Browsing by Author "Tesfaye, Fikru"

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    Assessment of Feasibility of Implementing Dots in Private Health Facilities in Addis Ababa, Ethiopia
    (Addis Abeba Universty, 2006-06) Lemessa, Bahirua; Tesfaye, Fikru
    Introduction: The MDG of reducing deaths from TB can be achieved, if TB control efforts approach as closely as possible the global goals for case detection of smear positive PTB (70%) and cure rate of 85% or above. Currently Ethiopia’s case detection rate stands 36% since the year 2002, and unless the current efforts are intensified with innovative approaches, such as the involvement of private health care providers in the service delivery, the government with its limited resources can't reach the target set by MDG regarding TB control. Before directly embarking to the new approach, a baseline assessment of private health facilities capacity and willingness to collaborate in TB control programme is of paramount importance. Objective: to assess feasibility of implementing DOTS in private health facilities in Addis Ababa. More specifically to assess willingness of private health facility managers, to asses staffs' knowledge, current practices in diagnosis, treatment and referral of Tuberculosis, and to assess private health facilities’ institutional capacity to provide comprehensive tuberculosis prevention and control services. Methodology: An institution based, cross sectional descriptive study was carried out from November 2005 to June 2006. Feasibility of implementing DOTS was assessed using a structured and pre tested interviewer administered questionnaire and observation checklist to collect the necessary information. A total of 96 health facilities, 96 respondents in charge of the health facilities and 162 health workers were participated in the study. Data were analyzed using SPSS version 10.1 statistical package. Frequency distribution and percentages were used to present findings. Stepwise aggregation of composite variables and their scores to reach to decision for feasibility were used. Feasibility status was rated as poor, fair, good, very good and excellent based on the attained composite score for the indicator variables. Result: The composite score calculated for willingness to implement DOTS is fair (52.1), general TB knowledge is very good (73.1). Structural capacity, availability of basic laboratory materials, general TB related practice and manpower as DOTS center were good with 67.3, 63.9, 61.0, and 60.7 scores respectively, resulting the over all feasibility status good (63.0). xi Conclusion: Implementation of DOTS in private health facilities is feasible, given appropriate DOTS training, technical assistance and supervision. Piloting of the project in limited areas and appropriate facilities is recommended.
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    A Case Study of Non - Farm Rural Livelihood Diversification in Lume Woreda, Oromiya Regional State.
    (Addis Ababa University, 2008-06) Tesfaye, Fikru; Tolossa, Degefa (PhD)
    The objective of this thesis was to examine, on a case study basis, dominant patterns of non-farm rural di versifi cation and identify and analyze the key constraints and opportuniti es as well as the determinants and principal motivations behind non-farm di versi fication. A blend of qualitative and quantitative methods was used where structured household questionnaire survey, quali tative investigation and part icipatory assessment was combined with a review of previous researches on the subj ect at local and developing countries level. Generally, the study showed that rural households in the study Kebeles have divers ified Jl1comes, engage in diversified activities, and non-farm li vel ihood diversification is important. The results indicated that diversification into 10w-entry-batTi er, low-retum actIVItIes predominate. Diversification into high value, high return activities are virtually absent. Micro-enterprise based di versification, while generally limited, is dominated by pettytrade and household-level small-scale activities. Manufacturing comprises a negli gib le part of all non-farm activities. Lack of access to su ffi cient fixed and working capital is a maj or constraint to undertake high-return non-farm activities. Poor infrastructure, especially lack of electricity, is also found to constrain diversification. Diversification among the ' farm-ri ch' was found to be very uncommon. The greatest extent of diversification was amongst the ' poor' and 'medium ' inhabitants. Although tenural security is hard ly a problem, diversification in the study sites is to a great ex tent associated with negative circumstances related to landl essness, especially among the youth. The results also indicated that diversification is significantly influenced by household head education and age. Other household characteristics, though positively or negatively associated with diversification, are not found to sign ificantly influence diversification. This study has also confil1l1ed the empirical findings of many other studies that an increase in income diversification leads to a rise in total income. The impact of proximity to urban center on diversification is fou nd to be negative. lnstitutional ownership of the non-fatm economy lacks wh ile proclamations and regulations on land use and investment gloss over non-faml activities. Di versification among the poor is enhanced by access to natural reso urces as evidenced by sign ificant participation of unemployed and landless persons in river sand and stone quatrying as well as pottery in the study sites.
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    A Case Study of Non - Farm Rural Livelihood Diversification in Lume Woreda, Oromiya Regional State.
    (Addis Ababa University, 2008-06) Tesfaye, Fikru; Tolossa, Degefa (PhD)
    The objective of this thesis was to examine, on a case study basis, dominant patterns of non-farm rural di versifi cation and identify and analyze the key constraints and opportuniti es as well as the determinants and principal motivations behind non-farm di versi fication. A blend of qualitative and quantitative methods was used where structured household questionnaire survey, quali tative investigation and part icipatory assessment was combined with a review of previous researches on the subj ect at local and developing countries level. Generally, the study showed that rural households in the study Kebeles have divers ified Jl1comes, engage in diversified activities, and non-farm li vel ihood diversification is important. The results indicated that diversification into 10w-entry-batTi er, low-retum actIVItIes predominate. Diversification into high value, high return activities are virtually absent. Micro-enterprise based di versification, while generally limited, is dominated by pettytrade and household-level small-scale activities. Manufacturing comprises a negli gib le part of all non-farm activities. Lack of access to su ffi cient fixed and working capital is a maj or constraint to undertake high-return non-farm activities. Poor infrastructure, especially lack of electricity, is also found to constrain diversification. Diversification among the ' farm-ri ch' was found to be very uncommon. The greatest extent of diversification was amongst the ' poor' and 'medium ' inhabitants. Although tenural security is hard ly a problem, diversification in the study sites is to a great ex tent associated with negative circumstances related to landl essness, especially among the youth. The results also indicated that diversification is significantly influenced by household head education and age. Other household characteristics, though positively or negatively associated with diversification, are not found to sign ificantly influence diversification. This study has also confil1l1ed the empirical findings of many other studies that an increase in income diversification leads to a rise in total income. The impact of proximity to urban center on diversification is fou nd to be negative. lnstitutional ownership of the non-fatm economy lacks wh ile proclamations and regulations on land use and investment gloss over non-faml activities. Di versification among the poor is enhanced by access to natural reso urces as evidenced by sign ificant participation of unemployed and landless persons in river sand and stone quatrying as well as pottery in the study sites.
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    Effect of Polygamous Marriage on the Reproductive Health and Nutritional Status of Currently Married Women in Meskan and Mareko District (Butajira) , Southern Ethiopia
    (Addis Abeba Universty, 2002-04) Girma, Aida; Tesfaye, Fikru
    Polygamous marriage is widely practiced in our country. About 14% of currently married women are in polygamous union with marked regional variations. Although polygamy is widely practiced, there are very few studies on its health or economic consequences. A total of 692 currently married women (226 in polygamous and 466 in monogamous union) aged 15-49 were selected in the Meskan and Mareko District southern Ethiopia using multistage systematic random sampling. Qualitative and quantitative methods were used to collect data. The study aimed at examining the effect of polygamous marriage on the nutritional status and reproductive health women. In addition the study tried to compare the two groups of women in terms of their socio-demographic & economic characteristics, decision making power, occurrence of diseases and health seeking behavior, nutritional status and selected elements of reproductive health. Result showed that women in polygamous union were more affected by chronic energy deficiency (CED) compared to those in monogamous union. [AOR (95% CI) : 1.55 (1.08,2.22). However attendance of ANC and use of family planning were not found to be significantly different between the two marriage forms (polygamous and monogamous). Urbanization and literacy of both women and husbands were the factors identified to be affecting both the nutritional status and reproductive health of women. More women in polygamous union were older in age, Moslem, illiterate and had previous marriages compared to those in monogamous union. Polygamous husbands were illiterate, farmers and had more number of children compared to monogamous husbands, which was significant. Although women in polygamous union possessed farmland they were at risk of having farm product insufficiency. On the average women in polygamous union vii compared to those in monogamous union got married earlier (mean age at first marriage 15.8 Vs 16.3), had larger number of pregnancies (5.61 Vs 4.8) and deliveries (5.3 Vs 4.7) where the observed differences were significant. The decision making power were at largely under the husbands'. Women in polygamous union seemed to exercise more decisions making compared to women in monogamous union except for major decisions where the difference became negligible. In conclusion women in polygamous union were at socio-demographic, socioeconomic, nutritional and reproductive health disadvantages. Hence there is a need to discourage polygamy through religious leaders, community participation and involvement of other related sectors. Urban residence and enhancing the educational level of both men and women are the key factors in improving both the nutritional and reproductive health states of women.
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    Health Seeking Behaviour among Individuals with STD Symptoms
    (Addis Ababa University, 1995-05) Tesfaye, Fikru; Kassaye, Mesfin (PhD)
    In Ethiopia and other developing countries the prevalence of STDs and their complications, as well as, resistance to antimicrobials is believed to be widespread. A community-based, cross-sectional study was conducted in Adami-Tullu Woreda during Sept. - Oct., 1994, to estimate the prevalence of STDs, and identify determinants of health seeking behaviour of individuals with STD symptoms. A total of 2240 individuals aged 12-49 years were enrolled in to the study using a cluster sampling method. The two-week prevalence of STD symptoms was 2.5% among individuals aged 12-49 years. Rate of seeking health care among individuals with STD symptoms was 26.8%. Perceived severity of illness, and also lack of money were significant determinants of health care seeking among individuals with STD symptoms, OR=0.23, 95% CI(0.05,0.95), and OR=3.29, 95% CI (1 . 63,6.66), respectively. It is concluded that the majority of individuals with STD symptoms do not seek health care due to high cost of STD treatment services and also because the diseases are not considred severe enough . Expansion of health education and other preventive services targeted at STDs, and free STD curative services to the rural communities, are recommended.
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    Infant and young Child Feeding practice in Predominantly Food Insecure Communitites of Hawassa Zuria Woreda in Sidama Zone, SNNPR , Ethiopia
    (Addis Abeba Universty, 2010-06) G/Tsadik, Achamyelesh; Tesfaye, Fikru
    Background: Inappropriate feeding practices and sub-optimal or no breastfeeding remains the greatest threat to child health and survival globally. Appropriate breastfeeding alone could save the lives of more than 3,500 children every day. Over two-third of deaths are often associated with inappropriate feeding practice occurring in the 1st year of life. Objective: The main objective of this study was to assess and describe feeding practices of infant and young children in predominantly food insecure communities. Methods: A cross-sectional study was conducted to assess the feeding practices of mothers of infants and young children 6-23 months. Dietary diversity, meal frequency, time of introduction to complementary feeding was used to measure optimal infant and young child feeding. And also household food security status measuring question were used to assess the food security status of the households. Result: Breastfeeding is universal in the study area. More than 95% of mothers reported breastfeeding at the time of the survey .Early initiation of breastfeeding is 67%. The majority of mothers 72.7% reported use of prelacteal feeding. More than 95% of mothers reported breast feeding at the time of the survey. The rate of exclusive breast feeding was only 12.4%. The majority of mothers (79 %) introduced complementary feeding too early, before six months of age. Minimum dietary diversity was 16% among infants 6-8 months and 27.7 % among those 9-23 months. Of the children 6-23 months of age 57.6% receive minimum recommended meal frequency. Optimal complementary feeding practice was identified in only 17.2%. Food insecurity with moderate and with severe hunger was 64.5% and 10.5%, respectively. Food insecurity was one of the factors that contributed to sub optimal feeding practice. Maternal education &antenatal care were factors related to infant and young child feeding practices. Conclusion: The prevalence of optimal infant and young child feeding practice was very low and household food security status was one of the factors related to optimal feeding practice. The rate of exclusive breastfeeding was very low. To reduce child morbidity and mortality of the infant and young child, the influence of maternal educational status and antenatal care provision should not be neglected .Integration of infant and young child feeding (IYCF) program with the other routine health service program is important to optimize the feeding practice and also to improve and maintain standard growth and development of the children