Browsing by Author "Solomon Shiferaw"

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    Anemia and its Determinant Factors among Pregnant Women in Ebantu District, East Wollega Zone, Ethiopia
    (Addis Abeba University, 2013-08) Wondimu Mitiku; Solomon Shiferaw; Seifu Hagos
    Background: Anemia affects almost two-thirds of pregnant women in developing countries and contributes to maternal morbidity and mortality and to low birth weight. Anemia during pregnancy is associated with negative maternal and neonatal outcomes. However, there is limited data regarding prevalence of anemia and its determinant factors during pregnancy in western Ethiopia. Objective: To determine the prevalence of anemia and its determinants among pregnant women in Ebantu District, East Wollega zone, Ethiopia Methods: A cross-sectional study was carried out among pregnant women. A total of 625 pregnant women were screened for hemoglobin level. The test was determined using hemocue screening technique. Weight and height was measured & other determinants of anemia during pregnancy were also assessed using a structured questionnaire. Results: The prevalence of anemia as defined by the World Health Organization as hemoglobin level <11.0 g/dl was 35.5% with 95%CI (32.0%, 39.2%). From this, 23.7% had mild anemia and 11.9% had moderate and none with severe anemia. Multivariate analysis showed that birth spaces less than or equal to two years AOR (95%CI):1.5(1.1, 2.9), a history of abortionAOR (95%CI): 2.4(1.6, 3.6), having two or more abortions AOR (95%CI) 2.6 (1.3, 6.2) ,illiteracy with COR (95%CI):2.974(1.5, 5.6) and AOR: 5.92(1.8, 18.9) were significantly associated with anemia in pregnancy. Conclusions: A higher percentage of pregnant women have mild to moderate anemia. The major determinants of anemia in pregnancy are illiteracy, short birth spaces less than or equal to two , history of abortion and lack of Iron supplementation while pregnant.
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    Assessment and Comparison of Patterns of Malnutrition and its Determinants Between Internally Displaced and Indigenous Under Five Children in Amuru District,Horo Guduru Wollega Zone,Oromia Region,March ,2013.
    (Addis Abeba University, 2013-03) Geleta Asebe; Solomon Shiferaw
    Introduction : Without proper nutrition, children are susceptible to more frequent and severe childhood illnesses, stunted growth, developmental delays, and death. Previous studies show that the prevalence of undernutrition (stunting, wasting and underweight) is generally higher among children with resettled (internally displaced) families compared to those of permanent residents. Objective :The objective of this study is to assess and compare nutritional status and identify its determinant factors among internally displaced and indigenous children of age 6-59 months in Amuru District, Horo Guduru Wollega Zone, West Oromia region. Method : A community based comparative cross sectional study was conducted from March to April 2013. Structured and pre-tested questionnaire was used to collect information on demographic and economic factors and child care practices. Information on anthropometric indices was also collected using well-calibrated weighing scale and height measuring board. Stratified sampling procedure was employed to select the required households. A total of 891 children, 442 from Internally Displaced Peoples and 449 from Indigenous communities were selected from eight kebeles by systematic sampling techniques. Data entry was done with Epi info version 3.5.3 which was then exported to SPSS version 20 statistical package for analysis. The 2006 WHO standard was used to convert height and weight measurements into Z-scores. Descriptive statistics and multiple logistic regression analysis were used as appropriate. Results :A slightly higher percentage of children aged 6-59 months among IDPs had stunting compared to those from Indigenous communities (52.9% versus 51.3%) although the difference was not statistically significant (p- value > 0.05). In contrast, there was a marked difference in the rate of wasting in the two populations (21% among IDPs, 7.1% among indigenous) (p- value < 0.05). Similarly, the percentage of children who were categorized as underweight was much higher among IDPs (36.8%) compared to Indigenous communities (11.8%) (P-value < 0.05). Sex of child (being male), younger children and children who had been on bottle feeding were significantly associated with stunting in both children of IDPs and Indigenous communities. Internal displacement was found to be a significant predictor of wasting [AOR: 95% CI: 2.4 (1.4, 4.1)] and under-weight [AOR: 95%CI: 2.4 (1.4, 3.9)] even after controlling for factors such as age of child, immunization, lack of farming lands, monthly income, parent’s education, availability of latrine and not having enough food in the households. Conclusions and Recommendations :The study revealed that child malnutrition is a major public health challenge in both IDPs and Indeginous communities of Oromia region. However prevalence of underweight and wasting were particularly more pronounced among children of IDPs compared to those of indigenous populations. Factors related to socio-demographic, access to sanitary facilities and health service including being male, younger children, bottle feeding, non-immunized children, not having farming lands, uneducated parents, not having latrine and presence of diarrhea in the two weeks preceding the survey were identified as significant predictors of the three forms of childhood malnutrition (stunting, wasting and under-weight). Based on the findings of the present survey, we recommend that policy makers consider the status of displacement of communities in priority setting and designing nutrition programs as they exhibit increased vulnerability to undernutrition and its negative consequences.
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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) Asteway Mengistie; Solomon Shiferaw
    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 Gender Differential in Magnitude and Risk Factors of Childhood Malnutrition in Menz Keya District North Shewa Zone Amhara Regional State Ethiopia.
    (Addis Abeba University, 2009-06) Getabalew Endazenaw; Solomon Shiferaw
    Background: Malnutrition remains one of the most common causes of morbidity and mortality among children throughout the world. The nutritional status of infants and children under five years of age is of particular concern since the early years of life are crucial for optimal growth and development malnutrition has been responsible, directly or indirectly, for 60% of the 10.9 million deaths annually among children under five. Malnutrition is an underlying factor in over half of under-five child death in Ethiopia, and children with severe acute malnutrition face 30-50 percent chance of dying unless treated. Objective: to assess gender differential in the risk factors and magnitude of malnutrition among children of age 0-59 months in Menz Keya district North Shewa zone Amhara Regional state, Ethiopia. Methods: the study design was community based comparative cross-sectional quantitative study and supplemented qualitative (FGD) methods. A total of 746 children were selected using cluster sampling technique. Quantitative data were collected using structured questionnaire and including anthropometric measurements. The study variables include; socio-economic and demographic characteristics, child and maternal related variables and environmental health conditions. Data were entered and processed using EPi-info and SPSS for analysis. The NCHS reference population standard of WHO was utilized to convert height and weight measurements into Z-scores of the H/A, W/H and W/A indices considering age and sex of the children. Results: Stunting was found to be significantly higher in female children (36.7compared to 25.7%) among male children both in urban and rural areas. Among male children, age group of 6-11 and 48-59 months were found to be more affected by stunting. It was found that multiple determinant factors among operating at individual (mother age, education of the mother, immunization status, and weaning time) and house hold levels (household income, family size) are significant predictors of stunting. Wasting was found to be statistical significantly higher in male children than female children (14.7%) in urban and rural areas. children in the age group 48-59 months were more affected in both male and female. Education of the mother, household income, family size, immunization status and waste disposal area were found to be the important determinant factors for wasting. Underweight was slightly higher male children compared to female children (22% vs 20.1%). Educational status of the mother, duration of breast feeding, immunization status family size, household income, and domestic waste disposal areas were determinant factors for underweight. Conclusions and Recommendations: The finding of this study showed that the prevalence of stunting was higher in female children in both urban and rural areas compared to male. Whereas wasting and underweight were more common in male children than female children regardless of their place of residence. Educational status of the mother and family monthly income were important determinant factors for chronic malnutrition for both male and female children. Empowering women to improve their education and income generation potential is recommended.
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    Assessment of Household Food Security and Nutritional Status of Women in the Context of High Food Price in Addis Ababa.
    (Addis Ababa University, 2012-06) Tesfaye Birhane; Solomon Shiferaw; Seifu Hagos
    Background: Since recently, the world’s economic crisis, mainly the high food price is increasing the number of poor people and aggravating their living conditions. In big urban areas of Ethiopia like Addis Ababa where populations rely on market based household food supply, increasing price of food and nonfood commodities can threaten households’ food security status. In many societies, women bear the brunt of the food price crisis. Thus, it is crucial to generate evidence about the food security of urban households and women’s nutritional status during time of high food price. Objective: To assess households’ food security status and nutritional status of women in the context of high food price in Addis Ababa City Methodology: A community based cross-sectional study using both quantitative and qualitative methods was conducted from January 18 to Feburary14, 2012. A total of 550 households were selected from three sub-cities of Addis Ababa using multi stage sampling technique. Food security status was assessed using Household Food Insecurity Access Score, and weight and height were also measured using standardized weight measuring scale and height measuring board. Data were collected using questionnaire based interview with household heads. Qualitative method using focus group discussion was employed to explore the possible effect of food price on household food security, and people’s perception about food security. Result: This study found that 75% of households were generally food insecure and 23 % were already in hunger state. Reduction in meal size and shifting to poor quality/less expensive food types/ were common coping strategies to high food price used by households. Household income and educational status of household head were significant determinants of food security. Households with higher food insecurity score have lower dietary diversity and are less likely to consume high quality diets. About 12.7% of women in the sample were underweight while 26% were overweight or obese. Being overweight was significantly associated with better dietary diversity of households. Conclusion and Recommendation: The study revealed that about three fourth of households were food insecure which forced them to reduce their meal size and quality with nearly a quarter of households were suffered from hunger. Household food insecurity was common among the low income households and those headed by uneducated, daily wagers and government employed household heads. Beside subsidization of food items at affordable manner, policy makers should work on stabilization of food market, and create opportunities and capacities for households to increase their per capita income.
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    Assessment of Knowledge and Utilization of Growth Monitoring and Promotion for Under Two Children in Butajira, Ethiopia 2017.
    (Addis Abeba Universty, 2017-05) Luwam Desalegne; Solomon Shiferaw
    Background: United Nations International Children Emergency Fund (UNICEF) defines Growth Monitoring and Promotion (GMP) is a prevention activity comprised of growth monitoring linked with promotion (usually counseling) that increases awareness about child growth; improves caring practices; increases demand for other services, as needed; and serves as the core activity in an integrated child health and nutrition program, when appropriate. This would help parents keep their young children healthy and well nourished. GMP has been implemented in Ethiopia since 2008 as nutrition specific intervention to prevent malnutrition. Objective: To assess knowledge and utilization of growth monitoring and promotion and identify factor associated with knowledge and utilization of GMP for children under two years in Butajira, SNNPR, Ethiopia. Method: Community based cross sectional study was conducted from April-May 2017. A total of 548 child mother pair less than 2 years old who resides in Butajira were selected by simple random sampling method. Qualitative study (in depth interview and observation) were also conducted to supplement the quantitative study and to assess the skill and knowledge of health extension workers working in selected heath post. The data was entered using Epidata version 3.1 and analyzed using STATA version 14 software. Multivariable logistic regression model was fitted to predict the association between knowledge and utilization of GMP and their determinants. All statistical analysis was set at 5% level of significance (i.e. p < 0.05. The results were reported as Odds Ratio and 95% CI). Appropriate tables and diagram were used to present findings. Result: Among 507 mother-child pair participates utilization of GMP was fifty five 11% [95%CI=8.4%-13.8%] while three hundred twenty five 64% [95%CI= 60%-68%] of the mothers had adequate child feeding and growth chart knowledge. The result showed that mothers gave birth in the health facility were 1.60 times more likely to be knowledgeable about child feeding and growth chart than those mother gave birth at home [AOR=1.60; (95% CI=1.06, 2.44)]. Whereas those child-mother pair traveled less than one hour to reach to the nearest health facility from their house were 2.06 times more likely to be knowledgeable about child feeding and growth chart than those mother travel more than an hour to reach to their nearest health facility [AOR= 2.06; (95%CI=1.35, 3.13)]. Mothers with elementary educational level were 3.31 time more likely utilize GMP [AOR=3.31(95%CI=1.50, 6.02)] while mothers with secondary and above education level were 3.33 times more likely utilize GMP than illiterate mothers [AOR=3.33(95%CI=1.30,8.50)]. Regarding occupation of the mother, framers were 4.03 times more likely utilize GMP than house wives [AOR=4.03(95%CI=1.32, 8.50)]. Mothers with child feeding and growth monitoring adequate knowledge were about 5 times more likely utilize GMP than those mother with inadequate knowledge [AOR=4.87(95%CI=1.80,13.16)]. Qualitatively, irregularity of GMP session due to health extension work load, not recording the age and weight of the child accurately, mother wrong belief and skill gap of heath extension workers were challenges of GMP utilization. Conclusion: growth monitoring and promotion is not implemented as it was supposed to be. More than half of the respondents had adequate child feeding and growth chart knowledge and utilization of GMP is very low in rural kebeles of Butajira. Monitoring implementation of growth monitoring and promotion should be needed throughout different weredas and kebeles that are expected to implement growth monitoring and promotion program.
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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) Sheleme Humnessa; Jemal Haidar; Solomon Shiferaw
    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) Melisachew Adane; Lemma Lessa; Solomon Shiferaw
    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 Long Acting and Permanent Contraceptive Methods Utilization and Associated Factors among Female Antiretroviral Therapy Attendees in Gondar Town, North West Ethiopia, 2014.
    (Addis Ababa University, 2014-06) Yordanos Demessew; Solomon Shiferaw
    Background: The prevalence of unintended pregnancy is high among HIV-positive women. Although there is higher motivation among HIV-positive women to avoid unintended pregnancy and desire for use of highly effective contraception, long acting and permanent contraceptive methods usage remained low. Preventing unintended pregnancy among women living with HIV is an important component of prevention of mother-to –child transmission (PMTCT), yet only a little is known about LAPMs use among women who are on ART in Gondar town, North West Ethiopia. Objective: To determine long acting and permanent contraceptive methods utilization and associated factors among female antiretroviral therapy attendees in Gondar town, North West Ethiopia, 2014. Method: Institution based cross-sectional study was conducted by interviewing 480 women of reproductive age (15–49years) that were selected using systematic random sampling technique from a list of ART attendees in government health facilities. Structured and pretested Interviewer administered questionnaire was used to obtain information from the respondents. Descriptive, bivariate, and multivariate methods were used to analyze utilization of LAPMs and the factors associated with LAPMs utilization. Result: Two hundred fifty six (85.0%) of the sexually active women were using some modern form of contraception. The current utilization rate of LAPMs (alone or with condom) was 62(24.1%). Women who had high knowledge [AOR=2.59, 95% CI [1.04, 6.45] and ever had been pregnant since the commencement of ART [AOR= 2.68, 95%CI [1.21, 5.93] had an increased odds of using LAPMs. Moreover, those women who had discussion about family planning with health care provider [AOR=2.69, 95% CI [1.18, 6.15] were more likely to use LAPMs. Conclusion and Recommendation: The finding discloses that the general usage of contraceptive amongst sexually active women on ART was high though specific usage of LAPMs was found to below. Based on the finding, there is a need to improve the implementation of integrated Family Planning service with ART service and improve counseling service that emphasized on LAPMs use.
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    Assessment of Nutritional Status of Adolescents Living with HIV Receiving Care at Public Hospitals in Addis Ababa, Ethiopia.
    (Addis Abeba Universty, 2012) Birra Abdulkarim; Solomon Shiferaw
    Malnutrition is a major threat to the health of HIV infected individuals and is associated with increased risks of morbidity and mortality. Objective; the objective of the study was to assess the nutritional status and associated factors among adolescents living with HIV enrolled at public hospitals in Addis Ababa, Ethiopia. Methods: Facility based across-sectional study was conducted between February and April2016.Data were collected on 340 adolescents aged 10-19 years attending government public hospitals in Addis Ababa. Nutritional status was assessed using BMI-for-Age (BAZ) and Height-for-age (HAZ) as measures of thinness and stunting respectively. Standard deviation (SD) scores (Z scores) were applied to determine the nutritional status. Adolescents whose BAZ and HAZ was less than -3SDwere considered severely malnourished; those adolescent with BAZ and HAZ between -2SD and-3SD were considered malnourished while those with BAZ and HAZ >= - 2SD were well nourished. Statistical analysis was done using WHO anthro plus and STATA 12. Statistical software package. Result: The prevalence of stunting was 37.4% [0.3218-0.425, 95% CI, with 8.2% [0.052-0.11, 95% CI] of adolescents being severely stunted. The risk factors for stunting included skipping of meal [(AOR: 1.74.; 95% CI:1.07- 2.83) and primary care (AOR: 1.23.; 95% CI, 1.03.-1.47). The prevalence of thinness was 15.6 % [0.117-0.194, 95%CI] with 2.9% [0.0113 - 0 .047, 95% CI] severely thin. The risk factors for thinness include treatment interruption [AOR 2.78, 95% CI, 1.20- 6.43] nutrition counseling[AOR 2.05,95 %CI,1.13- 3.72 ] and moderately household food insecurity (AORAOR1.67,95CI % 1.21-3.21) among adolescents living with the HIV enrolled at public hospitals in Addis Ababa, Ethiopia. Conclusion: The prevalence of stunting and thinness was high among the HIV infected adolescents. Skipping meal, getting primary care from relatives, nutritional counseling, and moderately household food insecurity were significantly associated with malnutrition (stunting and thinness). Recommendation: Greater recognition of the substantial burden of malnutrition among adolescents living with HIV is needed, and there is a need for more services aimed at nutrition counseling, retention in care , nutrition interventions beyond clinical settings and economic empowerments of adolescents living with HIV.
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    Assessment of Optimal Breastfeeding among Working and Stay-at-Home Mothers in Bahir Dar Town Amhara Regional State, North West of Ethiopia.
    (Addis Abeba University, 2010-06) Gezahegn Tamir; Solomon Shiferaw
    Background: Optimal breastfeeding practice is essential for the healthy growth and development of children during their early life. It improves the nutritional status and reduces the chances of contracting infection. Studies have shown that globally 70.0% of infants are sub-optimally breastfed, which is major contributor to infant mortality. Objectives: This study is aimed at assessing and comparing mother's knowledge, practices and determinants on optimal breastfeeding among working and stay-at-home mother's having children 0-23 months of age. Methods: A cross-sectional community based study was conducted on 825 mothers aged 17-49 years having children 0-23 months of age residing in Bahir Dar town Amhara Region April, 2010. Modified EPI cluster sampling technique was applied to select households. Experienced interviewers and qualified supervisors were employed and a pre-tested questionnaire was utilized for this purpose. Four FGDs among mothers (segregated by working status) complemented the quantitative survey Results: Three hundred seventy one (92.2%) working and two hundred seventy six (65.4%) stay-at-home mothers had satisfactory knowledge on breastfeeding practice, [AOR: 3.36, (1.94, 5.81)]. Mothers with formal education, those attended ANC follow up and gave birth at health institution were more likely to have satisfactory knowledge on breastfeeding practices [OR: 2.25, 95%CI :( 1.14, 4.43), (OR: 6.14, 95%CI: (3.18, 11.85) and (OR: 1.85, 95%CI :( 1.05, 3.26)] respectively compared to their counterparts. The prevalence of exclusive breastfeeding practice was 34%, 95%CI:(31%-37%) for working and 71.3%, 95%CI : (68.2%-74.4%) for stay-at-home mothers and the working status of the mother was significantly associated with exclusive breastfeeding practice, that those mothers who were working were less likely to practice exclusive breastfeeding than those who were stay-at-home[AdjusteOR:0.30,95%CI:(0.20,0.46)]. the median duration of EBF for working children was 4 months and 6 months for stay-at-home. Conclusions and Recommendations: Overall the study indicates that the maternal knowledge on breastfeeding practice was satisfactory. However, there is inadequacy of optimal breastfeeding practice especially exclusive breastfeeding for the first six month of life among working compared to stay-at-home mother. This would increase the risk of infant morbidity and mortality. Approximately three in four working and one in three stay at home initiated complementary feeding at appropriate time. The findings indicate that both groups of mothers don't have optimal child feeding practices, although the forms of suboptimal behavior are different. Therefore, the government, health workers and community members should work on strengthening the optimal breastfeeding practice by encouraging, supporting mother's to breastfed their children optimally.
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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) Ademe Tsegaye; Solomon Shiferaw
    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 sexual partners than AAU students [75(78.2%) versus42(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%); OR (95%CI)=1.50 (1.03,2.27)] seriously considered suicide. In addition, more students who had psychosocial 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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    Assessment of Suboptimal Breast-Feeding Practice and Associated Factors, among Mothers Employed in the Public Sector, in Nefas silk Lafto Sub-City Addis Ababa, Ethiopia.
    (Addis Abeba University, 2020-10) Asnake Kebere; Solomon Shiferaw; Yalemwork Getnet
    Background: Suboptimal breast-feeding is among the main general medical issues around the world. It represents about more than 1million infant mortality every year, 10% of worldwide disease trouble, and 11.6% under five mortality. Breast-feeding moms faces numerous impediments to practice exclusive breast-feeding and work is one of the major factors. Objective: To evaluate Suboptimal breast-feeding practice among mothers employed in the public sector with youngsters under a half year, in Nefas Silk Lafto sub-city, Addis Ababa, Ethiopia. Methods: The study was conducted in Nefas silk Lafto sub city, in Addis Ababa. A total of 265 mothers working in public service with children less than 6 month were selected by using sampling probability proportional to number of women public servant in each sector and mothers with children less than 6months were selected purposively until reaching at required number of mothers assigned for the sector. Data were collected using self-administered structured questionnaire designed according to 24 hours nutritional recall method. Data were entered into Epi-info version7, cleaned and exported to SPSS version 25 for analysis. Frequency, mean and standard deviation were performed for continues variables and categorical variables were assessed by computing frequency and percentage. Statistical association and Significance were assessed by crude and adjusted OR with 95% C.I respectively, the associations between dependent and independent variables were assessed by using binary logistic and multivariable regression. Result: Two hundred sixty five (95%) mothers of children have agreed to participate in the study, Mean maternal and infant’s age were 29.19 (SD ± 4.36) years and 4.86 (SD ± 1.07) months respectively, the magnitude of sub optimal breast-feeding practice was 58.1% 95% c.i (53.2,62.9). Mothers with breast feeding frequency <8 times/24 hrs [AOR 4.39(1.8, 10.5)], occupation being Health care provider [AOR 6.87 (1.45, 32.57)], returning from maternity leave and mode of delivery Spontaneous vaginal delivery [AOR 0.22 (0.06, 0.83)] were associated with suboptimal breast feeding. Conclusion and recommendation: The magnitude of suboptimal breast-feeding practice is high among public segment moms. Maternal occupation, getting back from maternal leave, and breast-feeding of < 8times/24hrs were among factors which increment suboptimal breast-feeding practice. SVD was found to decrease suboptimal breast-feeding practice. Measures ought to be made to improve work environment condition by benefiting on onsite breast feeding center and particular flexibility of work place for breast feeding moms after they get back from maternity leave. Health education about Spontaneous Vaginal Delivery for moms ought to be advanced.
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    Assessment of the Prevalence and Associated Factors of Exclusive Breastfeeding Practice in Afar. A community Based Cross Sectional Survey, Aysaita Wereda, Afar, Ethiopia.
    (Addis Abeba Universty, 2015-06) Medhin Tsegaye; Solomon Shiferaw
    Background: Breastfeeding is an important public health strategy for improving child and maternal health conditions. However, the prevalence of exclusive breastfeeding is very low in many developing countries including Ethiopia. Therefore, this study was conducted to determine the prevalence of exclusive breastfeeding and associated factors among infants aged six months in Asaita wereda, Afar Ethiopia. Objective: To measure the prevalence and identify determinant factors of exclusive breastfeeding practice in Afar. Materials and methods: A community based cross-sectional study was conducted with qualitative inquiry from March to April 2015. Quantitative data were collected from 631 mother infant-pairs residing in Aysaita wereda with pretested structured questionnaire using the modified EPI cluster sampling procedure. Seven clusters were selected using the PPS (probability proportional to size) after selecting the clusters, households were divided and distributed equally for each enumeration areas. Dividing 1958 HHs (estimated HHs to be visited) equal to the 7 EAs, 280 households in each selected clusters or enumeration areas were visited. The qualitative data were generated through focus group discussions among purposely selected discussants. Odds ratio with 95% confidence interval was estimated using bivariate and multivariable analysis with binary logistic regression model to identify independent predictors of exclusive breastfeeding while thematic framework analysis was employed for the qualitative data Results: The majority (97.9%) of the mothers have ever breastfed their infants. The prevalence of exclusive breastfeeding was 55% with a median duration of 0.5 months. Residing in Urban AOR: 5.7, 95%CI(3.5-9.2), having good knowledge on exclusive breastfeeding AOR: 2.3, 95%CI (1.6-3.5), lower parity (1 & 2-4) AOR: 2.2 95%CI(1.2,4.2) & AOR: 1.9, 95%CI(1.1,3.5) respectively, delivering at health facility AOR: 1.7, 95%CI (1.1,2.7) unemployment AOR: 1.8, 95%CI(1.1,2.9) and primary education AOR: 0.6, 95%CI (0.4,0.9) were found to be a predictor of exclusive breast feeding. Conclusion: The prevalence and median duration of exclusive breastfeeding was found to be low compared to the WHO recommendation. In the current study, however half of the mothers had good knowledge on exclusive breastfeeding, knowledge of mothers about the right time to initiate breastfeeding after birth, and knowledge on foods/liquids recommended to infants less than 6 months was far lower from many studies done in developing countries. Most of the study population had positive/favorable attitudes towards exclusive breastfeeding practice during the first six months. Urban residence, being unemployed, being knowledgeable on EBF practices, low parity and delivering at health facilities were the independent predictors of exclusive breastfeeding practice in the studied community. Thus Strengthening efforts on availability of basic services and promoting education on the cultural malpractices on rural areas, promoting knowledge on exclusive breast feeding using accessible means such as medias and public meetings, revising policies on maternity leaves and creating a baby friendly working environment, encouraging the mothers to deliver at health facilities and promoting its importance and encouraging further researches on the topic of area are recommended
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    Assessment on Food Security, Nutritional Status and their Association with HAART Adherence among Adult PLWHA in Public Hospitals of Addis Ababa, Ethiopia
    (Addis Abeba Universty, 2011-05) Solen Tezera; Solomon Shiferaw
    Background: Morbidity and mortality related to HIV/AIDS remain unacceptably high in developing countries, despite major advance in HIV therapy and increased international funding on HIV/AIDS. Individual’s ability to obtain, consume and utilize food is compromised by HIV/AIDS. It causes morbidity and mortality as a result of poor nutritional status and weight loss. Interactions between antiretroviral therapy (ART) and nutrition can affect medication efficacy, nutritional status, and adherence to drug regimens. The concept of enhancing access to food among PLWHA and managing the interactions between ART and food and nutrition is critical remains critical. Objective: To assess food security, nutritional status and their association with adherence of HAART among adult People living with HIV/AIDS. Methods: A hospital based cross-sectional survey was conducted between December 2010 and February 2011 among adult (≥18 years) PLWHA on HAART with a complementary qualitative interview among HAART adherence supporters at selected public hospitals of Addis Ababa, Ethiopia. A total of 394 adult PLWHA systematically selected and participated in the study having a 100% response rate. Semi structured and structured questionnaires, adopted from FANTA were used to collect data on food security. BMI measurements were taken to assess nutritional status. Univariate, bivariate and multivariate logistic regression analysis was done using SPSS version 16. Qualitative content analysis was done after importing the transcribed text onto the Open code program. Result: Majority 252 (65%) of the study participants were females, 305 (77%) in the age group 25-44 years. Overall 293(74.4%) PLWHA were food insecure with 95% CI: (70.09, 78.71). And the rate of self reported adherence based on the combined indicator of the dose and time adherence measurement was 321(81.5%) with 95% CI: (77.67, 85.33). Only 61(16.5%) with 95% CI: (12.83, 20.17) were underweight. Household’s monthly income (≤500 ETB) predicted food insecurity (AOR, 6.37; 95% CI, 2.98-13.63). And there was no statistical significant association between food security and self reported HAART adherence. food security, nutritional status & their association with HAART adherence Conclusions & Recommendations: Large number of adult PLWHA was food insecure. Wide ranges of coping strategies were taken to cope with food insecurity. Self reported HAART adherence was high. Medium to long term intervention aiming at generating and diversifying income to improve self reliance of PLWHA would help mitigate the food insecurity problem.
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    Chronic Energy Deficiency and its Predictors Among Older Adults in Addis Ababa, Ethiopia: a Cross-Sectional Study.
    (Addis Ababa University, 2025-06) Obsa Abebe; Solomon Shiferaw; Yakob Desalegn
    Background: The likelihood of malnutrition grows as individuals age and as their need for care becomes more intensive. Approximately 40% of fatalities in developing nations are associated with chronic energy deficiency. However, studies on chronic energy deficiency(CED) which is one form of nutritional deficiency and an important public health problem are quite limited in Ethiopia, which makes it difficult to identify their nutritional need. Objectives: This study aimed to assess chronic energy deficiency and its predictors among the population of older adults (defined as 50 years and above) in Addis Ababa, Ethiopia. Methods: A Community based cross-sectional study was conducted among older adults 50 years and above from February 12-22, 2025. Data from 635 individuals were collected through interviewer-administered questionnaires using the open-source mobile based Kobo toolbox. Data were downloaded, merged and cleaned on Excel 2019 and then exported to SPSS V27. A bi-variable and multivariable logistic regression model was used to determine associations between the outcome variable and its predictors. Result: A total of 635 older adults were interviewed with mean age of the participants was 64.7 (50 to 91 years) years with higher percentage of males (58.4%) represented. The study revealed that prevalence of chronic energy deficiency (CED) in older adult population was 10.1%(CI:7.9%-12.6%). Respondents in the age between 50 and 65 [AOR=3.9,95% CI:(1.6,9.3)], those having infrequent meal [AOR=3.9,95% CI: (1.7,8.8)],irregular meal pattern [AOR=2.4,95% CI:( 1.3,4.6)],insomnia [AOR=3.1,95% CI:(1.5,6.6)], Inadequate or poor dietary diversity [AOR=2.8, 95% CI:(1.5,5.3)] and household with food insecurity [AOR=6.2,95% CI (3.2,12.2)] were significantly more likely to have CED compared to their counterparts. Additionally, the study revealed that 1.4% of population were mis-classified on their CED status whenever physical activity level of the population was not considered for classification of chronic energy deficiency Conclusion: The prevalence of chronic energy deficiency was substantial in the study area. It was significantly associated with age between 50 and 65, poor dietary diversity score, infrequent meal and irregular meal pattern, insomnia and household food insecurity at 95% CL and P value<0.05. Therefore, efforts to combat CED should focus on supporting the most vulnerable groups identified in this study. Raising awareness within communities on meal frequency and meal pattern is also crucial.
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    Does Mothers/Caregivers‘ Fasting Status Affect the Dietary Diversity of Children 6-23 Months? A Before-After Study in Debrebirhan, Ethiopia
    (Addis Abeba University, 2019-10) Addisalem Zebene; Solomon Shiferaw; Esete Habtemariam
    Background: Ethiopia has various religions, of which the Orthodox Tewahido Christian religion accounts for 44% of the population. According to the Ethiopian Orthodox Tewahido tradition close to 200 days are dedicated to religious fasting annually, at which time all followers who are above seven years old are expected to abstain from all types of food, including animal source foods, and water for up to some hours daily. It is possible that such practice by mothers or caregivers could affect children’s food consumption. However, it is not clear if mothers/caregivers’ fasting status influences the diversity of food that children are getting during these periods. Objective: The objective of this study was to estimate the effect of mothers/ caregivers’ fasting status on dietary diversity of children 6-23 months in Debrebirhan, Ethiopia, 2019. Methods: A community-based longitudnal study was conducted in Debrebirhan, North Shewa Zone, at randomly selected seven kebeles with a sample size of 218, from January 29 to February 25, 2019 in the pre-fasting period and from March 18 to April 10, 2019, during fasting period on same participants. Data was entered on Epi data version 4.4.2.1 and analyzed using STATA 15 software. Children’s dietary diversity was measured using the WHO standardized questionnaire for infant and young child feeding. McNemar paired test was used for comparison of baseline and end line measurements. Statistical significance was determined at p<0.05. Result: A total of 218 and 216 mothers/caregivers with children 6-23 months participated in the study before and during fasting season with a response rate of 100.0% and 99.0% respectively. The median age of children was 15 months. It was found out that the proportion of children who ate four or more food groups in the pre-fasting period was 23.4% and it significantly decreased to 5.5% in the fasting period (p<0.0001). Conclusion: The study pointed out that mothers/caregivers’ fasting status during the Ethiopian Orthodox Tewahido fasting periods could negatively affect the dietary diversity of children 6-23 months in the household apparently by decreasing their consumption of animal source food. Therefore, intervention strategies in promoting children's dietary diversity should be designed in a way that considers Ethiopian Orthodox Tewahido Christian mothers/caregivers’ fasting practices.
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    The Effect of Iodine Deficiency on the Academic Performance of School Children in Sodo Town, Southern Ethiopia.
    (Addis Abeba Universty, 2011-05) Eskinder Wolka; Solomon Shiferaw
    Background: There are many reasons for children to underperform at school because of poor nutritional status, below average intelligence, socio-cultural environment and other environmental factors. Iodine deficiency disorder is a public health problem worldwide including Ethiopia and it is the major cause of preventable brain damage in children. Although there are studies on iodine deficiency in the country, its effect on academic performance is not well documented. Objective: This study intended to assess effect of Iodine Deficiency on academic performance of school children in Wolaita Sodo town, Southern Ethiopia. Methods: School based comparative cross sectional study on a sample population of 270children with goiter and 264 without goiter was conducted in a purposively selected primary school in So do town, Southern Ethiopia from Dec. 2010 to Feb 2011. Total students in each class were examined for the presence of goiter and classified based on WHO recommendation. For every child with goiter, next child without goiter was selected from the same class. Pre-tested structured questionnaire was used to collect data on socio-demographic factors and information on students’ academic performance was obtained from the school record. Multivariate logistic regression analysis was employed to see the effect of independent variables on the outcome variable. Ethical clearance was obtained from Research Ethics Committee of School of Public Health, College of Health Sciences, Addis Ababa University. Result: Among children with goiter higher proportion (54.8%) were females and proportion increase with age. Consuming foods (cabbage and cassava) was significantly associated with goiter (AOR=1.9; 95%CI=1.2, 2.9). The odds of scoring low school performance was higher among, children whose fathers were illiterate (AOR=1.9; 95%CI=1.1, 3.5) and absenteeism of more than four days (AOR=1.5; 95%CI=1.1, 2.21). Goiter was significantly associated with low academic performance (AOR=1.8; 95%CI=1.2, 2.5). Conclusion and recommendation: Goiter rate is significantly associated with consumption of goiterogens. Presence of goiter has negative effect on academic performance. Awareness on endemic goiter and its impact on school performance and emphasis on prevention and control by concerned bodies is recommended to alleviate the problem.
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    The Effect of Living Arrangements and Parental Attachment on Sexual Risk Behaviors and Psychosocial Problems of Adolescents in Dessie Preparatory School, Ethiopia
    (Addis Abeba Universty, 2004-04) Solomon Shiferaw; Mesganaw Fantahun
    The family environment is critical in supporting healthy adolescent development. Following the opening of technical and preparatory schools in Ethiopia, it has become necessary for students particularly of the rural areas to move to the nearby towns for the duration of their training. However, whether adolescents who come from rural areas (who might lack consistent adult supervision and exposed to a relatively new environment) are having an elevated sexual-risk taking behavior and more psychosocial problems remain unanswered. In an attempt to respond to questions posed on these differential vulnerabilities of adolescents, a comparative cross-sectional study that examined the effect of living arrangement and parent-teen connectedness on sexual risk behaviors and psychosocial problems of students was conducted in Dessie preparatory school, Ethiopia. A sample of 667 students (512 male and 155 female) completed a pre-tested structured anonymous questionnaire. Qualitative information was obtained from four focus group discussions and sixteen peer-to-peer interviews segregated by gender and residence. We found that living with friends (OR=2.77; 95%CI=1.47, 5.24), alcohol consumption (OR=1.94; 95%CI =1.24, 3.04), lower perceived family connectedness (OR=0.97; 95%CI=0.95, 0.99) and parental monitoring (OR=1.70; 95%CI=1.06, 2.73), older age (OR=4.37; 95%CI=2.11, 9.04), having peer pressure (OR=1.82; 95%CI=1.20, 2.77) and peers who are sexually experienced were associated with increased odds of sexual activity. Having a depressive symptom was associated with female gender (OR=1.96; 95%CI=1.18, 3.23) , lower family connectedness (OR=0.96; 95%CI=0.94, 0.99), lower grade-point average (OR=1.93; 95%CI=1.01, 3.71), and living with friends (OR=3.16; 95%CI=1.66, 5.00), relatives (OR=2.52; 95%CI=1.28, 4.95) or alone (OR=2.15; 95%CI=1.04, 4.46). The study revealed that suicide attempt in the past 12 months was linked to having a history of suicide attempt in the family (OR=2.59; 95%CI=1.09, 6.15) or among friends (OR=4.32; 95%CI=1.88, 9.94), female gender (OR=2.60; 95%CI=1.05, 6.48) and sexual activity (OR=3.00; 95%CI=1.27, 7.11). The overall research finding indicate that living with both biological parents and good parentteen connectedness are related to better psychosocial health and being sexually abstinent. The evidence from this study suggests that parents need to know the continued importance of having good relationship with their adolescents. Youth programs should also address the central role of familial influences (specifically high levels of parental connectedness and monitoring) in protecting boys and girls from unsafe sexual behavior and psychosocial problems. Additional research needs to explore the impact of familial influences on adolescent reproductive and psychosocial health and preferably use longitudinal designs to determine the stability of the observed association over time.
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    Effect of Maternal Characteristics During Pregnancy on Birth Weight of Neonates in Private and Public Health Facilities of Addis Ababa: a Cross Sectional Study
    (Addis Abeba Universty, 2016-06) Samrawit Sebsibe; Solomon Shiferaw
    Background: Birth weight is a good indicator of the newborn‟s chances for survival, long-term health, growth, and psychosocial development. Low birth weight increases the risk for certain adulthood chronic disorders which may increase risk of morbidity and mortality. The present study was intended to determine the effect of maternal characteristics during pregnancy on birth weight of neonates in health facilities. Objective: to determine the effect of maternal characteristics during pregnancy on birth weight of neonates and occurrence of LBW in private and public health facilities of Addis Ababa. Methods: A facility based cross sectional study was conducted on a total of 881women coming to health facility seeking delivery service. The study was performed in selected public and private health facilities of the city from February to march 2016. Data was collected using a structured questionnaire in a face to face interview. Data concerning condition of the mother during time of pregnancy were also collected by reviewing antenatal care (ANC) chart. Epi-Info version 7.0 and stata version 12 was used for data entry and analysis .Univarate analysis was used to measure the magnitude of LBW, Bivariate analysis was used to assess the strength of an association between low birth weight and list of independent variables and test significance of the association. Multivariate logistic regression model was used to identify the important determinants by controlling for possible confounding variables and statistical significance was considered at p-value <0.05. Result :The proportion of low birth weight was 14.7%[95% CI:(12.2,17) and among maternal determinants place of antenatal care visits, level of hemoglobin, gestational age, previous history of low birth weight, pregnancy induced hypertension and weight at third trimester were significantly associated with low birth weight. Conclusion and Recommendation: The proportion of low birth weight was high and most of them were associated with maternal obstetric and medical condition which can be prevented by improvement public health intervention on ANC follow up, and giving more attention for mothers history of past adverse outcome and with medical illness