Population Studies

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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.
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.
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.
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.
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.
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.
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.
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)).
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.
Prevalence And Factors Associated with Neonatal Mortality among Neonates Admitted to Neonatal Intensive Care Unit of Addis Ababa’s St. Peter’s Specialized Hospital
(Addis Ababa University, 2022-06) Hasset Feleke; Terefe Degefa (Professor)
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.
Youth Friendly Reproductive Health Service Utilization and Associated Factors among Preparatory School Students in Addis Ababa, Ethiopia
(Addis Ababa University, 2021-08) Hiwot Belay; Wondimye. A (PhD)
Youth make up a large, important, and rapidly growing segment of Ethiopia's population, but they account for a disproportionately high number of the country's unmet reproductive health needs. Promoting comprehensive YFRHS is critical for assisting young people in making responsible reproductive health decisions and empowering them to follow through on those decisions. Great majority of youths in school are undeserved for utilizing users’ friendly services due to lack of awareness to the service, poor communication on RH issues and inadequate service & counseling specifically targeted for this specific youth group. The school based quantitative cross-sectional study supplemented with qualitative method was conducted to evaluate YFRHS utilization and related factors among Addis Ababa city preparatory school students from April 2021 to July 2021. Multistage clusters sampling technique was used on a total of 695 sampled students by proportionally allocating to the selected government and private schools in the city. The quantitative data was collected using a structured questionnaire while focus group discussion and key informant interview guides were used to illicit qualitative information. Binary logistic regression analysis was performed on important predictor variables and odds ratio was used to determine the factors that predict the utilization of YFRHS with p- value of < 0.05 as measure of statistical significance. Qualitative data was thematically analyzed to convey meanings and interpretations out of the data. Of the 695 students participated in the study, only 73 (10.5%) reported to have used the YFRHS in the past twelve month. More than four-fifth of them (82.3%) had however heard about YFRHS, and the great majority of them (63%) also reported that they knew where they could find the services. In the multivariable analysis, being male in gender, living with both of the parents, having convenient working hours of service providers, being knowledgeable on genital ulcer and itching as major symptoms of STI and peer groups being the source of information for YFRHS were positively associated with utilization of YFRHS. On the other hand, being age of 17-18 years, attending in governmental school, having had RH discussion with parents and the presence of YFRHS in nearby areas were negatively associated with YFRHS utilization. The utilization of YFRHS in the study is very low. Being aware of the major symptoms of STI as RH problem and getting youth friendly services from peer groups have increased the utilization of YFRHS. Efforts that a target in creating and expanding RH information for youths from health providers’ side is paramount. Health service providers need to create a conducive environment in being a major and appropriate source of SRH information through strengthening of the awareness creation strategies on RH issues targeting the youths.
Demographic and Socio-Economic Determinants of Antenatal Care Service Utilization in Burayu Town, Oromia, Ethiopia
(Addis Ababa University, 2022-06) Dinka Geleta; Terefe Degefa (Prof.)
Although the utilization of antenatal care services has increased in Ethiopia, the majority of mothers still do not use the minimum of four visits and the six basic ANC services that the World Health Organization (WHO) recommends. As a result, the study's goal was to look into the demographic and socio-economic factors that influence how often antenatal care services are used in Burayu, Oromia, Ethiopia. About 422 mothers who had children within the previous five years were the subject of a cross-sectional study. SPSS version 23 was used to enter the data. The factors influencing the outcome variables were identified using binary logistic regression, multivariate logistic regression models. Accordingly, 61.8% of the 422 mothers who participated in the study attended four or more ANC visits. Women who started their antenatal care visits earlier, women's occupation, household income, healthcare providers who saw the women during those visits, and family support all had higher odds of receiving at least 4+ visits compared to the reference categories in a multivariate logistic regression analysis of the factors determining the frequency of ANC visits. Their respective odds ratios were women who were early starters of ANC visit (AOR =16.031; 95%CI: 3.088-83.228), working women’s (AOR = 2.548, 95% CI: 1.445–4.494), household income (AOR = 1.901; 95% CI: 1.011–3.575), professionals who saw women during antenatal care visits (AOR=9.063; 95%CI: 1.118-73.788), family support (AOR=2.846; 95%CI: .989-8.186). In Burayu town, there have been moderate and severely low levels of compliance with the minimum suggested ANC visit (4+ visits). To raise women' knowledge of the value of antenatal care and to enhance the scope and substance of ANC services in Burayu, health promotion activities are essential.
Relationship between Household Income and Fertility in Addis Ababa: The Case of Addis Ketema Sub city Wereda 4 And 10
(Addis Ababa University, 2021-09) Mohammednur Ahmed; Eshetu Gurumu (Proffessor)
Existing evidences show an inverse relationship between income and fertility among countries, and across households. Although the inverse association is observed quite often, there are conditions under which fertility and income are correlated positively. Many studies find lower fertility among those who earn high income. Nonetheless, it is sometimes argued that early on in the development process, a positive relationship between income and fertility could exist. Most of the studies that document a positive relationship are subsumed in agrarian economies, and often income is peroxide by farm size. This paper explored the relationship between household income and fertility, in cross sectional manner using primary data in Wereda 4 and 10 located in Addis Ketema Sub-City of the City Government of Addis Ababa. The study used Poisson regression model and descriptive statistics. Poisson regression model accounts for the nonnegative count variable. A cross-sectional based study was held on 422 randomly selected reproductive age women using primary data which was collected using structured questionnaire through face to face interview. The bivariate findings of the study indicated that the mean children ever borne was 1.92 which below the replacement level. On the other hand, to assess the effect of household income on children ever borne, the Poisson regression model was fitted and significant determinant of children ever born he multiple Poisson regression result shows that Household Yearly income was significant predictor on the mean children ever borne (b= - 0.019 S.E=0.005 Sig =.027 with weld confidence interval 95%) and the incidence rate ratio (found in EX (B) column) is 0.935 which indicates that household income was negative and significant determinant for the incident rate of children ever borne . Furthermore, marital status, educational level, age group, age at first marriage and occupation are significant determinant of children ever borne, while religion is not significant determinant.
Women’s Participation in Household Decision Making and Its Associated Factors in Ethiopia: Evidence from the 2016 Ethiopia’s Demographic and Health Survey
(Addis Ababa University, 2021-10) Selamawit Tesfaye; Eshetu Gurmu (PhD)
Background: In Ethiopia like rest of the world, women have played indispensable role in improvement of household’s well-being. However, women decision making concerning their health care, major household purchase and movement outside of their home also determined by pre-disposing factors among married women not compressively understood, less investigated, and implemented in Ethiopia. Hence, principal aim of this study is to examine the levels and patterns of women’s participation in household decisions and its micro-level socio-cultural and demographic factors in Ethiopia. Methods: The study used data from 2016 Ethiopian Demographic Health Survey (EDHS). It comprised of sample women of reproductive age group from 15-49 years, living in rural and urban areas covering nine states and two city administrations, and have completed women’s participation decision making data during the survey year. Descriptive statistics and maximum likelihood estimation of logistic regression analysis applied to investigate participation of women decision-making process and factors influencing women’s decisions making. The Stata statistical software used to analyze the data. Logistic regression models have been specified for each of decision making, diagnostic has been made for each of the models to test assumptions related to logistic regression models. Results: Descriptive statistics analysis showed that about 70% of sample women participate in all decision type, 82% on their own health care, 78% on major household purchase and 82% on visiting their relatives. The odds of making decision by primary, secondary and higher education among women who participate in their health care, making household purchase, visiting their relatives and all these decisions higher than compared to women having with no education. Compared to women who were in poorest household, those who were rich had higher odds of participation in all decision area. Women’s age gap greater than equal to twenty years and between even and twenty years were significantly influenced women’s participation on decision-making of household purchase and visiting their family or relatives respectively. Access to media negatively and significantly influence women’s participation all of decision making and women who lived in rural area positively and significantly influenced women decision making on health care only. Working status of women significantly influenced all of women decision-making areas except women’s mobility. Regions/sub-nationals has also positive and negative contribution in affecting women’s decision making. Conclusion: Considering the above results, women’s participation in household decision making increases by working on women’s centered education program, wealth improvement program such as employment importunities and women’s empowerment intervention in some of the rural part of the region.
Social Networks Interaction and Fertility Aspirations among Youth in Bishoftu Town, East Shewa Zone, Oromiya, Region, Of Ethiopia
(Addis Ababa University, 2022-07) Alemayehu Bedassa; Tariku Dejene (Associate Professor)
Presented the result of multivariable liner regression, First is current age of youths, younger youths (ages 15-19) desired to get married at least three years earlier and those in the age group 20-24 desire to get married on average 2 and half years earlier (B= -2.459, P=0.000) than older youths (ages 25-29). Having social support decreases the desired age of marriage by 0.645 (P=0.020), as compared to those without social support. Presents the result of multivariable ordinal logistic regression analysis for determinants of the desired number of children. Protestant religion followers had a 4.665-time odds of having a higher desired number of children (OR=4.665 with a 95%CI: 1.030-21.125); than respondents of traditional religion followers. Respondents with limited family interaction had a higher odds of having a higher desired number of children (OR = 2.153 with a 95%CI: 1.032-4.490) than those with no family interaction. Respondents who have large number of siblings desire a higher number of children (OR= 1.138 with 95%CI: 1.015-1.276) than those with no siblings.
Determinant of Risky Sexual Behaviors among Students of Addis Ketema Secondary and Preparatory School
(Addis Ababa University, 2022-07) Bikila Dinka; Chalachew Arega (MSc)
Background: - Risky sexual behavior is a behavior identified with sexuality, which expands the vulnerability of a person to regenerative health issues. High school students engage in a variety of behaviors that put them at risk for serious health problems. Those health-related behaviors are associated with short and long-term health consequences including injury and violence. Objective: - The main objective of this study was to examine the factors associated with Risky sexual behavior among Addis ketema secondary and preparatory school students. Methods: - The quantitative cross-sectional study supplemented with qualitative method was employed. The study was conducted on 364 students using structured pretested questionnaire in April 2022.The study was conducted among Addis ketema secondary and preparatory school student in Addis Ababa, Ethiopia. The data was collected using structured self-administered questionnaire. The Data entry and cleaning was undertaken using Epi-info version 7.1 and SPSS 22 for windows for analysis. Descriptive statistics was used to describe the study population by independent variables in terms of frequencies and percentage. The logistic regression analysis technique was employed to evaluate independent effect variables on the outcome variable. Results were also presented in tables, graphs and texts. Whereas the quantitative data was collected using a structured questionnaire while focus group discussion and key informant interview guides were used to illicit qualitative information. And also the data was thematically analyzed to convey meanings and interpretations out of the data. Conclusion: -The risk of sexual behavior among Addis Ketema High School, Addis Ababa is high. In this study 24.5% of students‟ drunk alcohol, 13.5% chew khat, 11.3% smoked cigarette and 19.9% of students used illicit drugs at least once in their lifetime. This study also showed that the majority of the students were engaged in unsafe and risky sexual practices. About 57.1%of sexually active students‟ had one of the risky sexual behaviors. The use of Khat, alcohol and tobacco products is significantly and independently associated with risky sexual behavior among Addis Ketema High School students.
Demographic and Socio-Economic Factors Affecting Maternal Health Service Utilization among Women in Reproductive Age Group in Addis Ketema Sub-City, Addis Ababa, Ethiopia
(Addis Ababa University, 2021-08) Belete Tekola; Tariku Dejene (Assi Prof)
Maternal mortality is unacceptably high, about 295,000 women died during and following pregnancy and child birth in 2017. The vast majority of this death (94%) occurred in lowresource settings and most could have been prevented. The purpose of this study was to examine demographic and socio-economic factors that affect the utilization of maternal health care service of reproductive aged women lived in all weredas of Addis Ketema sub city. The study addresses three objective and try to answer three questions. A mixed based study design method was used to address those objectives and to answer the research questions. The study population comprises of 8145 childbearing age women lived in the sub city at least for six months having less than three years of age children and total of 343 study participants were selected by systematically random sampling method for quantitative study. Three methods of data collection were used those are quantitative questionnaire, professional focus group dissolution and in-depth interview selected from quantitative study participant selected based on a list of selection criteria. The data analyzed by frequency, percentage, binary regression and multiple logistic regression by using SPSS 23 processing software. Findings revealed that 207 (60.3%) of the respondents were between the ages of 20-34 years, 110 (32.1%) had attained secondary level education. Significant proportions 162 (47.4%) were unemployed or house wives, while among the husband’s occupation only 23 (6.7%) were unemployed. Based on the monthly income, more than half (60.9%) had monthly per capita income of less than the middle level or average income. Use of maternal health services revealed 322 (93.9%) of respondents were use at least one skilled antenatal care service, among those had at least one antenatal care service the majority 193 (60%) were registered at second trimester and almost half of the participant 164 (50.9%) made at least four antenatal care visits. According to place of delivery 305 (88.9%) were delivered in modern health institution. The strength of association was checked by adjusted odds ratio and by level of significance (p value). It was concluded that utilization was high though very few registered at first trimester and considerable high proportion of women delivered at home compared with the last EDHS report of Addis Ababa. It was recommended that determinants of MHS utilization are multi-sectorial approach to tackle it.
Determinants of HIV/AIDS Knowledge, Attitude and Practice (KAP) Among High School Students in Yeka Sub City, Addis Ababa, Ethiopia
(Addis Ababa University, 2021-12) Helen Tsegaye; Chalachew Getahun (PhD)
Knowledge, attitudes and practices (KAPs) regarding HIV/AIDS is one of the corner stone in the fight against the disease. Youths, especially high school students, are most vulnerable to infection, among others due to lack of adequate information, bad attitude towards PLWHIV/AIDS, and risky sexual practices. Evaluation of their KAPs remains crucial in designing appropriate prevention strategies. This study sought to investigate the determinants of HIV/AIDS transmission and prevention knowledge, attitude and practice among high school students in Yeka Sub City of Addis Ababa. The study employed multivariate binary logistic regression to analyze the patterns and determinants of the disease, using crosssectional data collected from randomly selected 608 students aged 15–22 years. All respondents reported to have heard about HIV/AIDS before. However, misconceptions about routes of transmission were observed in 20 % of respondents. In addition, out of the total study participants, 89 (14.6%) have ever been exposed to sexual intercourse, but only 20 (22.47%) of them used condom during intercourse. In terms of determinants, students, who were at higher grade level, were more likely to have higher HIV/AIDS transmission and prevention knowledge than those in lower grade levels (AOR: 15.5; P=0.001: 95 % CI: 3.036- 80.05). Respondents whose mothers achieved secondary education compared to those students whose mothers were unable to read and write were more likely to have more positive attitude towards PLWHIV/AIDS (AOR: 0.24; P=0.007; 95% CI: 0.06-66). Students had a satisfactory level of knowledge on HIV/AIDS transmission and prevention. None-the-less misconceptions about HIV transmission, intolerance and discriminatory attitudes towards PLWHIV, and risky sexual practices were observed among study participants, which can be minimized by boosting their knowledge through sex education since the latter was their main source of information on HIV/AIDS. In addition, maternal education status and fathers’ education status are also determinants of high school student HIV/AIDS KAP so there should reinforcement of educational interventions particularly in the secondary school and Parents should be thought, and work with to change their attitude and belief about communication with their children in order to protect youth from the virus.
Prevalence of cervical cancer and associated factors among women living with HIV in selected public health facilities in Addis Ababa, Ethiopia, 2022
(Addis Ababa University, 2023-05-20) Birhane Yifru; Yibeltal Tebekaw (PhD)
Background: Cervical cancer (CC) is the second and the fourth most common cancer women in the reproductive age group worldwide and in nations with limited resources respectively. Despite being the most treatable and preventable form of cancer as compared to other malignancies but it is still public health problem. Why common, risk factors and how the magnitude of CC among women who had HIV positive detail seen in this study. Human papilloma virus (HPV) is the primary cause of CC; nearly all sexually active people typically acquire the virus once throughout their life time and spread faster in immune-compromised persons. Objective: To assess the prevalence of cervical cancer and its risk factors in selected public health facilities that serve women who are HIV positive in Addis Ababa, Ethiopia. Methodology: A cross-sectional study was done at the institution level in five selected governmental Hospitals in Addis Ababa. Four hundred twenty four participants were selected in a systematic random sampling technique and data was collected through face-to-face interviews using structured questionnaires’ .The collected data was entered into Epi-data version 4.6.0.6 and analyzed by SPSS version 26. The association of the variables was checked by using bivariate and multivariate logistic regression and 95% CI and pvalue less than 0.05 was computed to determine the level of significance. Results: The sample population for this study consisted of 424 females with 99% (four hundred twenty one) response rate; Prevalence of CC was 6.5% (28/421). Women who hadn’t a history of cervical cancer screening were at a higher risk of obtaining the disease than those clients who had history of screening (AOR 330 (92.8-973.38) p-value = 0.000) , Participants who smoked cigarettes had a 14-fold increased risk of developing cervical cancer compared to non-smokers (AOR 14.098 (CI2.191- 90.729, p-value =0.005).Women who had low CD4 count were more likely to have cervical cancer than those with normal CD4 count (AOR 139.680(43.225_ 451.366 ), p-value =0.000). Conclusion and Recommendation: The study came to the conclusion that factors related with cervical cancer included, smoking history, low CD4 cell count, and poor cervical cancer screening practices. The results of this study indicate that, in order to improve CC screening, to enhance reproductive health education and promotion and scale up limited services, routine care and treatment should include cervical screening so that HIV-positive women can receive counseling during every clinical encounter. Raise knowledge about the impact of smoking, encourage early HIV diagnosis and HAART initiation, and timely baseline CD4 cell count is important.

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