Browsing by Author "Yemane Berhane"
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Item Air Pollution in Ethiopia: Indoor air Pollution in a Rural Butajira and Traffic air Pollution in Addis Ababa.(Addis Abeba Universty, 2009-06) Abera Kumie; Yemane BerhaneBackground: About half of the global population and over 70% of countries in the Sub-Saharan Africa rely on biomass fuel as a source of household energy. Over 95% of households in Ethiopia use biomass fuel for cooking. Despite the prevailing major concerns among policy makers and professionals on air pollution, the magnitude of air pollution from domestic and traffic sources in Ethiopia is not well established. Objectives: This thesis attempted to examine the magnitude of air pollution by measuring 24-hrconcentrations of indoor nitrogen dioxide in rural Butajira and daily measurement of ambient carbon monoxide in traffic congested areas of Addis Ababa. Materials and Methods A longitudinal study was conducted to assess the indoor air pollution component between March2000 and April 2002. Concentrations of NO2 were measured cross-sectionally at about three month interval using a modified Willems badge air samplers. Mothers of children in households were interviewed within 24 hours of air sampling about characteristics of fire use, type of fuel and cooking pattern. A Saltzman colorimetric method using a spectrometer calibrated at 540 nm was used to analyze the mass of NO2 in field samples. Roadside traffic air pollution was assessed using portable CO USB data loggers. CO monitor is small electronic equipment installed along 40 roadside sampling points to continuously measure and record CO concentrations at an average interval of 10 seconds for about 10 hours in the daytime. Four on-road traffic light posts were also included to explore the association with the results of roadside CO concentrations. Data were entered and analyzed using EPI INFO version6.02 statistical software. SPSS version 15.0 was further used to run regression analysis. Data from CO logger were downloaded in Excel format. Summary statistics, graphs, charts, and tables were the main tools used to present findings. One-way ANOVA, multiple regression analysis and linear mixed model analysis were also used to sort out any non-random differences in NO2and factors affecting the levels of NO2. Results: Wood, crop residues and animal dung were the main fuels in rural households in the study area. The mean 24-hr concentration of NO2 was 97.3 μg/m3 (95% CI: 95.9, 98.6). The median (IQR)was 68.4 (98.7) μg/m3. Ecology and season have shown differences in the mean concentration ofNO2. Households in the highland areas and during wet season had higher indoor NO2concentration. Biomass fuel type, ecology, purpose of fire use, cooking of at least one type of food in a day, and frequency of fire use were important household variables to explain the variations in the daily NO2 concentration. While ecology was the major predictor, housing physical structures showed little influence on the variation of indoor NO2.In Addis Ababa, the 15-minute mean (+SD) CO concentrations were 2.03 (1.94) and 2.64 (2.53)ppm respectively observed during the wet and dry seasons of 2007 and 2008. The two means didnot vary significantly. There were variations in average CO by time and location of sampling.CO tended to be high in early mornings and in the afternoon rash hours. The CO profiles between roadside and on-traffic post light were, however, not different from each other. Conclusions and Recommendations: About 70% of NO2 Key words: magnitude, NO indoor measurements were more than double the currently proposed annual mean of WHO air quality guideline. Ecology and fire-fuel use household characteristics were important determinants of indoor air pollution. Although average CO concentrations were below the US-EPA and WHO ambient air quality guidelines, there is a strong indication that CO concentrations will exceed or approach these guidelines shortly. Further studies in the description of burden of diseases attributed to indoor air pollution are highly recommended. Interventions targeting at improving the design and utilization of fuel stove efficiency and ventilation are essential. The measurement of traffic particulate matter in high traffic areas is suggested given the high proportion of on-road diesel-engined vehicles in Addis Ababa.2, indoor air pollution, agro-ecology, sources, biomass fuel, variation, Addis Ababa, CO, traffic air pollution, Ethiopia.Item Are Reminder Stickers Effective in Reducing Immunization Dropout Rates?(Addis Ababa University, 1992-03) Yemane Berhane; Joyce PickeringA field trial to assess the effectiveness of a reminder sticker in reducing immunization dropout rates was conducted in two districts of Addis Ababa between October 14, 1991 and January 31, 1992. A total of 703 children were entered into the study. The study population was divided into intervention and control groups according to a randomly determined schedule. The intervention group received the reminder sticker and the control group did not receive the sticker. All other services were identical. A baseline interview documented the socio-demographic and maternal characteristics potentially related to immunization services utilization and revealed no statistically significant differences between the intervention and the control group. The dropout rates were 7.3% and 13.3% in the intervention and control groups respectively. The Relative Risk of being a dropout in the intervention group was 0.55(0.35,0.87) . This difference is clinically and statistically (p<.Ol) significant. Therefore, it is concluded that the reminder sticker is effective in reducing immunization dropout rates. Further, large scale investigations under operational conditions are recommended prior to the routine introduction of stickers into the immunization services.Item Assessment of Barriers To Emergency Contraception Use Among Antenatal Care Seekers of Addis Ababa Health Centers.(Addis Abeba Universty, 2007-01) Etalemahu Dinku; Yemane BerhaneBackground: In Ethiopia where maternal mortality is one of the highest and induced abortion secondary to unwanted pregnancies contributing the highest proportion of maternal deaths using emergency contraception as a backup method can contribute to reduce unwanted pregnancy secondary to method failure, contraception nonuse and also rape. Objectives: the study is designed to assess the knowledge and practice to emergency contraception & also barriers to its use among the antenatal care attendees of Addis Ababa health centers. Methodology: cross sectional institution based descriptive study was conducted in ten health centers of Addis Ababa from September to October 2006. One health center from each ten sub cities of Addis Ababa were included in the study after selecting by simple random sampling technique from each sub city .By using systematic random sampling technique 636 Ante natal care attendees were interviewed with a response rate of 97.8%. Pretested and structured questionnaire was used to collect the data & the data entered to EPI6 and SPSS version 11 used for analysis. Result: Of the 636 women included in the study 148(23.3%) of the women reported that the current pregnancy is mistimed, 90(14.2%) is unwanted and 60(9.4%) reported that they had induced abortion in the last two years. Of the study participants 65(10.2%) had ever heard of emergency contraception. Whereas, only 12(1.9%) of the women had actually used emergency contraception. The preferred places for the provision of emergency contraception were public hospitals 331(52%), health centers 214(33.6%), private clinics 34(5.3%), &pharmacies 33(5.2%). Conclusion: This study showed that the major barrier to the use of emergency contraception is lack of awareness of this contraceptive method & also there is demand for education and provision of emergency contraception methods.Item Assessment of Community Volunteers Home Based Care for Peoples Living With HIV/AIDS in Adama (Nazareth) Town, Ethiopia.(Addis Ababa University, 2006-05) Wondwossen T/ selassie; Yemane BerhaneBackground: Currently, HBC programs for PLWHA are implemented indifferent African countries after the inceptions of the epidemic. However, the designed HBC programs may differ from place to place, that means whether model of community/NGO-based initiative or Hospital-based initiative HBC programs. To implement CHBC program for PLWHA efficiently and effectively, it is necessary to assess the perceptions and contextual experience of home caregivers in the community. Objective: It was to assess and explore the contextual based experience of CVHBC service for PLWHA in oromia region, Adama (Nazareth) town. Methods: Using a qualitative method the perceptions, range of activities, and the major challenges in HBC were described in this study. In-depth interview and FGDs were conducted with VHC givers and their team leaders selected from the ‘six’ HBC-teams in the town. The selection of study-participants was purposive with the aim of obtaining knowledgeable and experienced individual VHC-givers from the team members. Findings: The findings were described in three categories: perception of VHC givers to HBC, range of HBC activities, and challenges in HBC. The result showed that VHC givers perceived that HBC is a continuum of care that help PLWHA by providing basic care according to their needs in their home without any gap between health facilities and HBC. However, they performed a limited range of home care activities that were inadequate care. Furthermore, patients’ poverty, lack of adequate resources, lack of adequate support; presence of stigma, rejection, and abuse; lack of training and supervision by health professional and for caregivers, and lack of health care infrastructures were indicated as the major factors that affect the provision of better quality home care. Conclusion: In general, the HBC process in the study areas were indicated that it was unorganized and not coordinated, which means there was lack of professional support as well as lack of adequate materials and financial support besides the lack of all stakeholders’ participations, lack of adequate HBC infrastructure and the absence of communications among the organizations. Further studies, however, are recommended for better understanding of these major challenging issues in HBC of PLWHA, using a combination of qualitative & quantitative research methods.Item Assessment of Effect of Household Health Extension Package on Pretension of Trachoma in Kola Tembien, Tigray Region, North Ethiopia.(Addis Ababa University, 2006-06) Yohannes Tewelde; Yemane BerhaneBackground: Tigray is one of the first regions in Ethiopia that implementing health extension package program at household level. In 2002/2003 EC this program strengthened and expanded in all woredas of the Region. Kola Tembien woreda, which is our study area, has 4000 households which are graduated and involved in the program for the last 3 years. Objective: To assess the impact of having HEP on active trachoma prevalence, and identify challenges, achievements and factors for sustainable implementation of the program. Methodology: This is a quasi-experimental study conducted in Kola Tembien District. Using systematic random sampling 310 households from intervention and 621 households from non-intervention households were interviewed in 31 randomly selected villages. Ophthalmic nurses use a simplified clinical grading to assess stages of trachoma while environmental technicians assessed risk factors of trachoma. Qualitative data were also collected through FGDs to identify community perception on household HEP program and the relation within all stakeholders, major achievements and challenges, and mechanisms used to sustain the program. Results: Prevalence of active trachoma in less than ten years in household with HEP is 17% and in households without HEP is 35.5%. Prevalence of active trachoma is lower among households with HEP [OR: 0.37 95% CI, 0.22-0.63]; who have latrine and used properly [OR: 0.62 95%CI, 0.38-0.95]. who washed face frequently [OR:0.10 95%CI, 0.05-0.18], who used soap to wash face [OR:0.37 95%CI, 0.15-0.94]; and clean face [OR:0.40 95%CI, 0.29-0.57] but higher in those who dispose waste to disposal pit [OR:1.43 95%CI, 1.04- 1.95] and distance to fetch water less than one kilometers [OR:1.47 95%CI, 1.00-2.15]. The FGDs suggested that households who implement the HEP program prevented eye diseases and eye irritation and they internalize importance of the HEP program. Conclusion: Health extension package has significant effect in prevention of active trachoma and has to be expanded to households who have not implemented the HEP program. Further sensitization and training of woreda and kebele councils, health workers and CHW and make understanding with stakeholders like Agriculture, Education, Water development and Cooperatives is necessary to enhance expansion of the program.Item Assessment of Factors influencing Utilization of Post Abortion Care in Public Facility in Agaro Town Jimma Zone, Oromiya Regional State, Southwest Ethiopia.(Addis Abeba Universty, 2006-06) Medhanit Wube; Yemane BerhaneBackground: Unsafe abortion is one of the five major causes of maternal mortality in Ethiopia. It is estimated that between 10 and 50% of the women who undergo unsafe abortions need medical care for complications. The use of post abortion care services is believed to low. Objective: The objective of this study is to determine factors associated with utilization of post abortion care service in public health facility in Agaro town administration, Jimma zone, Oromiya Regional State. Methods: Across sectional comparative study is conducted from January to February 2006. Study subjects were women drawn childbearing age (15-49 years) in Agaro town. Women had history of abortion in the last 5 years were identified by household census. Sample of women were drawn from all Kebele proportional to population size. Relevant data were collected using face to face interviewing of women in their home Results: Abortion was reported by 310 (17%) of those pregnant in the last five years. Maternal education and marital status were significantly associated with PAC service utilization in public facility. Women with at least read and write are more likely utilize post abortion care service in public facility compared to those illiterate.{(OR(95%CI)=3.55(1.2,9.75)} But the association is decreased as educational level increases. Married women are more likely to utilize post abortion care in public facility compared to those unmarried women {(OR(95%CI)= 2.21(1.08, 4.17)}.Women with induced abortion are less likely utilize post abortion care in public facility compared to those with spontaneous abortion {(OR(95%CI)=0.46(0.27,0.97)}. Women’s attitude to wards general and post abortion care in public health facility has shown significant difference between women utilized post abortion care in public facility compared to not utilized {(OR(95%CI)= 2.23 (1.15, 4.13) Vs 3.36 (1.77, 6.38)}. Conclusion: Socio-demographic factors such as education and marital status of women, stigma attached to induced abortion morbidity, poor attitude of women towards general and post abortion care in public facility are preventing women from utilizing PAC in public facility. Empowerment of women, improving health management system, training programs in order to sensitize health care providers about the context and realities of women who obtain unsafe abortions are recommended.Item Assessment of Obstetric Needs in Emergency obstetric Services, Addis Ababa 2006.(Addis Abeba Universty, 2007-07) Mesrak Nadew; Yemane BerhaneIntroduction: Obstetric needs are health problems that necessitate EmOC services or interventions. The sum of incidence of pathologies (obstetric emergencies and complications) is taken as an indicator of obstetric need. The assessment of UON has never been articulated in studies conducted on EmOC in Ethiopia. This study identifies gaps and deficits in MOI for AMI in comparison to the existing need. Objective: To assess UON in Emergency Obstetric services in hospitals of Addis Ababa. Methodology: A Cross-sectional study was conducted from July-September 2006 on 625 mothers who delivered with Absolute Maternal Indication (AMI), Major Obstetric Intervention (MOI) and non-AMI in 19 hospitals of Addis Ababa 6 Public and 13 Private. The data collectors were Midwives working in the Obstetric units of the hospitals. They were trained on pre-tested structured formats. Data quality was ensured through continuous supervision. Results: A total of 666 MOI were conducted and Caesarean section took the largest share 531(80.5%). The C/S rate per 100 births was 5.3%. The number of women with AMI was 367 where majority had Obstructed Labour 145(39.5%) The number of MOI done without AMI was 354 where majority were done for previous C/S 143 (40.4%) and foetal distress 127(35.9%). The odds of C/S in Private hospital 1.77 (1.09, 2.90) and daytime admission 1.61 (1.01, 2.57) was significantly higher than in public hospitals and night time admissions. The results of the new born showed that 538(92.4%) were born alive and discharged alive. Some of the mothers 39(5.4%) had complication after delivery mainly sepsis and hemorrhage with 4 resulted in maternal deaths which occurred in public hospitals. The vi average hospital stay in days was 3.9 and 7.1 for private and public respectively where the difference of means was statistically significant (p=0.000). Nearly 9 out of 100 births which needed major obstetric intervention in Addis Ababa during the period of data collection (July17-September 17, 2006) did not receive it. In other words the deficit of MOI/AMI per 100 births is 9.46%. Conclusion: The UON in Addis Ababa was higher than urban figures of other countries that underwent the UON exercise. The rural situation is expected to be worse than the capital where better socioeconomic indicators and several health facilities exist. If purely preventive measures are out of favor, the move towards managing maternal health through a hospital network still seems in its infancy. Finally, this study should not remain one more theoretical study, but should pave a way for practical and effective decisions to be taken which will through advocacy and resource mobilization allow the country to move out of the poverty of the maternal health services. Words used: Unmet Obstetric Needs, Major Obstetric Intervention (MOI), Absolute Maternal Indication (AMI), non Absolute Maternal Indication (non AMI), Caesarean Section (C/S), Emergency Obstetric services.Item Assessment of Quality of Service Delivery in Immunization in Western Gojjam, Amhara Region Ethiopia.(Addis Ababa University, 1997-12) Teshome Teklu; Mesfin Kassaye; Nigussie Taffa; Yemane BerhaneMany developed and developing countries have achieved the 1990 uel target. However ,few countries, like Ethiopia, have neither achieved nor maintained it. The coverage in Western Gojjam in 1995\6 for three doses of DPT was below 40%, far below the coverage level expected to bring morbidity and mortality reduction. A cross-sectional health facility based study to assess the quality of immunization service delivery using qualitative and quantitative methods was conducted from March to May 1997 in 10 districts of Western Gojjam zone. All hospitals and health centers in the zone and randomly selected health stations were included in the study . Exit interview, observations of client-provider interaction, document review, inventory of equipment, interview with service providers, and focus group discussions with service providers and mothers were the techniques utilized. Though the geographical access is satisfactory, vaccine shortage, lack of incentives and transport facilities , delayed replacement of needles and syringes were among the structural factors that affect the quality of service delivery , while poor communication, lack of aseptic procedure, lack of proper screening, weak supervision, and absence of EPI target disease surveillance were weakness in the process of service delivery. More than 98 % satisfaction rate was reported by clients of the service duringthe exit interview on the dichotomous scale. But the finding was not consistent with the FGDs and the specific items addressed to assess the satisfaction. Therefore, it is concluded that quality of service delivery in immunization was not satisfactory and hence need improvement to have an effect on coverage and mortality and morbidity reduction targets.Item Child Prostitution in Bahir Dar.(Addis Ababa University, 1998-12) Tesfaye Ayalew; Yemane BerhaneIn Ethiopia, very little is known about prostitution In general and about child prostitution in particular. The purpose of this research is to determine the magnitude of child prostitution and to identify factors associated with and problems of child prostitution. A cross-sectional study design was utili zed. Data were collected using structured questionnaire. Data entry and analysis was done using Epi Info version 6 statistical software. A total of 650 commercial sex workers were interviewed. Eighty eight (13.5%) were below the age of 18 years at the time of data collection and 268(41.2%) at the time of joining prostitution. Poverty, disagreement with family and peer influence were the major reasons reported for prostitution. Child prostitutes were more likely to have STDs than adult prostitutes [OR= 1. 68; (95% C.l.) 0.95,2.96]. Condom use was poor among child prostitutes compared LO adult prostitutes [OR=1.67; (95%C.I.) 0.97,2.87]. Child prostitutes were likely to be victim of physical violence [OR= 1.93; (95% C.l.) l.l 8, 3.15] and sexual violence [OR=2.20; (95% C.l.) 1.36,3.35] compared to adult prostitutes. More child prostitutes observed having the ambition to rejoin their family. It is recommended that strategies need to be developed to rescue child prostitutes from on-job violence ,to minimize entry in prostitution and to establish a rehabilitation program for those interested to discontinue prostitution. Further study is required to more deeply understand the cause and effect of child prostitution.Item A Community Based Study of Health Related Problems among Adolescents in Awassa Zuria Woreda, Southern Ethiopia(Addis Abeba Universty, 1995-05) Solomon Mengeste; Yemane BerhaneThe prevalence and determinants of substance use (alcohol, khat, cigarette), mental illness, suicidal attempt, STDs and teenage pregnancy among adolescents aged 10-24 years have not been well documented in the country. A community based cross - sectional study was conducted in Awassa Zuria Woreda, southern Ethiopia from November to December 1994 G.C. A total of 1953 adolescents were included in the study . Data were collected using questionnaire by trained interviewers. The likelihood of substance (alcohol, Khat, Cigarette) use on average was at least two times higher (p<0.05) among adolescents who reported history of run away from their family and police arrest. Mental illness, suicidal attempt, STDs and teenage pregnancy were found to be more likely to occur among adolescents who use one or more of the substances than others. The older adolescents in general were found to be more likely to be exposed to all of the heal th related problems studied. Risk factors identified for substance use and association of substance use with the health related problems among adolescents were observed in this study. The level s and the interactions observed between the adolescent risk behaviours and health related problems indicate the need to set an immediate intervention programmes .Item Comparative Study of Drug Resistance in Smear Positive New and Re-Treatment Cases of Tuberculosis in the Somali Region, Ethiopia.(2002-04) Abdurahman Said; Yemane BerhaneAn institution-based retrospective cohort study was carried out in four hospitals located in four zones of the Somali Region to assess the magnitude and pattern of resistance to 5essential anti-tuberculosis drugs currently in use and to determine the risk factors associated with drug resistant TB.A total of 190 patients were enrolled consecutively between March and August, 2001; culture was performed on 187 specimens and 127 of these (41 re-treatment and 86 new cases)underwent drug susceptibility tests (DST) to five first-line anti-tuberculosis drugs (isoniazid,rifampicin, ethambutol, streptomycin and thioacetazone) at the Ethiopian Health and Nutrition Research Institute in Addis Ababa. Serology for HIV was done on 112 of the 127 patients with MTB isolates which were included in the analysis. Resistance to any drug was 17.4% in new cases and 46.3% in previously treated cases. MDRTBwas seen in 1.2% and 10% of the new and re-treatment cases, respectively. Double drug resistance ranged between 1.2%-2.3% and 7.3-14.6% for new and re-treatment cases, respectively while triple and four-drug resistance were 1.2% for new cases and ranged between 5-7.5% in re-treatment cases. Resistances to all the 5 drugs were 1.9% and 7.3% in new and re-treatment cases, respectively. The differences in resistance level between the two groups were statistically significant at the P<0.01 level. Ethambutol resistance of 2.3% in new cases and 12.2% in re-treatment cases were the highest recorded in the country so far. Resistance to rifampicin is increasing in Eastern part of Ethiopia. The overall HIV sero prevalence was 6.3%, lowest in Sub-Saharan Africa; it was 4% in new cases and 11.4% in the old ones but the difference did not achieve significance due to a small sample size. The prevalence of drug resistance in general and MDR-TB in particular are high in the Somali region. Regulating the private sector and strict control of drugs in the black market, active involvement of the public, the private sector and others concerned, and considering alternative regimens for those harboring resistant strains are suggested for averting the dangers of wide spread MDR-TB.Item Determinants and Causes of Adult Mortality in Butajira.(Addis Abeba Universty, 2000-12) Kidest Lulu; Yemane BerhaneInformation on adult mortality is essentially non-existent in Ethiopia as in the rest of subSaharan Africa. This nested case-control study was conducted with the aim of assessing sociodemographic and behavioural factors associated with adult death in Butajira, Ethiopia. All deaths in the age-group 15-49 years during 1995-99 were taken as cases and unmatched controls of age 15-49 years were selected randomly from the computerized demographic surveillance database. Data were collected by lay interviewers using a simpli fied verbal autopsy questionnaire. Crude and adjusted odds ratio with 95% confidence interval were calculated to determine associations. Causes of death were diagnosed using an "expert algorithm" programmed into a computer. A total of 515 deaths and 1507 controls were interviewed. The major determinants of mortality identified are age-groups 30-39 and 40-49 years (OR 2.99, 95%CI 1.91-4.71 and OR 4.01, 95%CI 2A9-6A6), male sex (OR 1 A6, 95%CI 1.09-1.95), living in a rural lowland area (OR 1.54, 95%CI 1.03-231), single marital status (OR 1.63, 95%CI 1.13-2.35), having no educated person in the family (OR 1.91 , 95%CI 1.11-3.29), being unemployed (OR 1 AO, 95%CI 1.01-1.82), and poor and very poor perceived economic status (OR 1.97, 95%CI IJ 1-2.94 and OR 2.98, 95%CI 173-5.13). The major causes of death observed were acute febrile illnesses (25.2%), liver diseases (11.3%), diarrheal diseases (11.1 %), tuberculosis (9.7%) and HIY/AIDS (7A%). Communicable diseases accounted for 60.8% of the deaths. The factors associated with mortality and the high level of mortality from communicable diseases reflect the poor socioeconomic development of the country and inadequate coverage as a whole in education, health and poverty alleviation . Therefore, eff0I1s should be directed at planning and implementing cost-effective interventions to decrease morbidity and mortality particularly from communicable diseases. Emphasis needs to be given also to poverty alleviation programmes.Item Does Community-Based Distribution (CBD) of Pills increase the Contraceptive Prevalence rate? A Comparative Study Between CBD and Non-CBD Areas in Central Tigray, Northern Ethiopia.(Addis Ababa University, 1997-12) Tsegay Legesse; Negussie Taffa; Yemane BerhaneA retrospective cohort study was undertaken to assess the effectiveness of Community-Based Oistribution (CEO) of Family Planning services as a strategy to increase Contraceptive Prevalence rate (CPR) in Central Tigray. Thirty "Tabias" each from the CBO and the non-CEO areas were chosen; 683and 676 panicipants from CEO and non-CBO areas respectively were interviewed. Men and women panicipated in the study were 672 and 687respectively.The CPR was fOllnd to be [4.4% in CBO and 4.4% in non-CEO areas (OR = 3.67; 95% CI = 1.88/ 5.7). Eighty nine percent of the women in CBO and 82.7% in non-CBO areas (OR = 1.70; 95 % CI = 1.07, 2.7), and 94.1 %of the men in CBO areas and 87.5 % in non-CBO area (OR = 2.26; 95 % CI= 1.26, 4. I) knew at least one method of modem contraception. Similarly,87.3% of women in CEO areas and 79.5% in non-CBO areas (OR = 1.77;95% CI = 1.15, 2.73), and 92.9% of the men in CBO area and 84.8% of men in non-CBO areas (OR= 2.33; 95% CI = 1.4, 4.0) approved the use of family planning. Among the current non-users who knew about modem contraceptives,86.4% of the women in CBO and 80.5% in non-CBO areas had a future intention to use them. Reasons for non-use in both groups were need for more children, lack or low knowledge, and naturally spacing. Reason for dis continuation of modem contraceptives use in CBO areas were need to get pregnant, lack of method choices, and health concerns. With these findings we coneiude that CBO was effective in raising knowledge, positive attitude towards FP and CPR. We recommend that the CBO program has to be strengthened and extended to other villages of the region. IEC with emphasis on mechanisms to encourage inter-spousal communication about FP should be expanded and adequate method mb: es must be available to CBO agents cognizant to their level of training.Item The Effect of Maternal Work on the Nutritional Status of Mothers and Children(Addis Abeba Universty, 1999-07) Samrawit Negussie; Yemane BerhaneMaternal work has been seen to have two contradictory effect on child nutrition-via increasing income and decreasing time available in the household . The net effect will depend on the decision making pattern of the household and the adequacy and quality of child care substitute . A sample of 422 mothers and their children were selected In the rural town of Butajira through household survey to exami ne the effect of working for profit/ gain on nutritional status of both the mother and children. Result showed that children of working mothers had a better nutritional status [OR(95%CI) 0 . 38 (0 . 19,0.76] however working mothers themselves were at a risk of being malnourished compared to non-working mothers (95%CI): 1. 62 (1. 05, 2 . 5). The decision making pattern and the child care substitute did not show any effect on the overall result . In the attempt to improve the nutritional status of children the encouragement of maternal involvement in income generating activities is indispensable. Working mothers in the informal work needs to be considered in any nutritional intervention programme as they are likely to be at risk of being malnourished .Item Exposure Assessment to Indoor Smoke Pollution in Rural Ethiopia.(Addis Abeba Universty, 1999-12) Berhanu Eshete; Yemane BerhaneVery little effort has been made in Ethiopia to assess the effect of indoor air p8l1ution at a community level. The aim of the study was to assess exposure to indoor air pollution at a house hold level and find out the feasibility of using questionnaire in determining exposure level for indoor air pollution . Cross sectional study design was utilized. Data were collected using structured questionnaire, in-depth interview with key informants and child movement recording . Data entry and analysis was done using Epi Info version 6 statistical software. A total of 600households from the three study areas (rural high land , rural lowland and town)were assessed . Three hundred thirty four(55 . 7%)of the households had high exposure level to indoor smoke . Rural households were less likely to have adequate smoke clearance compared to urban households (OR~O . 3 ; 95% CI~O . 16 , 0 . 54) . Being Muslim , married , Mother illiterate and and low economic status were less likely to De in the low exposure status with adjusted OR(95%CI) of 2 . 24(1.39, 3. 54) , 0 . 41(0 . 18 , 0 . 82) , 0 . 36(0 . 2 , 0 . 66)and0 . 34(0 . 22 , 0 . 54) , respectively . The main source of indoor smoke was biomass fuel used by 98 . 5% for cooking and 29 . 6% for heating. The majority (94. 9%) were using open type of stove without flue or chimney . The median (SO) of exposure time by the interview and observation was found to be 180(202) and 125(148) minutes, respectively. From this we conclude and recommend that bio mass fuels are the principal sources fo r the indoor smoke, the poor socio-demographic and environmental factors expose children to indoor smoke and collecting information about exposure time of under five children using interview and observation methods has no statistically significant difference. Using cleaner fuels, improving social, economic , cultural and environmental conditions could improve the exposure level to indoor smoke .Item Factors Influencing Children's Nutritional Status in Adami-Tulu Woreda.(Addis Abeba Universty, 1996-05) Abera Hunde; Tadesse Alemu; Yemane BerhaneEthiopia is one of the developing countries where malnutrition and communicable diseases represent the major health problems. A community based cross sectional study was done in Adami-Tulu Woreda to determine and identify factors influencing nutritional status of children between 6 and 59 months of age in rural communities. The result showed a high prevalence of malnutrition. Out of 568 children who were involved in the study, 255 (44.9%) were well-nourished and 313 (55.1%) malnourished, 264 (43.3%) under-weight, 210 (37%) stunted and 103 (18.1%) wasted. The rates of sever and moderate malnutrition were highest when using weight-for-age scale. Age of the child, ethnicity, availability of latrine, family income, birth order, frequency of feeding and weaning age were significantly associated with nutritional status. As the prevalence of malnutrition among the children was found high and it is recommended that nutritional intervention aiming at altering the local factors be implemented all relevant social sectors in a coordinated way.Item Health and Social Problems of Street Children in Nazareth Town.(Addis Ababa University, 1995-05) Yemane Beyene; Yemane Berhane; James FarrowThe exact number of street children in any givencountry is not known. To determine the number, health,and social problems of the street children, a crosssectional survey was conducted in Nazareth town, southeastern Ethiopia, from November to December 1994.Accordingly 5138 street children were counted during a one day census , by means of a systematic sampling. 597 subjects were selected into the study, 526(88.1%) Males and 71(11.9%) Females. The age ranged from 5 to 18 with mean age of 12.9 and SD of 3. 16. (41.2%) of the children left their families when they were 10-14 years old, and 30 . 7% were separated in early childhood (0-4 years). Only (1 8 . 3%) were attending school currently, (54.6%) were children "on" the street and t he rest (45 . 4%) were "of" the street children, (67.2%) of the children eat at least twice daily, (14. 6%) of the children reported the use of at least one of the substances like Alcohol ,cigarette, and chat. (61.6%) of the children reported an illness during the survey. The major health complaints were abdominal pain, cough and chest pain, eye and ear problems, headache and leg ulcer . This survey indicated that substance use, police arrest, sexual intercourse and STDs were reported more frequently among the "of " the street children . In conclusion, the street children have complex social and health problems which need to be addressed utilizing a multisectoral approach.Item Health and Socio-cultural Problems of Women in Rural Butajira(Addis Ababa University, 1998-12) Yegomawork Gossaye; Yemane BerhaneStudies on the social and cultural problems affecting the health of women is rare in Ethiopia. This study illustrates the common socio-cultural problems influencing the health of women and the women's perception towards health and illness in rural Butajira. Qualitative and quantitative methods were employed to develop the data collection instrument and actual collection of data, respectively. A total of 675 randomly selected rural women participated in the study. Over 94 percent of women are illiterate and only 8.7 percent of girls are sent to school. The mean working hour for rural women in Butajira is 15 hours. Very high proportion (96.6%) women are victims ofFGM. The decision making power of women at a house hold level is low. Women have almost no access to information, about 88 percent of them never listened to the radio for the last six months. About 97 percent of women reported that they are suffering from some kind of infectious, obstetrics or mental illness at the time of the survey. Punishment from God, lack of nutritious food, exposure to cold, evil eye and evil spirit possession were the major perceived causes of illness. The participants mostly use herbal medication during sickness or buy drugs with out consulting health workers in response to illnesses. They give high regard to traditional healers, witchcraft and religious leaders to solve health problems. The women by large have no idea on how to promote health except that they resume individual or group prayer. Therefore, it is concluded that women in rural Butajira are surrounded by traditional taboos and social problems affecting health. In order to improve the situation of women the health service strategy needs to be devised after considering what women believe, what they actually do and need. Such strategies should be based on local problems and the involvement of Locally accepted healers.Item Health and Socio-Cultural Problems of Women in Rural Butajira.(Addis Ababa University, 1998-12) Yegomawork Gossaye; Yemane BerhaneStudies on the social and cultural problems affecting the health of women are rare in Ethiopia. This study illustrates the common socio-cultural problems influencing the health of women and the women's perception towards health and illness in rural Butajira. Qualitative and quantitative methods were employed to develop the data collection instrument and actual collection of data, respectively. A total of 675 randomly selected rural women participated in the study. Over 94percent of women are illiterate and only 8 . 7 percent of girls are sent to school. The mean •",or "'ing hour for rural women in Butajira is 15 hours. Very highly: proportion (96 . 6%-) women are victims of FGr'l. The decision making power of women at 3. House bold leveJ. is10\.\1 . Volume has almost t no access to information D, at YJut 88 percent of them never listened to the radio for the last six months. About 97 percent of women reported that they are suffering from some kind of infectious, - obstetrics or mental illness at the time of the survey. Punishment from God, lack of nutritious food, exposure to cold, evil eye and evil spirit possession were the major perceived causes of illness. The participants mostly use herbal medication during sickness or buy drugs without consulting health workers in response to illnesses. They give high regard to traditional healers, witchcraft and religious leaders to solve health problems. The women by large have no idea on how to promote health except that they resume individual or group prayer. Therefore, it is concluded that women in rural Butajira are surrounded by traditional taboos and social problems affecting health .In order to improve the situation of women the health service strategy needs to be devised after considering what women believe, what they actually do and need. Such strategies should be based on local problems and the involvement of locally accepted healersItem Health Problems and Service Preference of School Adolescents in Addis Ababa With Emphasis on Reproductive Health.(Addis Abeba Universty, 2000-12) Frehiwot Berhane; Yemane BerhaneA cross-sectional descriptive survey to assess adolescent’s health related problems and service utilization pattern and preferences was conducted from January to December 2000 in randomly selected school adolescents in Addis Ababa. Data were collected using an anonymous self-administered questionnaire. A total of 2647 high school students from 13 schools participated in the study. Of these 1177(44.5%) were males and 1470(55.5%) were females. Five hundred fifty eight (21.9%) adolescent reported to be sexually active. Condom use during the last intercourse among the sexually active was 72.9%. Forty-four (7.9%) of the sexually active adolescents claimed to have had symptoms of STD in the past three months. Among the sexually active female, 32 (5 .7%) claimed to have been pregnant out of which 22 (68.8%) ended up in abortion. Overall 1045 (39.5%) of the students reported the use of at least one of the substances (alcohol, cigarette, kaht or cannabis);1229(51.6%) had mental distress, and 284(10.9%) had attempted suicide in the past. Seven hundred eighty three (32. 3%),523(24.5%) and 610(25.9%) of the adolescents claimed that the existing reproductive health services are inaccessible, unaffordable or unacceptable respectively for adolescents. For 1852(72.0%) of the adolescents feeling of embarrassment at seeking reproductive health service was the reason for not utilizing existing service while 1738 (67.8%) claimed it was for fear of being seen by parents or others. The majority 1402 (57.0%) claimed that service fees are unaffordable for adolescents. Five hundred fifty two (21.6%) preferred to have ARHSwith in the existing system but with special approach to adolescents by service providers, while 1070(41 .9%) in separate setting outside of the existing service including youth centers. It was concluded that adolescents have specific health problems, risk taking and careseeking behavior that have not been well addressed by the existing health services. Hence recommended that organizing youth friendly RHS be given an urgent attention by decision makers, public health planners and health care providers at all levels.