Browsing by Author "Tassew, Berhan"

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    Assessment of Catastrophic Health Expenditure and Coping strategies of Multi Drug ResistantTuberculosis (MDR-TB Patients in Addis Ababa, Ethiopia.
    (Addis Ababa University, 2023-06) Asmerom, Hiwot; Worku, Alemayehu (Prof.); Tassew, Berhan
    Introduction: The World Health Assembly (WHA) in 2014 adopted the World Health Organization’s (WHO) END TB strategy containing three pillars among which TB affected families’ catastrophic costs to be zero percent by 2030. Tuberculosis (TB), which mostly affects the poorest of the poor, is an example of a disease that can substantially contribute to the disease poverty trap. Even though most countries have aimed to provide the diagnosis and treatment of TB free of charge, a number of studies have found out that patients are still subject to direct and indirect cost due to TB illness and care-seeking, hampering access and putting people at risk of financial ruin or further impoverishment. A number of health care financing schemes have been designed and implemented in Ethiopia. However, the status of catastrophic cost for TB in general and MDR- TB have not been established for the country. Objective: The objective of this study is to assess catastrophic health expenditure and coping strategies of MDR-TB patients in Addis Ababa. Methods: Facility based cross-sectional survey to assess catastrophic health expeditures and coping strategies of patients with MDR-TB was employed at two hospitals in Addis Ababa, the leading of which are known TB care and research. All MDR-TB patients being cared for the disease at the time of the survey were identified from the national TB registry for inclusion. For accurate estimation of costs and other associated factors such as coping strategies all MDR-TB patients being treated in two hospitals known for initiating treatment and follow-up for MDR-TB fulfilling the inclusion criteria were part of the survey. Result: In this survey about 54.3 % of households experienced catastrophic health expenditure more than 20% of their annual household income. To cope with the costs associated with TB care, patients underwent variety of coping mechanisms including about 61 (33%) patients borrowing an estimated average of 5739 birr (108 USD); about 26 (14%) patients selling house properties (mainly household items, land and livestokcs) with the estimated mean market value of the property sold being 21375 birr (403 USD); and about 21 (11.4%) patients undergoing dissavings including withdrawal of money from banks the amoung standing at an average of 55000 ETB (1037 USD). Conclusion: The catastrophic cost of MDR-TB service Addis Ababa cannot be overlooked, despite the free policy. This study has revealed the incidence of catastrophic health expenditure among households affected by MDR-TB is about 54.3%..
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    Assessment of Diabetes Self-Care Practice and Its Associated Factors among Patient on Follow Up at Public and Private Primary Level Health Care in Addis Ababa, Ethiopia
    (Addis Abeba Universty, 2015-06) Tassew, Berhan; Assefa, Demeke(PhD)
    Background: Diabetes mellitus is as one of the rapidly increasing non communicable diseases requiring continuous medical care and mainly life time patient self-care practice to prevent acute and chronic complications. Various factors influence one’s ability to perform diabetes self-care and these factors are not typically stable for all patients. Despite the importance of identifying these factors for health care providers to individualize clinical approaches, as to the current knowledge of the investigator there is no comprehensive assessment and documentation in Ethiopia particularly at primary health care level where these are closer to the people and first line contact point to the patients. Objective: To assess the magnitude of self-care practice and associated factors among diabetic patients who are on follow up at primary level health care (health centers and private clinics) in Addis Ababa, Ethiopia Methods: Facility based, cross-sectional study design was conducted from February to March 2015.A total of 595diabetic patients were selected by systematic random sampling method from both public health centers and private clinics in Addis Ababa. Data was collected based on interview administered method using pre tested structured questioner. Descriptive analysis was done and level of diabetic self- care practice was determined based on the mean value among the self -care practice questions asked. Bivariate and multivariate logistic regression was done to identify factors that were associated with diabetic self -care practice. The odds ratio with 95% CI was used to determine the association. A statistical significance was declared at p value <0.05. Result: Among 595 respondents about 311(52.3%) had good diabetic self-care practice. The mean (SD) age of the respondents was 53.5(14) and 343(57.6%) were male. The presence of co-morbidities (AOR=1.68, 95%CI; 1.07-2.65), having glucometer at home (AOR=2.01, 95%CI; 1.19-3.38), diabetic association membership (AOR = 3.02, 95%CI; 1.30-7.04), follow up in private clinics (AOR=3.05, 95%CI; 1.55-5.97), treatment satisfaction (AOR =1.69, 95%CI; 1.08-2.59) were significantly associated with good self-care practice. Conclusion: The study demonstrated almost half of the patients 52.3% had good diabetic self-care practice but still substantial number 47.7% of respondent had poor self-care. Good self-care was associated with having glucometer at home, diabetic association membership, attending follow-up in private clinics, treatment satisfaction. Advocating and empowering patients regarding the importance of diabetic self-care practice is highly recommended.
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    Increasing the Infection Prevention Coverage in Shoarobit Primary Hospital Northshoa, Ethiopia.
    (Addis Abeba University, 2019-01) Bizu, Abebe; Tassew, Berhan
    Introduction Infection prevention and control is a central component of safe and high-quality service delivery at the facility level. With an inadequate practice of infection prevention, the risk of acquiring infections through exposure to blood, body fluids or contaminated materials in healthcare facilities is substantial.Lack of compliance with infection prevention and control measures has a number of consequences. Adherence to infection prevention and control practices is essential to providing safe and high quality patient care across all settings where healthcare is delivered. Objective – The overall objective of the project is to increase infection prevention and patient safety implementation from 50% to 80% at the end of June2011E.C in Shoarobit Primary Hospital ANRS,Ethiopia. Methods –Facility based pre-post interventional study design was applied in Shoarobit Primary Hospital.To understand the actual processes and problems faced on the ground, an actual state analysis was performed after measuring base line assessment. This allowed us to analyzed and understand the bottlenecks and problem areas within the hospital before implementing selected best interventions. Timeline and budget for capstone project completion:-from January 1st /30 to April /30/2019, with total project budget of 25465 ETB.
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    The Magnitude of Chronic Renal Failure and Its Associated factors among patients at St. Paulo’s Hospital, Addis Ababa, Ethiopia
    (Addis Abeba Universty, 2016-08) Zeleke, Meaza; Tassew, Berhan
    Background: Chronic renal failure is on the rise to cause of morbidity and mortality worldwide. According to the latest world health organization data, renal disease deaths in Ethiopia accounted for 1.47% of total deaths. However, limited study had previously been conducted to show the magnitude of CRF among medical outpatients at St. Paulo’s hospital. Therefore, this study was designed to determine the magnitude of CRF and associated factors on medical outpatient’s patients. Objective: To assess the magnitude & associated factors of chronic renal failure from Medical outpatient department in St. Paulo’s Hospital, Ethiopia Method: This study used an institutional based cross sectional study. A trained nurse using structured questionnaire to interviewed participants. The survey questionnaire was first written in English and then translated into Amharic. 320 patients were interviewed from using a structured questioner and their Medical record revised. Data entry and analysis was done using SPSS statistical package version 20. The descriptive statistics was done. Logistic regression used to check for the presence of association between variables at the 95% confidence level. Result: The overall magnitude of CRF among medical outpatient department patients was 12.2%. CRF all age group likely develop the disease at statistically significant P value < 0.05. CRF cases with kidney infection were 5% greater than without kidney infection (AOR = 0.05, 95% CI 0.02, 0.16, P<0.01). In addition CRF cases with hypertension were 40% greater than without hypertension (AOR =0.43; 95% CI 0.18, 0.97; P=0.04). Conclusion: It is demonstrated that chronic renal failure common in all age group and common among male than females. Chronic renal failure magnitude among patients with hypertension and kidney infection had statistical significance. Chronic renal failure is rising at an alarming rate therefore, we recommend that relevant prevention, diagnostics, and therapeutic measures must undertake in all health facilities
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    The Relationship between Demand for Health Insurance and Civil Conflict in Pastoralist Communities: a case of Liben District in Oromia Regional State
    (Addis Abeba University, 2020-12) Girma, Dera; Dr.Derseh, Anagaw; Tassew, Berhan
    Background: In sub-Saharan Africa, out-of-pocket expenditures constitute approximately 40% of total health expenditures, imposing financial burdens and limiting access to care in some of the poorest countries around the globe. Out of pocket (OOP) health care spending is one of the main sources for financing the Ethiopian health system. To reduce the catastrophic health expenditure the Community-Based Health Insurance (CBHI) scheme, implemented since 2011, is being progressively scaled up and targets informal sector workers and the poor in rural areas.There are a lot of impacts on health due to conflict it is possible to understand those drivers of health status that are direct measures such as mortality and indirect measures that is morbidity. Objective: - This study aims to explore the relationship between demand for health insurance and civil conflict in pastoralist communities in Liben district of Oromia Regional State, 2020. Methods: -a cross-sectional study was conducted by using Systematic random sampling technique among395 householdsthose are the residents of Liben woreda.Each household was interviewed using structured questionnaire. Descriptive statistical methods were used to generate frequencies and the results were presented using table and graphs. Logit regression model were used for data analysis to explore if there is a link between demand for health insurance and the civil conflict. The study wasconducted from May up to June, 2020 with 43,642.50 ETH. Birr budget. Result: Fifty eight percent of the study households were members of CBHI and 75.6% of the households also faced civil conflict.Household with family size of 9-11 were 3.82 times more enrolled to CBHI than those their household family size of with 3-5.The finding of this study indicate (AOR=6.17, CI=3.25, 13.84) those people who did not experience severe losses of income since the onset of the conflict had 6.17 times more enrolled to CBHI than those who experience severe losses of income. Conclusion: -The findings in this study reveal the adverse effect of conflict on demand for health insurance. The enrollment rate of CBHI among non-affected by conflict was higher. The implication of the study finding is that the need to control civil conflicts in order to enhance utilization of health service and provide financial protection using health insurance schemes.