolescence. Women who reported ever use of modern contraceptives were 231(65.8%) and those who were using contraceptives at time of data collection were 130(37%). Forty one (11.7%) of women beggars had history of rape and (36.9%) women encountered unwanted pregnancy at least once in their life time. Two-third (66%) of women beggars reported utilization of reproductive health services. There were statistically significant association between reproductive health service utilization and marital status, having disability and information about reproductive health issues. The odds of reproductive health service utilization among women who were currently unmarried (never married/widowed) was 63% times lower than women who were married [AOR= 0.37(0.19- 0.72)]. The odds of reproductive health service utilization among women who had disability was about 60% lower than women who had no disability or chronic illness [(AOR=0.39(0.21-0.74)].On the other hand reproductive health service utilization by women beggars who had no information about reproductive health services was 76% times lower than those beggar women who had information [AOR=0.24(0.13-0.44)]. Conclusions and Recommendation: Early first sexual encounter, early marriage, unintended pregnancy and STI including HIV/ADIS were identified as major reproductive health problems of women beggars. Two-third of women beggars had health service utilization for any reproductive health services. Being disabled and lack of reproductive health service information are strong predictors of non-use of reproductive health services among women beggars. Increasing/strengthening information provision about reproductive health among women beggars, addressing disability related problems and further researches are recommended. Key words: RH problems, RH service utilization, women beggarsItem Perceptions of Unprotected Sex and Contraceptives use among Ethiopian youth Female Migrants(Addis Abeba Universty, 2013-06) Mulatu, Befirdu; Seme, Assefa(PhD)Introduction: Although all stages of migration possess reproductive health (RH) risks such as unwanted pregnancies, unsafe abortions, STIs including HIV/AIDS and the predisposing factors including unprotected sex and non use of contraceptives, no studies focused on these issues among youth female migrants. Many Ethiopian girls are moving to Arab States as house maids in search of better paying jobs. Most of them are noticed to be young, rural with primary or lower level of education and with no or low levels of contraceptives knowledge and use. The processing of their passport and VISA, which might take two to three months, are facilitated or mediated by the middle men - locally known as “delala” – to mean brokers. The delalas who facilitate where to stay for these young girls in Addis Ababa are entitled to have sex with them. Temporary separation from family increases their vulnerability to casual sex and sexual violence which, if unprotected, will expose them to unwanted pregnancy, unsafe abortion and sexually transmitted infections (STIs) including HIV/AIDS. These in turn will deny their long-term ambition of getting better paying jobs overseas. Objective: To assess youth migrant‟s perceptions about risks associated with unprotected sex and the use of contraceptives to reduce its consequences during migration process, 2012/2013. Method: Mixed-method was used, among Ethiopian youth female migrants to different Arab States, those selected by convenient and purposive. Data were collected from 18/03/2013 to 05/ 05/ 2013 at Ministry of Labor and Social Affairs (MOLSA) using semi structured questionnaire from 258 females, and in-depth interview, having topic guides, from twelve respondents. The analysis for quantitative data was done by using SPSS version 17 and thematic analysis was done for the qualitative data. Result: The youth migrants have low knowledge (33.5%) about the meaning of unprotected sex and low levels of both the knowledge about the use of contraceptives (42.53%) and the practice (34.5%). In addition the use of contraceptives is hampered by shame, inaccessibility and mixed feelings among these youth migrants. Fear of unprotected sex is a common concern whereby middlemen 112 (55.2%) and sex for exchange for money 66(32.5%) are the most reported exposing factors. Attitude towards using contraceptives is favored by their perceived risk of unprotected sex 98(56.3%). Eighteen (24.0%) respondents reported having unprotected sex and ever using contraceptive methods was independently associated with it (P-value<0.001). Conclusion and recommendation: Getting awareness about unprotected sex are almost nonexistent, the levels of both knowledge (42.53%) and practice (34.5%) of contraceptives use are low that is further hampered by shame, inaccessibility and mixed feelings, putting Ethiopian female youth migrants at risk of the consequences of unprotected sex. Hence, they need more awareness on unprotected sex and its consequences, increasing their knowledge of contraceptives use for both unwanted pregnancy and STIs including HIV/AIDS.Item Smoking, and associated factors among military personnel in Ethiopia(Addis Abeba Universty, 2011-05) Tadesse, Alemayehu; Seme, Assefa(PhD)Background: Cigarette smoking is a known risk factor for chronic diseases. It is predicted that by the 2020s there will be about 10 million tobacco related deaths annually worldwide. Improved understanding of factors that contribute to smoking initiation and cessation may help to set strategies that lead to smoking behaviour change. Objective: To assess the prevalence of smoking, and factors associated with smoking initiation among military personnel. Method: A cross-sectional study was conducted and data was obtained from 398 men and women aged 18-52 years in two Defence military academies, located in Holeta and Awash Arba, 30 km and 250 km away from Addis Ababa, respectively. Information on smoking habits, socio-demographic and psycho-social factors were collected through self-administered questionnaire, from January to February 2011. The study population was selected by systematic sampling technique after stratification was made. Data was entered using Epi Info 3.51 version and analyzed using SPSS version 15. Bivariate analysis was used to examine association between dependent and independent variables. Result: Of 398 respondents 86 (21.6%) were current regular smokers, and 165(41.5%) reported having alcohol drinking habit. Majority of smokers were men, unmarried, low education and income status. Smoking initiation was associated with low educational status, OR (2.70, 95% CI, 1.14-6.39), and low income status, OR (3.29, 95% CI, 1.39-7.84). Conclusion: Current smoking status was found to be associated with low educational and low income status. Recommendation: Addressing socioeconomic and educational differences, by upgrading income status and promoting access to education and awareness raising on smoking harm will be required to reduce prevalence of smoking among military personnel.