Browsing by Author "Seme, Assefa (PhD)"

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    Assessment of Knowledge, Attitude and Practice of Adult Women Towards Breast Cancerscreening in Addis Ababa, Ethiopia; 2015
    (Addis Abeba Universty, 2015) Abeje, Sandra; Seme, Assefa (PhD)
    Background: Breast cancer has been a worldwide public health problem and it is the most common cancer in women both in the developed and less developed countries. Public and individual awareness can play a vital role in the prevention, early diagnosis and treatment of breast cancer. Objective: To assess the knowledge, attitude and practice of adult women clients (20-49 years of age) towards breast cancer screening in health centers of Addis Ababa, 2015. Methods: A cross-sectional facility based quantitative study complemented by qualitative (in-depth interview) study was conducted on a total of 633 women clients who came to selected health centers for maternal and child health services. Data was collected from January 1stto 30thFebruary, 2015. For quantitative data Epi-Info version 7and SPSS Version 21 were used for data entry and analysis, respectively. Cross tabulation of each independent variable with the dependent variable with their 95% confidence interval was done to see if there was any association between them. Those variables associated at binary logistic regression with a significance level of 0.2 were entered into multiple logistic regression to identify determinants by controlling possible confounding effect. The transcribed and translated qualitative data were imported into an Open Code program and coded, categorized, thematically described and the emerged themes were included in the final thesis report. Results: Overall 53% of women have heard about breast cancer and35.5% knew at least one breast cancer screening method. While among women who were informed of breast cancer, 97% of theme indicated that screening improves chance of survival. Generally among the common screening methods; self-breast examination, clinical-breast examination and mammographic examination were practiced by 24.3%, 7.6% and 3.8% of respondents, respectively. Factors like family history of breast illnesses, income, educational status, general knowledge of breast cancer were highly associated with the knowledge, attitude and practices of breast cancer screening. Socio-cultural factors, lack of attention and facilities patient load were among the dominant factors raised by qualitative interviewee. Conclusion and Recommendation: This study has revealed that self-reported breast cancer screening coverage is low. About two-third of studied women had no information of breast cancer screening methods. There is a need to design and implement awareness creation program on screening for breast cancer. Different print and mass media can be engaged in teaching women to undergo regular breast cancer screening for early identification and intervention.
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    Assessment of Postnatal Care Utilization and Associated factors in Asella town, Regional State of Oromia, Ethiopia
    (Addis Abeba Universty, 2015-05) Tafesse, Mulatu; Seme, Assefa (PhD)
    BACKGROUND: Most maternal and neonatal deaths occur during the first 24 hours after childbirth. Utilization of postnatal care prevents the maternal mortality and morbidity. OBJECTIVES: The objective of this study is to assess the postnatal care utilization and associated factors in Asella town, Regional State of Oromia, Ethiopia. METHODS: A community based cross-sectional study supported by a qualitative study conducted from March-April, 2015 in Asella town to assess the utilization of postnatal care services and associated factors among women who had given birth in the last one year prior to the study. A multistage sampling technique was used to select participants in the study. The total sample size in this study was 630 mothers. A structured questionnaires and focus group discussions were used to collect the data. Data were entered, cleaned and coded into EPI info and exported to SPSS version 20 for the quantitative study. Thematic framework analysis was implemented manually for the qualitative type of study. RESULTS: Results of this study revealed that majority of mothers were sought ANC visit during their recent pregnancy and 98.6% of the respondents were delivered at health facilities. However 65% of women did not received PNC services. The most frequent reasons for not obtaining PNC services were due to lack of awareness, apparently healthy, shortage of money and cultural barriers. In this study the following factors were identified as having an important predictors in the utilization of PNC services Husband’s occupation (self employed husbands) with (AOR=6.433, 95% CI=1.72- 24.03), number of ANC visit (four times and above) (AOR=2.614, 95%CI= 1.71-9.57), and decision making power of the mother (AOR=13.828, 95%CI= 1.39-137.28) were statistically significant associations with the utilization of PNC service. Another important reason which was indicated by FGD participants was lack of willingness and unfriendly approach by some health professionals in government health facilities may hinder mothers from utilization of PNC services. Conclusion: This study revealed that utilization of PNC in Asella town is low compared to other studies previously done in Ethiopia. To increase utilization of PNC coverage and reduce maternal and neonatal mortality mothers should obtain more appropriate education and quality ANC, delivery and PNC services. The results of this study may be useful for policy makers to develop appropriate strategies to improve utilization of PNC services. Key words: PNC services. Utilization. ANC visit. Asella town.
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    Pattern of Knowledge and Practice of Pharmacists Regarding Medication Abortion in Private Pharmacies in Addis Ababa Ethiopia: a Mystery Client Study
    (Addis Abeba Universty, 2016-06) Tefera, Mahlet; Seme, Assefa (PhD)
    Background Comprehensive abortion care holds particular promise for Africa where abortion-related morbidity and mortality are high [2]. In Ethiopia, the service is available and is semi legalized with listed indications. One of the method for terminating pregnancy is medication abortion. In many developing countries pharmacy employees, many with no training in medication abortion sell the pills without prescription [4]. In this study we examined the pattern of knowledge and practice of pharmacists on medication abortion in private pharmacies Addis Ababa using mystery client study. Methods A descriptive cross sectional design was used using both facility based assessment and mystery client observation. From 8 sub cities that were selected randomly 84 pharmacies were chosen by an equal probability systematic sampling. Facility based data collection was done using interview with the pharmacist then after a month undercover clients returned to these pharmacies to gather data using observation. A bivariate analysis was conducted to examine pharmacy workers’ behavior, and dispensing practices and P < 0.05 was considered statistically significant. Results All pharmacies that were visited provide medication abortion service. In the facility based data 8(10.3%) said they give the service using prescription, but in the mystery client study none of the pharmacists asked for prescription to give the service. Concerning dosage of drugs only 33(71.74%) told the women the correct dose of the drug. Discussion The overall practice of the care providers in this study show that even if the law does not allow for pharmacists to provide medical abortion drugs without prescription, over-the-counter sales without prescriptions is widespread. Conclusions Access to medical abortion has significantly increased in private pharmacies but knowledge and practice regarding medication abortion provision is sub-optimal among pharmacists. Recommendation It is recommended that focus should be given in addressing the most vulnerable groups in the community by creating awareness concerning constitution and technical guideline of safe abortion
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    Postpartum Contraceptive use and Associated Factors among Women of Reproductive Age Group within the First 12 Months of Delivery in Public Health Facilities of Addis Ababa, Ethiopia
    (Addis Ababa University, 2017) Tedla, Zelalem; Seme, Assefa (PhD); Assefa, Niggussie
    Background:Globally over 9 out of 10 women wants to avoid pregnancies after having a child but only one in seven of mothers who want to avoid pregnancy are not using family planning method. Majority of the women wanted to space births and hence have high desire to avoid getting pregnant soon after their recent births. However due to various reasons larger number of women get pregnant within 7- 9 months their recent delivery. Objective: To assess the use and factors associated with postpartum family planning among women of reproductive age in Addis Ababa. Method: A health institution based cross sectional study was conducted in Addis Ababa City. A total of 631 women of reproductive age who gave birth in the past 12months prior to the study and who came to the selected health facilities for child immunization services and/or antenatal care services during their postpartum period were interviewed. The collected data were entered into EPI info version 7and transferred to STATA version 14 for analysis. Descriptive statistics has been used to describe the study variable. Bivariate analysis and multi variable logistic regression was done to see the association between independent variable and the outcome variable (Postpartum Family Planning Use). Result: A total of623 respondents have participated in this study, with 98% response rate. From the total respondent 86.2% fall in the age group of 20-34,(97.4%) are currently married and 86.5%. Over all twelve-month’ magnitude of PPFP use was found to be 50.8%.From the total respondents85.4%knewat least one method of postpartum family planning, 97.3% of them had reported that they have ANC attendance,78.5% had obtained (PNC) service. Menses return (OR=1.9), resumed sexual intercourse (OR=7.8), discussion with husband/partner (OR=3.0) and PNC counseling (OR=3.0) were found to have statistically significant association with postpartum family planning use among study participants. Conclusion: contraceptive use during postpartum period is low. Injectable and POP were the most widely used types of method used during postpartum period. It has significant association with factors like discussion with husband, Menses resumed, sex resumed and postpartum counseling. Recommendation: PNC counseling should be stronger in the possible contact of postnatal.
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    Premarital Sexual Practice and Associated factors among Orphan Adolecents in Selected Charity Organizations of Addis Ababa, Ethiopia, 2014.
    (Addis Abeba Universty, 2014-07) Tena, Meheret; Seme, Assefa (PhD)
    Background: Adolescence is a period of great physical, mental and emotional turmoil; teenagers in curiosity to prove their sexuality start experimenting sex. Premarital sex during adolescence is often unprotected against unwanted pregnancies and sexually transmitted infections (STIs). Ethiopia counts one of the largest populations of orphans in the world. Orphans may not receive the adequate caregiver monitoring that deters risky sexual behaviour. There is little or no information about the prevalence of premarital sexual risks among orphan adolescents in Ethiopia. Objective: To assess pre-marital sexual practice and associated factors among orphan adolescents (15-18 years) in Addis Ababa charity organizations. Methods: The study used mixed methods approach by combining institution based cross-sectional survey of orphan adolescents (15-18 years) who were beneficiaries of community based support in charity organizations. A total of 422 sample size was calculated using single population proportion formula & simple random sampling technique was used to select the study units. The survey was complemented with qualitative FGDs and in-depth interviews with purposively selected orphan adolescents and guardians that work as child development projects in those selected charity organizations. For quantitative data Epi-Info version 3.5.4 software was used for data entry then data exported to SPSS Version 21 software for analysis. Bivariate logistic regression analysis was used to assess the presence and degree of association between dependent and independent variables. Multivariate logistic regression model was applied to identify the important determinants for premarital sex and used to control for possible confounding effects. The transcribed and translated qualitative text data was imported into Open Code program and coded. Then codes were categorized and thematically described. Result: From the selected charity organizations that provide community based support, a total of 393 orphan adolescents aged 15-18 completed the questionnaire, giving a response rate of 93.1%. Eighteen (4.6%) orphan adolescents have ever had sex. The mean and median age at first sex were 14.5 (SD+-3.69) and 16 years respectively. Nearly 53% of the respondents were females; the majority (82.4%) were in the age group of 15-16 with mean age of 16 (SD 1.12). More than a quarter (26.7%) orphan adolescents were encouraged by their peer friends to have sexual partners. However, 86.5% of respondents had drunk alcohol but 3.8% of them practice sex after drinking alcohol. About one third (33.3%) of respondents viewed pornographic materials. In multiple logistic regression after controlling for confounders, age (17-18 years old), alcohol use, having boy/girl friend and peer pressure were found to be significantly associated with the out come variable. Conclusions and Recommendations: In the current study though the prevalence of sexual practice was smaller when compared to earlier studies done in other countries; those orphan adolescents affected by peer pressure, alcohol use & who had boy/girl friend were more exposed to premarital sexual practice. Thus, sex education programs that focus on risky sexual behaviours shall be designed at school levels. Further studies shall also be conducted on premarital sexual risks of orphan adolescents.
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    The role of Socio Cultural factors on Early Sexual Initiation among youths in Doba Woreda
    (Addis Abeba Universty, 2016-06) Begna, Mulu; Seme, Assefa (PhD)
    Background: Early sexual initiation is having sexual intercourse before age of eighteen years. It increases the risk of unwanted pregnancies, maternal morbidity and mortality, and exposure to HIV and other STI infections. Little is known about the impact of socio-cultural factors on early sexual initiation. Knowing time at first sexual intercourse and associated factors, particularly focusing on socio cultural factors, is important to design effective program addressing the young people’s problem through providing evidence-based information for AYRH strategy. Objective: the objective of the study is to assess age of sexual initiation and factors associated with it among youths (15-24) in Doba woreda. The study particularly explores socio cultural factors that have impacts on early sexual initiation. Methods: A community based cross-sectional study was conducted using both quantitative and qualitative methods. A total of 613 youth who were drawn using multistage stratified sampling method were interviewed between February 01 and 15, 2016. Data entry and analysis were done by using EPI Info and STATA version 12.1 softwares, respectively. Descriptive statics, bivariate analyses and multivariable analyses were carried out. Moreover, qualitative data was collected through Focus Group Discussions and key informant interviews to augment the result of quantitative data. Then content analysis was done by using Open code software. Result: The prevalence of early sexual initiation among youths in Doba woreda is 66.6%.The median ages of sexual initiation in this study was 17 years (range 15-18 years). Multivariable logistic regression analysis show that being female (AOR =4, 95%CI, 1.9-8.3), Youths with the age range between 15-19 years (AOR=3.9 95%CI, 1.1-13.5), Youths who shared bedroom with their father and mother during their adolescence (AOR=3.5 95%CI, 1.4-8.9) and Youths who smoked shisha (AOR=2.7 95%CI, 1.3-5.4) were identified as associated factors of early sexual initiation. A cultural play which is locally called “shaggoyyee” or “danci” is one of the factors that triggers youth for early sexual initiation. On the other hand a culture of preserving virginity before marriage in the community was found as a protective culture against early sexual initiation in the community. Regarding perception of youths about the consequence of early sexual initiation they mentioned unwanted pregnancy, unsafe abortion, STI and school drop out as the major negative consequences resulted due to early sex. Conclusion: This study showed that the prevalence of early sexual intercourse is very high. Gender (being female), young age (15-19 years), sharing bedroom with father and mother during adolescence period and smoking shisha were associated factors of early sexual initiation. Discussion with peers about sexual issue is found as a protective factor for early sexual initiation. In order to protect youths from early sexual initiation education should be provided for the community regarding harmful effect of substance use (such as shisha) through different Medias, churches and mosques.Young children and adolescents should have separated bed rooms from their father and mother so that visual and auditory privacy will be maintained.