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    Youths' Transition to Adulthood in Oromia Region, Ethiopia: Reproductive Endeavors and Successes
    (Addis Ababa University, 2024-03) Tariku Dejene; Eshetu Gurmu (PhD)
    The transition from childhood to maturity is a journey, not a destination. It is a time of exploration, growth, and transformation. Young people's transition to adulthood entails managing a number of changes as they choose their future paths and adjust to these life-changing events. As a result, it is a crucial phase in human development wherein youths transition from childhood and take on new roles and responsibilities. The study differentiates between reproductive endeavors and the reproductive successes of youths as they can have different implications for youths. By considering the life course theory as a framework, the study attempted to assess youths' reproductive endeavors and success in the Oromia National Regional State of Ethiopia. The interest in the life course theory is to investigate how people's lives progress over time. The theory contends that various factors shape people's lives, including individual characteristics, familial and social networks, and the historical and cultural context in which they live. The study employed a mixed-method approach; while the quantitative data were drawn from 2005, 2011, and 2016 Ethiopian Demographic and Health Surveys, the qualitative data were collected from youths residing in the Oromia regional state using an in-depth interview. The study used a variety of analysis techniques. First, sequence analysis was employed to identify the reproductive trajectories of youths and make an inter-cohort comparison of these trajectories on three different synthetic cohorts. Secondly, flexible parametric survival models were fit to explore the factors that shaped the reproductive trajectories. Thirdly, a decomposition analysis was employed to explain the gender gap in the reproductive transition of youths. Finally, the qualitative data were analyzed using thematic analysis using MAXQDA software. First, the study focused on identifying the patterns of reproductive trajectories among youths in Oromia, Ethiopia. Three reproductive role indicators were utilized, and four different typologies of reproductive trajectories among the youth were identified. The study's findings are noteworthy, as they suggest that changing norms in reproductive behavior are occurring among less educated youth. Thus, the study provides valuable insights into the changing patterns of reproductive behavior among youth in Ethiopia and highlights the importance of education and targeted interventions in promoting positive reproductive health outcomes. XII Secondly, the timing and intensity of reproductive transitions among youths and their correlates in Oromia, Ethiopia, were analyzed. The use of data from multiple demographic health surveys spanning over a decade allows for a robust analysis of trends and changes in reproductive patterns. Regardless of the changing pattern in the reproductive transition of youths, the study finds that family formation takes the major share of the transition. However, early premarital sexual initiation is rising as a competing risk to the marital union over time, which is considered as the main precursor to social ills such as early and single parenthood. The persistence of a gender gap in reproductive transition highlights the need to address the excessive risk female youths face. Education, although not found to reduce the risk of sexual debut significantly, remains an essential tool for empowering youths, particularly females, to make informed decisions about their reproductive health. Thus, the study provides insights into the reproductive behavior of youths, underscoring the importance of policy revisions and interventions that consider these gender gaps in reproductive transitions to encourage positive reproductive transitions. Thirdly, the study investigated the factors contributing to the gender gap in the reproductive transition of youths using data from the 2011 and 2016 Ethiopian Demographic and Health Survey. The results show that premarital sex prevalence increased with a delay in age at first marriage among youths. The gender gap in reproductive transition was found to be triggered by both compositional and structural effects of covariates such as education, modern contraceptive use, and media exposure. The study recommends addressing structural components in addition to reducing inequalities in education, media exposure, and deprivation between male and female youths to close the gender gap in reproductive transition. Finally, the study investigated the perception of youths about a successful transition to adulthood, the challenges, and the required social support to overcome the challenges. The study's findings suggest that reproductive transition is a crucial indicator of a successful transition to adulthood. The challenges identified, such as unpreparedness, health risks, and erosion of cultural norms, should be addressed through policies and strategies that promote access to accurate information and resources and emotional and financial support. Additionally, the importance of community and family involvement in supporting young people during their reproductive transition is highlighted.
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    Assessment of Determinants of Perinatal Mortality among Public Hospital Deliveries in Addis Ababa, Ethiopia: An Unmatched Case Control Study
    (Addis Ababa University, 2023-10) Micky Birhanu; Tariku Dejene (M.SC.)
    Background: According to accepted terms, the period known as the perinatal period begins at week 22 of pregnancy and lasts until day seven following delivery. However, different nations' legal systems have varying definitions of late fetal death (stillbirth). Late fetal death is seen as occurring at and after the 28th gestational week in the majority of poor nations, notably Ethiopia as well as in some affluent ones. Even though there has been a marked decline in fatality among babies of post-neonatal age in Ethiopia, the rate of infant deaths during the perinatal period continues to be substantial. This research has identified the determinant factors and causes of perinatal mortality in Addis Ababa, Ethiopia. Objective: The aim of this study is to assess determinants of perinatal mortality among public hospital deliveries in Addis Ababa, Ethiopia. Method: A hospital based unmatched case control study was carried out. In all, 318 samples (106 cases and 212 controls) were collected from Addis Abeba's three government hospitals. Cases were perinatal deaths and controls were live births and neonates who were discharged alive from the hospital and did not die before the age of 7 days. The study period was from 1st March – 31st May. For data input and analysis, Epi-Info version 7.0 and SPSS version 23 were utilized. Logistic regression model was utilized to identify the variables that are determinants of perinatal death. Results: Obstetric complication occurred in 42.5% of cases and 18.9% of controls. Obstetric complications (AOR 4.399; 95%CI (2.288 - 8.456)), very low birth weight (AOR 5.033; 95%CI (1.499 - 16.896)) and low birth weight (AOR 14.479; 95%CI (4.484- 46.749)) were the determinants of perinatal mortality that increase risk of perinatal death. Whereas, education (AOR 0.135; 95%CI (0.037 - 0.492)) and partograph use (AOR 0.374; 95%CI (0.176 - 0.797)) were found to be protective factors for perinatal mortality. Conclusion & recommendation: The determinants of perinatal mortality in the study area were largely educational status, obstetric complications, low birth weight and partograph use. Some of them can be avoided by examining pregnant women early on and monitoring them after delivery.
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    Demographic and Socio-Economic Determinants of Fertility and Implications among Married Women in Bishoftu Town, Oromiya, Ethiopia
    (Addis Ababa University, 2024-01) Milkessa Birhanu; Terefe Degefa (Prof.)
    The main objective of the study was to investigate the demographic and socio-economic determinants of fertility and implications among married women in Bishoftu Town, Oromiya, Ethiopia. Interviewer-administered questionnaires were used in a community-based crosssectional study with 422 randomly chosen respondents in Bishoftu Town. A mixed method study approach (Quantitative and Qualitative study) was used. Primary data were collected from 422 married women in the study area and analyzed using SPSS (Statistical Package for Social Sciences) version 25 software. Simple frequencies, cross- tabulation and regression model were used to analyze the data. Five FGDs have been organized on the 6 major themes [Relationship between mortality and the number of children women want to have; the relationship between educational level of women and the number of children they want to have; the impact of family, neighborhoods and communities on the number of children women want to have; age of first marriage and the number of children women can have in their lifetime and its influences; the relationship between high and low birth rates and national development] and analyzed accordingly. The income of the respondents, the educational status of the women, and age at first marriage significantly determine fertility status among married women in Bishoftu town. About 44.5 % of women who had no education had 5 or more live births but only 2% of women who completed more than secondary school had 5 or more live births. Women with more than secondary school educational status were 58.4% less likely to have high fertility status compared to those who had no education (aIRR=0.416; 95% CI: 0.230-0.753). On the other hand, women who experienced infant mortality were 18.8% more likely to have more children than those who did not experience infant mortality (aIRR=0.812; 95% CI: 0.725-1.002). Women who earn 6000 ETB and above monthly income were found to be 19.8% less likely to have more children when compared to women who earn less than 1000 ETB monthly income (aIRR=0.802; 95% CI: 0.456- 1.411). Based on the findings of the study, to decrease high fertility, the government and concerned bodies are expected to avail appropriate mechanisms and control systems that influence women’s age at first marriage
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    Determinants of Postnatal Care Service Utilization in Public Health Center of Kirkose Sub-City Addis Ababa, Ethiopia
    (Addis Ababa University, 2022-03-27) Yemisrach Ayalew; Chalachew Arega (Mr.)
    Postnatal care (PNC) is a period immediately after delivery to six weeks. It is critical but the most ignored period. A large percentage of maternal and neonatal deaths occur during 48 hours following childbirth. Obtaining the recommended three postnatal check-ups within seven days of delivery plays a vital role in preventing maternal and neonatal deaths. So the objective of this study to assess the Determinants of postnatal care service utilization in public health center of kirkos sub city with the method of an institutional-based cross-sectional study design with mixed (quantitative and qualitative approaches. The study was conducted between August and September 2021. A simple random sampling technique was used to select the study subjects. The sample size determined for the study was 399. Out of 399 participant 73.2%, was PNC service utilization while 26.8% did not utilized PNC services. Whose age was between 25 and above years were 0.001 times Adjusted odds ratio [0.001 (0.000, 0.084)], respondents higher and above education were 0.040 times AOR [0.040 (0.002, 0.933)] and respondents who had two Antenatal care visits were 0.036 times Adjusted odds ratio [0.036 (0.003, 0.438)] were significantly associated with Post natal care service utilization (p<0.05). This indicated that PNC service is a major demographic, socio-economic, and reproductive health problem. So, there is a need to creating awareness on sexual and reproductive health, increasing the accessibility of maternal health services for women to improve PNC services.
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    Demographic and Environmental Dererminants of Rural-Urban Migration in Yeka Sub-City of Addis Ababa: A Perception-Based Study
    (Addis Ababa University, 2023-08) Afewerk Jembere; Dula Etana (PhD)
    In Ethiopia, various forms of population movements, mainly rural out-migration, have been recorded over many decades as a direct response to the potential influences of environmental factors like drought, famine, and land degradation in combination with economic crisis. At the national broad level, environmental factors such as vulnerability to serious environmental degradation onsets and rainfall variability are major push factors that drive people to engage in rural out-migration in Ethiopia. In line with such problem, this study is conducted with an objective to explore and portray how key demographic variables, coupled with environmental determinant perception factors, can influence rural-urban migration trends in the study area by employing a perception-based data collection approach. The study employed a quantitative research method with a cross-sectional survey design by using systematic random sampling method and single population proportion sampling formula. After a primary data about sampled rural migrant’s demographic and environmental determinants were extracted from respondent households, descriptive statistics and logistic regression analysis were done. Multivariable logistic regression model was fitted to identify demographic and environmental determinants of rural-urban migration. In the study area, there are about a total of 355 rural migrant households were included in the selected sample, and 351 of them were fully covered. Results of the analyzed data showed that about 57.8% of respondents were male migrants, and nearly 36.2 %of the migrants surveyed were belonged to the age group between 30 to 34 years old, which is a young adult group of a population. About 53% were discovered to be Never married (Single), and the remaining 47 percent of respondents were found among an Ever married migrant category. Concerning environmental perception determinants of rural outmigration, land/ environmental degradation, drought, rainfall variability and access to water resource constitutes about 64.4%, 40.2%, 51.9% and 54.7% of all respondents, respectively. In a concluding pursuit, the analyzed data of the study has unveiled the prominent role of environmental factors in shaping migration decisions. Notably, environmental degradation emerged as a compelling driver those respondents expressing concerns about its impact. This result highlights the urgent need for sustainable resource management and ecological restoration strategies to curb the detrimental effects of land degradation. Environmental drought and irregular rainfall patterns also stood out, and influencing perceptions of migrants. In addition, the analyzed study data has aligned with respondents' experience of illuminating the influence of water scarcity on their migration decision and intentions. Based on analyzed findings, the study recommends that relevant stakeholders and actors should collaborate and act together to mitigate the problem of rural-to-urban migration both at the rural origin and destination place by encompassing policy implications, research avenues, and community-based engagement strategies.
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    Practice of Essential Newborn Care and Associated Factors among Postnatal Women at Selected Public Health Centers of Addis Ababa, 2023
    (Addis Ababa University, 2023-08) Bethel Aberra; Dula Etana (PhD)
    Neonatal Mortality is very high in most developing countries including Africa. Many countries are trying to reduce neonatal mortality by institutionalizing essential newborn care. The main aim of this study was to assess practice of essential new born care and associated factors. Facility based cross-sectional study design was employed among 414 postnatal women. The overall proportion of postnatal women with poor knowledge and poor practice towards essential newborn care was 53.9% and 28.1% respectively. Being age group of 21-25 years, being unable to read and write, traveling greater than 30 minutes to reach health facility, being self-employee. Having female baby, and initiating ANC follow-up after 16 weeks of gestation are significant predictors of having poor knowledge about ENC. While having educational status of unable to read and write, having female baby and having poor knowledge on essential newborn care were significant factors associated with poor practice of ENC. In this study the level of poor knowledge about essential newborn care is high but the level of poor practice of essential newborn care is relatively high as compared to the 19% Study done in Mekelle town (Berhea et al., 2018). Age(blow 25 years), educational status(unable to read write, distance to health facilities(>30 minutes), occupation status(self-employed),sex of baby(female) and ANC initiation time(after 16 weeks) are significant predictors of having poor knowledge about ENC. Therefore addressing universal education, availing health facilities and health education about the importance of keeping baby warmth play significant.
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    Predisposing, Enabling, and Need Factors Associated With Sexual and Reproductive Health Service Utilization among Internally Displaced Women and Girls: Evidence from Amhara Region
    (Addis Ababa University, 2022-10) Bethlehem Fekade; Chalachew Arega (MSc.)
    Background: Millions of people worldwide are displaced due to conflict and natural disasters. In Ethiopia's Amhara region, over two million people are internally displaced (IDPs) due to the northern conflict, creating a critical gap in access to essential health services, including Sexual and Reproductive Health (SRH) services. Objective: This study examines the factors influencing SRH service utilization including the levels, determinants, and challenges among IDPs in Amhara. Methods: A cross-sectional study design employing quantitative (survey with 549 IDP women aged 15-49) and qualitative (FGDs and KIIs with service providers, government officials, and IDP youth) methods were used in DebreBirhan, Gondar, and Woldiya town. Results: The study found significant associations between SRH utilization and education level, source of SRH information, household size, and preference for using health facilities. Qualitative findings revealed a gap between SRH policies and their implementation in IDP settings, with commodity shortages being a major constraint. It also revealed that inadequate attention was given to IDPs in general and for those who reside particularly in Gondar Camp. Recommendations: This study recommends multisectoral collaboration to improve SRH service delivery, including disseminating information through various channels, establishing youth-friendly services in camps, and coordinating with stakeholders to ensure adequate SRH commodity availability.
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    Reproductive Health Knowledge and Service Utilization among Migrant Workers: A Cross-Sectional Study around a Bus Station in Addis Ababa
    (Addis Ababa University, 2023-06) Eyasu Hailu; Terefe Degefa (Professor)
    Most migrant workers are of reproductive age, adolescent, and youth. However, their reproductive health needs have not been met adequately. The question of migrant workers whether they adequately understood reproductive health, access RH services enough, and what factors are contributing to their knowledge and access to reproductive health is not yet investigated in Addis Ababa. This study is aimed at assessing knowledge and utilization of reproductive health services among migrant workers. This study employed a cross-sectional-survey among migrant workers in Autobus Tera, Addis Ketema sub-city. A simple random sampling method with a sample size of 424 was employed. Data was collected using an online-based system. Data were analyzed through descriptive, bi-variate, and multi-variate analysis using SPSS version 26. Four hundred and one respondents were surveyed resulting in a 94.6% response rate. The study finds 67.6% of respondents as knowledgeable of reproductive health matters. It also finds 33.7% RH service utilization among migrant workers. Age (AOR = 2.05, 95%CI: 1.098, 3.082), Sex (AOR = 1.84, 95%CI: 1.098, 3.082), Relationship with the opposite sex (AOR = 2.84, 95%CI: 1.757, 4.581), and Discussion over reproductive health matters (AOR = 3.33, 95%CI: 2.045, 5.439) were found to be predictors of knowledge on reproductive health matters. Religion (AOR = 7.27 95%CI: 2.155, 24.513), Years in Addis Ababa (AOR = 2.6 95%CI: 1.354, 4.996), and Discussion over reproductive health matters (AOR = 14.14 95%CI: 7.819, 25.583) were found to be significant in predicting reproductive health service utilization among migrant workers. A moderate reproductive health knowledge and low reproductive health service utilization was observed among migrant workers. Targeted awareness-raising interventions can help reduce the information/knowledge gap and underutilization of reproductive health services migrant workers are experiencing.
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    Women Decision Making on Use of Modern Family Planning Methods and Associated Factors, Evidence from PMA Ethiopia
    (Addis Ababa University, 2022-11) Fitsum Tariku; Dula Etana (PhD)
    Family planning decision making is defined as women´s ability to choose family planning methods that she wanted to use through the process of informed decision making. Despite the availability and accessibility of family planning methods, the utilization rate is not more than 41% in Ethiopian. Evidences and experts have consistently show that women decisions making ability on family planning method they desired to use is one of the possible reasons for this slow rate of family planning use increment . In consideration with this and further motives family planning use decision making has become one of the top sexual and reproductive health related sustainable development agendas. Hence, this study aimed at determining the level of family planning use decision making among married and identify factors affecting it. This study was based on Performance monitoring for action (PMA) 2020 cross sectional national survey data. Married women who are currently using or recently used family planning method were included in this study. Frequency was computed to describe the study participants while chisquare statistics was computed to examine the overall association of independent variable with family planning use decision making. To identify predictors of family planning use decision making multinomial logistics regression was employed. Results were presented in the form of percentage and relative risk ratio with 95% CI. Candidate variables were selected using p value of 0.25. Significance was declared at p value 0.05. This study revealed that one in two women (51.2%; 95% CI: 48.8%-53.6%) decide their family planning use by themselves while 37% (36.8%; 95% CI: 34.5%-39.2%) decide jointly with their husband and/or partner. Women alone family planning use decision making increased significantly 32.8% (95% CI: 29.4%, 36.4%) in 2014 to 51.2% (95% CI: 48.8%, 53.6%) in 2020. It also show variation across regions from scanty in Afar and Somali to 63.6% in Amhara region and 61.5 Addis Ababa. Obtaining desired family planning method was found significantly to improve women alone and joint planning use decision making. Women who have perceive control and feeling if they get pregnant now were found to be positively associated with women alone family planning use decision making. Discussion with husband, his feeling towards family planning were found positively to influence family planning use joint decision making. Moreover, women religion, was found reducing the likelihood of both women alone and joint family planning use decision making while experiencing side effect reduces the likelihood of joint family planning use decision making. Half of the women independently decide their family planning use which calls up on further improvement. Family planning use decision making ability is expected to be improved by efforts targeted on husbands' approval on wife’s family planning use, discussion on family planning use with husband/partner, improving women psychosociological readiness and trust on her own to decide her desired family planning method; informing the possible side effects and what to do when they encountered during their family planning use visit. In addition, influencing women on the use of family planning via religious leader will help much in this regard. Monitoring and evaluating reproductive health policy 2021 to2025 and addressing bottlenecks which hinder women decision making health service use is hoped to improve women family planning use decision making. Further qualitative study to identify and address factors that contribute for the variation across regions also help much.
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    Socio-Economic and Demographic Determinants of Postnatal Care Utilization in Oromia Region
    (Addis Ababa University, 2021-09) Tsegalem Sitotaw; Chalachew Getahun (PhD)
    Background: The postnatal period which is also called postpartum is defined by the World health organization as the period beginning one hour after the delivery of the placenta and continuing until 6 weeks (42 days) after delivery. Objective: The prime objective of this study is to examine the socio-economic and demographic factors that influence PNC service utilization in Oromia Region of Ethiopia. Methods: cross-sectional data from Ethiopian Demographic and Health Survey 2016. A multivariate binary logit model was employed, and odds ratios were used to analyze the determinants. A qualitative in-depth interview was also implemented to triangulate with the secondary data of the 2016 EDHS and to capture and thereby to fill some of the data gaps of the EDHS. Totally 1031 women were covered by the 2016 EDHS of Ethiopia. Results: The study results have shown that woman’s education level, ANC visit, parity, and place of delivery have a significant positive effect on PNC checkup. The estimated odds ratio of PNC service utilization for women delivered at health facility is11.6 time more likely to use PNC service as compared to women delivered at home. Women antenatal visit with of less than four antenatal visit is 1.706 times more likely to have PNC checkup relative to women whose no antenatal visit is [P<0.05, OR =1.706, 95% CI 0.929-3.1308]. Women with primary education level 1.79 more likely to have PNC checkup after delivery [P 0.05, OR =1.79 at 95% CI 1.05-3.06].Women Birth order with of 2-4 is 2.14 times more likely to have PNC checkup relative to women whose Birth order one is [P 0.05, OR =2.14, 95% CI 1.18-3.87]. Conclusion: To improve the level of PNC checkup in the study area all concerned bodies should work towards empowering women’s educational participation, promote and design appropriate designs and strategy to increase the ANC utilization rate and health facility in particular and to improve, encourage and enhance maternal health care service utilization in general.
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    Correlates of Children Ever Born Among Women of Reproductive Ages in Ethiopia: Evidences from the 2019 Mini Ethiopian Demographic and Health Survey
    (Addis Ababa University, 2022-07-25) Woinshet Defabachew; Chalachew Arega (M.Sc.)
    Ethiopia's total fertility rate reduces slightly from 4.6 in 2016 to 4.15 in 2019 with an average annual decline rate 0.15 per women. This trend still demands to find the factors that may currently affect the currently fertility rate in Ethiopia due to still high rate of fertility and population growth. Children ever born, for this study, is the total number of children born by a woman (both alive and dead) and reported during the data collection period. The study on fertility is significant as the actual fertility depends on women current fertility level. However, there is limited study conducted about children ever born in Ethiopia so far. As a result this study is necessitated to be conducted. The objective of the study to study is to examine the key factor that affecting fertility in Ethiopia based on the EDHS data on women of reproductive ages. The survey was conducted using a multistage stratified cluster sampling method that covers all the 9 regions and 2 city administration of Ethiopia. A cross sectional study design was used to conduct the research. The analysis process was conducted by negative binomial regression model, by using this model current age of women, marital status, educational attainment, place of usual residence, wealth index, contraceptive usage and its knowledge was found to have higher significant predictor of current fertility level of women. Unexpected result such as child sex deference, daughter loss experience and duration of marriage of mothers was not found any association with the children ever born. Factors which were found to have statistical effect on the dependent variable needs receive attention by concerned bodies to make women to reduce their current fertility level reasonably. So in conclusion Ethiopia still need to take necessary step to control sustainably the current fertility level by making proper policy on the factors found in this study.
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    Quality Youth Friendly Sexual and Reproductive Health Services, Youths' Satisfaction Levels, and their Determinants in Selected Public Health Facilities of Addis Ababa, Ethiopia
    (Addis Ababa University, 2022-07) Lidiya Dawit; Chalachew Getahun (PhD)
    Background: Adolescence, age between 10 and 19 years, is marked as a period of transition and experimentation. This period not only brings changes to their body but also vulnerabilities to the undesirable effect of sexuality, marriage, and childbearing. Globally, pregnancy and childbirth are among the main contributors to diseases and disability among adolescents: early childbearing is linked with a higher risk of unsafe abortions, maternal mortality, and morbidity. Teen pregnancy and sexually transmitted infections (STIs) can have negative consequences for maternal and child health, as well as limit women's future chances, resulting in increased gender and social inequities Objective: The main objective of the study was to assess quality of youth-friendly sexual and reproductive health service and determinants of satisfaction among youth in selected public health facilities of Addis Ababa, Ethiopia, 2022. Method: Facility-based cross-sectional study supplemented with the qualitative design was conducted from 27 April to 10 June 2022 in 25 selected public health centers in Addis Ababa, Ethiopia. To determine the satisfaction of youth, 238 clients were included in the study using a simple random sampling technique. Data was collected by using an interview-administered questionnaire, observation checklist, and key informant interview. Both descriptive statistics was used to measure the quality of YFS and multi-variable binary logistic regression was employed, and the odds ratio with a 95% confidence interval along with p-values were used in reporting the results. Result: The study revealed that only six (24%), seven (28%) and three (12%) of the sampled health care facilities have good structural quality, process quality and output quality respectively. Only 2 (8%) of the health facilities had good overall quality of YFS. Regarding client satisfaction, 33.6% of the study participants were satisfied. Female clients were nearly two times [AOR (95%CI) 1.87 (1.07- 3.26)] more likely to be satisfied than their male counter parts. Similarly, youths aged ≥20 years were about 2.5 times [AOR (95% CI) 2.52(1.35-4.70)] more likely to be satisfied than those aged 15-19 years of age. Students were 76% less likely [AOR (95% CI) 0.24(0.04- 1.40)] to be satisfied when compared to unemployed. Our qualitative assessment showed that weak support system, inadequate capacity of the service provider, overburden of the health service provider and lack of adequate infrastructure are barriers for implementation of quality YFS. Conclusion: The quality of YFS in Addis Ababa is low even when compared to studies done in regional facilities. Both the overall quality and each dimension of YFS quality is lower when evaluated based on the WHO standard. In addition, our study revealed that two-third of youths who were using YFS were not satisfied. Barriers such as weak support system, inadequate capacity of the service provider, high workload of the health service provider and lack of adequate infrastructure contributed for low quality of YFS.
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    Determinants of Fertility Desire among HIV Positive Women of Reproductive Ages on Antiretroviral Therapy in Selected Rehabilitation Centers in Addis Ababa, Ethiopia
    (Addis Ababa University, 2022-06-05) Martha Eshetu; Womdimye Ashenafi (PhD)
    Background: The magnitude of unprotected sex to satisfy the desire for fertility among women living with HIV/AIDS (PLHIV) has raised concerns due to the availability of antiretroviral therapy (ART) in most HIV-affected countries. This could, however, have risk of passing on HIV to sexual partners and children. The aim of this study, therefore, is to determine prevalence and factors associated with fertility desire of reproductive-age women who are HIV positive in Addis Ababa, Ethiopia. Objectives: To assess the prevalence of fertility desire among HIV positive women and factors associated with it among women who are on ART in selected rehabilitation centers in Addis Ababa, Ethiopia. Methods: A cross sectional study was conducted on HIV positive women on ART at selected rehabilitation centers in Addis Ababa, from February 1-28, 2022.The total sample size considered was 418. Systematic random sampling technique was used after the total sample size was proportionately allocated to each rehabilitation center. Data were collected by interviewing, reviewing registration logbook, and FP chart (card). The collected data was entered and analyzed using SPSS-25 software. Descriptive statistics and binary logistic regression analyses was done. For variables with P value <0.25 on bivariate analysis, multivariable logistic regression analysis was performed in order to see association between independents and dependent variable (desire to fertility) using Odds Ratio (OR) as measure of association. Result: The overall the prevalence of fertility desire was 45.6%. Multivariable regression analyses revealed that being 25-34 years of age (AOR=5.49, p=0.003, 95% CI 1.77– 16.98), having secondary and above education (AOR=0.07, P=0.038, 95% CI 0.06-0.86) and being user of contraceptive (AOR=0.18, P=0.004, 95% CI 0.04-0.53) were statistically associated with fertility desire. Conclusion and recommendation: With the increasing desire of fertility among HIV positive women, attentions need to be given on counseling as how to prevent transmission of HIV to partner and the offspring.
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    Predictors of Maternal Mortality among Mothers Who Delivered In Selected Public Hospitals in Addis Ababa, Ethiopia: Unmatched Case Control Study
    (Addis Ababa University, 2022-06) Mihret Abebayehu; Womdimye Ashenafi (PhD)
    Background: Maternal mortality ratio in Ethiopia is one of the highest in the world. Despite measures to alleviate it and showing a promising declining trend, it still remains one of the highest at 401 nationally maternal deaths per 100,000 live births in 2017. The maternal death risks have been known to be associated with different socio-demographic and obstetric factors. This study aimed at assessing the predictors of maternal mortality among mothers delivered in selected public health hospitals in Addis Ababa, Ethiopia using unmatched case control design. Objectives: To determine predictors of maternal mortality among mothers who had given birth the last three years in the selected public hospitals of Addis Ababa Ethiopia. Methods: A case control study was conducted on pregnant mothers admitted to Addis Ababa selected public hospitals (St. Paul Hospital Millennium Medical College, Ghandi Memorial Hospital, and Zewditu Hospitals) for delivery from the past three years 2019 to 2021, data was collected from May 1-May 30/2022. Cases were pregnant mothers admitted to delivery and died, while controls were those who survived. A total sample size for this study was 245, of which 49 cases and 196 controls were proportionately allocated to each hospital. Data were collected from delivery registration logbook, death reports and referral papers. Data were analyzed by descriptive analysis and also logistic regression analysis used to see association between different characteristics and maternal mortality, controlling for confounders. The association was measured using crude and adjusted odds ratios (ORs), with 95% CI and p-value <0.05 as used to determine the presence of a statistically significant association. Result: From the total of 245 study participants 49 were cases and 196 controls, all included in the analysis (100%). The mean age of cases were 32.6(±SD3.5). The mode of delivery (C/S) (AOR=4.86, 95% CI (1.18-14.94), mothers age being above 35(AOR=2. 11, 95% CI (1.15-7.10), being referred from other health facility (AOR=3.16, 95% CI (1.87-7.76), having history of no ANC (AOR=3.65, 95% CI (1.53-13.34) and having any chronic illness (AOR=9.54, 95% CI(6.54-17.38) were found to be factors that showed a statistically significant association with maternal mortality. The most common causes of death were postpartum hemorrhage, sepsis, retained placenta, post-operative complications and anemia. Conclusion and recommendation: Caesarean delivery, older maternal age, being referred from another facility, having no ANC in previous delivery and having any chronic illness were Predictors for maternal mortality. As some of these factors were modifiable factors, identifying risky groups and designing targeted interventions must be given emphasis by stake holder.
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    Determinants of Chronic Malnutrition among Children aged 6-59 Months in Burayu town, Oromia special zone, Central Ethiopia
    (Addis Ababa University, 2022-06) Negesse Gebissa; Dula Etana (PhD)
    Under-five malnutrition is a major public health issue contributing to mortality and morbidity, especially in developing countries like Ethiopia where the rates remain unacceptably high. Identification of critical risk factors of malnutrition Among Children Aged 6-59Months using appropriate and advanced statistical methods can help formulate appropriate health programmes and policies aimed at achieving the United Nations SDG Goal. This study attempts to develop a quantile regression, an in-depth statistical model to identify critical risk factors of Children Aged 6-59Months chronic malnutrition (stunting). Based on the quantitative cross sectional study design was conducted from march-1/2022 to March-30/2022, height-for-age z-scores (HAZ) was estimated. Multivariable quantile regression model was employed to identify critical risk factors for with the lower cut off height-for-Age-Zscores (a measure of chronic malnutrition in populations). Quantiles of HAZ with focus on the lower cut off HAZ were modeled and the impact of the risk factors determined. Significant test of the difference between slopes at different selected quantiles of HAZ and other quantiles were performed. Quantile regression plots of slopes were developed to visually examine the impact of the risk factors across these quantiles. Data on a total of 489 children were analyzed out of which 15 (3.1 %) were stunted and 25% of the children were height-for-age Z-score value <-1. The models identified child level factors such as Child’s age, Educational level of mother/caregiver, marital status, household wealth quantile, Latrine/Sanitation status, Disposal of solid wastes, Availability water &soap at hand washing facility, Hygienic practice, Complementary Feeding and Colostrums milk at birth. Highly significant differences exist in the slopes between the lower cut 0.25 and the higher cut 0.97 quantiles. The quantile regression plots for the selected quantiles for the lower cut 0.25 and the higher cut 0.97 showed substantial differences in the impact of the covariates across the quantiles of HAZ considered. Critical risk factors that can aid formulation of child nutrition and health policies and interventions that will improve child nutritional outcomes and survival were identified. Modelling under-five chronic malnutrition using multivariable quantile regression models could be beneficial to addressing the under-five chronic malnutrition.
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    Magnitude of Neonatal Mortality and Its Associated Factors among Neonates Admitted to Neonatal Intensive Care Unit at Menelik II Comprehensive Specialized Hospital, Addis Ababa, Ethiopia, 2022
    (Addis Ababa University, 2022-11) Ereda Belete; Yibeltal Tebekaw (PhD)
    Background: Since 2000, Ethiopia has seen an exceptional decrease in infant and child deaths. However, the main cause of death in children under the age of five is still neonatal mortality. Hospital service quality can vary and affect how much newborn death occurs. Objective: To determine the frequency and contributing variables of neonatal mortality among newborns admitted to Minelik II Comprehensive Specialized Hospital in Addis Ababa, Ethiopia, in 2022. Method: retrospective document review was carried out from March 2017 to March 2022. The study used a sample of one out of every two admitted patients. Neonatal patients without neonatal medical records or discharge status charts met our exclusion criteria. To choose the study participants, the systematic random selection technique was employed. The variables that had a P-value of 0.05 in the multivariable model were deemed statistically significant in the binary logistic regression model. Result: The study included 316 neonates in total andneonatal mortality was 18% (95% CI: 14.2, 22.2). Low birth weight [AOR=4.40(1.73-11.21)], small for gestational age [AOR=3.27(1.50- 7.14)], Neonates with age less than 24 hours [AOR = 6.328 (1.83-21.88)] and Apgar score [AOR=3.46(1.14-10.50)] were factors significantly associated with neonatal mortality. Conclusion: Neonatal death was a common occurrence (higher prevalence) at Minelik II Comprehensive Specialized Hospital. Newborns that were low birth weight and those who are under 24 hours old have a higher risk of neonatal mortality. Therefore, neonates with low birth weight, small for gestational age, poor APGAR scores, should receive special attention from physicians, legislators, and program administrators.
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    Knowledge, Attitudes, Risky Behavior and Preventive Practices on Sexually Transmitted Diseases among High School Adolescent students in Addis Ababa, Ethiopia
    (Addis Ababa University, 2022-06) Fasil Alene; Tariku Dejene (Ass. Professor)
    Sexually transmitted diseases are major cause of infertility, acute illness, long-term disability and death in both developed and developing country. Preventing and controlling STDs will have reducing bad pregnancy outcomes and women’s risk of cervical cancer, infertility and chronic pelvic inflammatory disease and an attempt has been made to assess knowledge, attitudes, risky behavior and preventive practices on sexually transmitted diseases among high school adolescents in Addis Ababa. Ethiopia. School based cross sectional study was conducted among 419 students and stratified random sampling technique was used in proportion to number of school and finally, the respondents were selected by simple random sampling in proportion of grade and sex. Semi structured questionnaire was used to collect information from respondents and data was entered and analyzed using SPSS Version 20 software. The descriptive results were presented by table and chart, and logistic regression analyses were used to identify associated factors and to measure the association of outcome variables. From 419 randomly selected adolescent students 409 of them participated in the study which gives a response rate of 97% and majority 337 (82.4%) of students were from Government Schools and the rest 72 (17.6%) were from Private Schools. Mean (+SD) and median age for the respondents were found to be 17.03 (+1.457) and 17 years respectively. 87.3% of students had good knowledge of STDs but more than half of the participants (64.1%) never knew STDs other than HIV/ AIDS. About half (50.4%) of respondents had appropriate attitude and more than half (68.7%) of respondents had good preventive Practice towards STDs but students who practiced sexual intercourse ever had 99% less likely to have good preventive practice than who never had sex (AOR: .011, 95% CI (0. 004, .030)). The odds of having risky sexual experience among Students who have appropriate knowledge on STDs were decline by 82% than those students who haven’t appropriate knowledge on STDs (AOR: 0.182,95% CI(.044,.756)).
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    Magnitude and Factors Associated with Unintended Pregnancy among Pregnant Women Attending Antenatal Care in Addis Ababa, Ethiopia.
    (Addis Ababa University, 2022-08) Hanamaryame Getenet; Dula Etana (PhD)
    Unintended pregnancy is either unwanted or miss-timed at the time of conception and has a great impact on the health of fecund sexually active women in developing countries. This study aims to assess the magnitude and factors associated with unintended pregnancy among pregnant women attending antenatal care in Arada, Yeka sub cities, Addis Ababa. A facility based crosssectional study was conducted from March to April 2022 at 6 selected public health centers. Using a pre-tested questionnaire 355 pregnant women were included this study. All collected data were cleaned, entered and analysed using SPSS version 28. Summary statistics was used to present the findings. Multicolinearity and model fit test were performed before the analysis. Bivariate and multivariate logistic regression analysis was done to test the association between the independent and outcome variables. P-value of <0.05 was considering as a cut-off point. Three hundred fifty five pregnant women with mean age 29.5 years included and 321(90.4%) were married. The prevalence of unintended pregnant was 65(18.3%) and majority of them 58(89.2%) experienced unintended pregnancy once until this study conducted. From the total unintended pregnancy 65 (18.3%), 37 (59.9%) were mistimed and 28 (43.1%) were unwanted. Significant determinant/factors of unintended pregnant were no or lower educational status, history of abortions, family planning accessibility and openly discussion with their partners/husbands. It is important that reproductive programs consider expanding their focus to the growing population of urban dwellers. This can be an interim strategy until the majority are empowered through better education and receive user friendly services.
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    The Relationship between Viral Load Status and Fertility Intentions of HIV-Positive Women of Reproductive Ages in Addis Ababa: A Facility Based Cross-Sectional Study
    (Addis Ababa University, 2022-07-20) Hirut Alemayehu; Chalachew Getahun (PhD)
    Back ground: People living with HIV/AIDS (PLHIV), like everyone else, want and intend to have children. Although the fertility impact of HIV is already well acknowledged, women’s fertility behaviors could also largely be influenced by the level of their viral loads. Being sexually active and not taking contraception, women who never became pregnant had greater HIV viral loads. Objectives: to assess the relationship between viral load status and fertility intentions of HIV positive women of reproductive ages in six selected public health hospitals, in Addis Ababa, Ethiopia. Methods: A sample size of 432 reproductive ages HIV-positive women who got ART service at selected public hospitals were interviewed. A binary logistic regression analysis was used to assess the relationship between viral load status and fertility intention. Results: Of the total respondents, 196 (45.4%) had intention to give birth within the coming 3 years, while the remaining 236 (54.6) had no intention. Fertility intention was 2.71 times higher among women of ages 25-34 compared to age > 34 years (95% CI: 1.005-7.339). Moreover, married women had fertility intention 6.06 times higher (95% CI: 1.12-32.7) compared to widowed women. Further, fertility was higher among women who knew their partner HIV status. Intention was 5.63 times higher (95% CI: 0.846-37.484) and 19.28 times higher (95% CI: 2.533- 148.326) among women who knew their partner HIV status to be positive and negative respectively, compared to those with no knowledge of their HIV status. On the other hand, fertility intention decreased for women with no formal education and primary by 95.1 (95% CI: 0.010- 0.252) and 83.9 (95% CI: 0.039-0.662), respectively compared to secondary and above level of education. For women who believed they have enough number of children; the odds of fertility intention decreased by 99.7 (95% CI: 0.001-0.011). Further, the odds of fertility intention of women who made decision on pregnancy or contraceptive use alone were lower by 71.5% compared to those who jointly made the decision. Conclusion and Recommendation: - A high proportion of HIV positive reproductive ages women desire to conceive. However, the finding witnessed that there was no significant association between viral load status and fertility intention. Beside that there were no fertility differentials between women who have undetectable and detectable viral loads. The findings strongly implicate the need for strengthening and proper implementation of the various health policies and guidelines pertaining to HIV/AIDS for increased uptake of reproduction health services by PLHIV women. The government and other stakeholders should reach young women including sexually active with HIV prevention, testing and treatment services.