Browsing by Author "Shiferaw, Solomon(MD, MPH)"

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    Assessment of Factors Associated with Infant and Young Child Feeding Practices of HIV Positive Mothers in Selected Hospitals of SNNPR, Ethiopia.
    (Addis Abeba University, 2011-05) Mengistie, Asteway; Shiferaw, Solomon(MD, MPH)
    Introduction: Mother-to-child transmission is the largest source of HIV infection in children. About one third of children infected are believed to be vertically during breast-feeding. Infant feeding in the context of HIV is complex. HIV positive women are confused about feeding methods and mixed feeding continued to be widespread. However, there is little literature on the practice of HIV positive mothers and counseling message of health workers in Ethiopia. Objective: The objective of this study was to assess magnitude and factors associated with infant and young child feeding practice of HIV positive mothers in selected hospitals, Southern Nations Nationalities and Peoples of Region, 2011. Methods: An institution based cross sectional study was conducted using both quantitative and qualitative methods. A total of 201 HIV positive mothers with children less than two years of age were selected at morning time in order of arrival. Health workers working on anti -retroviral therapy and prevention of mother to child transmission clinics were taken for in-depth interview in Hawassa, Yirgalem and Dilla Hospitals. Result: A sample of 183 HIV positive mothers participated in the study making the response rate of 91%. Of all respondent, 87(47.5%) HIV positive mothers had children with the age of less than 6 months, among 87(47.5%) HIV positive mothers, 56.3% had experience of exclusive breast feeding, 35.6% mixed feeding and 8.1% exclusive replacement feeding. Regarding issues discussed during counseling time by health workers, from total of 183 HIV positive mothers, 78.7% mothers received counseling on different feeding options. Most, 96.2% and 76.0% of mothers received counseling on advantages & disadvantages of breast feeding respectively, and 67.8% and71% disadvantages of replacement and mixed feeding respectively. Mother‘s who had antenatal follow up and favorable attitude towards feeding options were more likely to practice exclusive breast feeding and less likely to practice mixed feeding. Conclusions and Recommendations: more than half of mothers practiced exclusive breast feeding and very small proportion of HIV positive mothers chose replacement feeding, but still greater than one third of HIV positive mothers practiced mixed feeding. In general, infant and young child feeding practices observed in this study fall sort of the WHO recommendations, so it is recommended that all HIV positive mothers should be provided with adequate information to enable them to select the best feeding option for their babies, and to successfully carry out their infant feeding decisions.
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    Assessment of Knowledge, Attitude and Intention to Breastfeed among Pregnant Women Following ANC in Addis Ababa, Ethiopia.
    (Addis Abeba University, 2011-07) Humnessa, Sheleme; Haidar, Jemal (MD, MSc, DRM); Shiferaw, Solomon(MD, MPH)
    Background: Optimal infant and young child feeding includes initiation of breastfeeding within the first hour of life, exclusive breastfeeding for six months, supplementary diet started besides breast milk is 6 month and continued breastfeeding for two years and beyond. However, in reality many mothers are unable to practice as advocated among mothers who did not receive antenatal education. Objective: To assess the knowledge, attitude and intention to breastfeeding among pregnant women attending antenatal care (ANC). Methods: Facility based cross- sectional study was carried out during January -February 2011 among randomly selected pregnant women who were attending ANC service in Addis Ababa. A total of 420 respondents participated in the study. Data were collected using interviewer administered Amharic version structured questionnaire. The data were entered in epi info version 3.3.2 and analyzed using SPSS for windows version 15.0. Results: Adequate knowledge of breastfeeding, favorable attitude and intention to breastfeed were 53.8%, 80.5% and 96.1% respectively. Majority, of respondents (47.1%) heard breastfeeding information from mothers with previous breastfeeding experience. Pregnant women’s older age (p<0.05), high house hold income (p<0.05), educational status (p<0.01), previous breastfeeding experience (p<0.01) and breastfeeding counseling (p<0.01) were predictors of adequate knowledge of breastfeeding. In addition, middle and high house hold income (p<0.05), educational status (p<0.01) and previous breastfeeding experience (p<0.05) were predictors of favorable attitude toward to breastfeed. Whereas, socio demographic, RH factors and attitude toward to breastfeed did not associate with intention to breastfeed. But, having adequate knowledge of breastfeeding was associated with favorable attitude toward to breastfeed (p<0.01). Conclusion: Almost-all’ prevalence of intention to breastfeed and high level of favorable attitude towards breastfeeding among pregnant women in the study area. However, the knowledge of breastfeeding was found to be at lower level than studies done before in other areas. This is influenced by age and breastfeeding counseling. In addition, house hold income, educational status and previous breastfeeding experience of pregnant women were the major factors affecting knowledge of breastfeeding and attitude toward to breastfeed. Recommendations: Targeting younger age, low family income, none education and those who were pregnant for the first time is needed in order to promote the initiation and duration of breastfeeding. In addition, combined approaches of one to one education, group education including media campaigns are important.
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    Assessment of Knowledge, Attitude and Utilization of Information Communication Technology among Medical students and Health care providers at Tikur Anbessa Specialized Hospital
    (Addis Ababa University, 2009-07) Adane, Melisachew; Lessa, Lemma(M.Sc); Shiferaw, Solomon(MD, MPH)
    Background: The advancement in Information Communication Technology (ICT) provides greater ease of access and use to exploit the benefits of computing for medical education as well as quality health service delivery. However, there is no adequate information on the level of knowledge and utilization patterns of ICT among medical students and health care providers in Ethiopia. Objective: To assess the knowledge, attitude and utilization of ICT among students and health care providers in AAU, Medical Faculty and Tikur Anbessa Specialized Hospital, Addis Ababa. Methods: A cross sectional survey was conducted in AAU, MF and Tikur Anbessa Specialized hospital from February to March 2009, a total of 403 study participants were randomly selected from undergraduates, residents and health care providers based on their population size proportionally. The quantitative data were collected using self administered pretested questionnaire. The study was complimented with in-depth interview. Data were initially entered into EPi-6 dos version and exported to SPSS version 15.0 for analysis. Result: A total of 334 students and 59 HCPs participated in the study and about 25% of the respondents had satisfactory knowledge. Around 52% of the respondents had at least one computer at home and 74.8% of study subjects had Internet access mostly from Internet café(46.6%). Among study participants who had Internet access, 89.3% were users though 90.1% of them using it for e-mail service. About 83.2% of study participants had positive attitude towards ICT. The utilization rate of computer was 32.6% for all respondents. Computer possession [OR(95%CI) = 5.67(2.68, 11.99)], having computer training [OR (95%CI) = 2.26(1.12, 4.55)], knowledge on ICT [OR (95%CI) = 2.52(1.31, 4.84)], being intern [OR (95%CI) =5.01(1.71,14.69)] and resident [OR (95%CI) = 6.84(1.46, 31.99)] had significant difference in level of utilization among students in Addis Ababa University, Medical Faculty. Conclusions and recommendations: The study indicated that students and HCPs had low knowledge level and poor utilization status of ICT for academic purpose and service delivery needs. The findings indicate the need for improving the existing ICT course in the curriculum to be more skill oriented and also formal in-service ICT related trainings for the health care providers. Further, it is recommended that the medical faculty as well as MOH should consider improving the ICT facilities for students and health care providers with the aim of achieving universal access.
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    Assessment of Psychosocial Health and Risk Sexual Behaviors of Students in Higher Learning Institutions: A Comparative Cross-sectional Study between Old and Newly Established Universities
    (Addis Abeba University, 2009-06) Tsegaye, Ademe; Shiferaw, Solomon(MD, MPH)
    Students in higher institutions are exposed to many psychosocial problems and risky sexual behaviors as they are away from their parents and possibly due to suboptimal counseling services. The problems may be more apparent in newly established universities. Despite this concern, there is no information regarding the psychosocial health status and risky sexual behaviors of students in higher learning institutions in Ethiopia. The study aimed to assess and compare the magnitude of risky sexual behaviors and psychosocial ill health among students of newly established and old universities. The study employed a comparative cross-sectional survey supplemented with qualitative methods. Cluster sampling technique was used to select the departments after dividing the total sample size proportionally to first year and second year students. A total of 1033 students were included in this study: 518 from DBU and 515 from AAU. Quantitative data were processed in SPSS v.13.00 statistical software. Ethical clearance was obtained from ethical review committee of the school of public health and institutional review board at Medical Faculty of Addis Ababa University. Taped qualitative data were transcribed, translated into English, and manually analyzed by grouping into predetermined thematic areas. The response rate was 97.4%. The results indicate that significantly more students of DBU than AAU [(24.7%)versus 69(13.4%)] were likely to have had sexual intercourse [P<0.001]. More students of AAU than DBU used condom in their last sexual intercourse [40(60.6%)versus 21(22.8 %); AOR (95%CI)= 7.08 (3.00, 16.71)]. Students at DBU were significantly more likely to have multiple se xual partners than AAU students [75(78.2%)versus 42(62.7%): COR (95%CI)= 2.13(1.06,4.24)]. More students of DBU than AAU [64.9% versus 50.9 % ; AOR(95%CI)=0.60(0.45,0.8 0)]were found to have sad feelings. More students of DBU than AAU [69 (13.4%)versus 47(9.14%); O R (95%CI)=1.50 (1.03,2.27)] seriously considered suicide. In addition, more students who had psychos ocial ill health had multiple sexual partner [ 82(70.1%)versus 35(29.9%); COR(95%CI)= 1.82(1.20,2.75)].Overall the findings indicate that substantial segment of the student population in both universities have risky sexual behavior and psychosocial problems. This calls for strengthened effort to expand the existing and initiate additional preventive measures. In both universities, proper orientation is crucially important especially when students first join the university. Preventive activities for HIV/AIDS like condom distribution, providing health information about HIV are urgently needed at DBU. In addition, mechanisms for economic support (for example loan service)should be arranged to the needy students in both universities.
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    Trends and Magnitude of Women’s Overweight and/or Obesity and its Socio-demographic Correlates among Urban Ethiopian Women, Urban Ethiopia; Evidence from EDHS, 2000 to 2011
    (Addis Abeba University, 2013-06) Abreha, Solomon; Shiferaw, Solomon(MD, MPH)
    Background: Overweight and obesity are among the risks factors of various chronic diseases. In developing countries undergoing nutritional transition, overweight and/or obesity is becoming more prevalent among women. Though less attention is given to the problem of overweight and/or obesity in Ethiopia, its prevalence is on a rise among urban Ethiopian women (15% in 2011). Hence, documenting the magnitude of overweight and/or obesity and identifying its socio-demographic correlates will help to understand the scope of overweight and/or obesity among urban women. Objective: To examine trends and magnitude of overweight and/or obesity and to identify its socio-demographic correlates among urban Ethiopian women aged 15-49, between 2000 and 2011. Methodology: Cross sectional data from the three Ethiopian Demographic Health Surveys was used for this study. A total of 7,312 non pregnant urban women were included in this study. The main outcome of interest was overweight and/or obesity and the independent variables were age, wealth index, parity, occupation, region of residence, educational and marital status. Complex sample descriptive, bivariate and multivariate logistic regression was used to analyze the data. Results: The prevalence of overweight and/or obesity among urban women was 10.7% in 2000,14.0% in 2005 and 14.9% in 2011. The overall prevalence increased by 4% from 2000 to 2011 though it was not statistically significant: [from 10.7% with 95% CI; (9.8, 12.8) in 2000 to 14.9% with 95% CI; (12.4, 17.6) in 2011]. Particularly, the prevalence significantly increased over time among women who were older, 40-49 years: [from 15.6% with 95% CI; (11.6, 20.5), in 2000 to 32.2% with 95% CI; (25.4, 39.8), in 2011, x 2=25.7 and p < 0.001]. It was also significantly increased among those who were residents of the three Metropolis (Addis Ababa, Dire Dawa and Harari): [from 15.9% with 95% CI; (13.3, 17.7) in 2000 to 20.3% with 95% CI; (18.2, 22.50), in 2011, x2=5.3 and p < 0.05]. Being older, 40-49 years, [OR=4.5 (95% CI; (2.2, 9.0)], attainment of secondary education or above, [OR= 2.5 (95% CI; (1.4, 4.7)] and living in the three metropolis [OR=5.8 (95% CI; (3.2,10.4)] were significantly and positively associated with the condition of overweight and/or obesity in 2000. Being older, 40-49 years, [OR=5.1 (95% CI; (2.3, 11.7)], resident of the three Metropolis,[OR=3.8 (95% CI; (1.4, 8.2)], in the richest quintile, [OR=2.2 (95% CI; (1.2, 4.1)], attainment of secondary education or above, [OR=2.2 (95% CI; (1.2, 4.3)] and being currently married[OR=2.5 (95% CI; (1.2, 5.3)], were found to be significantly and positively associated with being overweight and/or obese while women engaged in manual work were less likely to be overweight and/or obese, [OR=0,4 (95% CI; (0.2, 0.8)] in 2005.The odds of be being overweight and /or obese was significantly higher among women were older, 40-49 years [OR=9.8 (95% CI; (5.1, 13.8)] , resident of the three Metropolis [OR=2.2 with 95% CI; (1.2, 4.2)], in the richest quintile, [OR= 1.8 (95% CI; (1.1, 2.5)], currently married[OR=2.0 (95% CI; (1.2, 3.1)] and among those with secondary education or above [OR=2.0;with 95% CI; (1.3, 3.1)]. Conclusions and Recommendations: the findings of this study have provided information on the prevalence and socio-demographic correlates of overweight and/or obesity among urban Ethiopian women. The findings also showed that the problem of overweight and/or obesity is on a rise among urban Ethiopia women. Hence, there is a need for policies and public health interventions which promote healthy lifestyle (consumption healthy diet and doing regular physical activity) to address the problem of overweight and/or obesity. These policies and interventions need to be age sensitive and need to target more urbanized cities and towns. However, the scope of such interventions can be broaden based on evidences from future researches.