Client satisfaction and contributing factors towards sexual and reproductive health services delivery system among youth at Family Guidance Association of north Ethiopia (FGAE) clinics, 2023: mixed method study.

BACKGROUND: The Family Guidance Association of Ethiopia (FGAE) operates as a non-governmental organization dedicated to offering family planning and reproductive health services to the Ethiopian population. The gap in the study regarding client satisfaction and contributing factors towards sexual and reproductive health services for youth at FGAE clinics highlights the need for a comprehensive investigation to fill this void. By conducting a mixed-method study, this research aims to provide a holistic understanding of the factors influencing client satisfaction in the delivery of sexual and reproductive health services to youth at FGAE clinics. The added value of this study lies in its potential to offer valuable insights and recommendations for improving service delivery systems and enhancing client satisfaction levels, ultimately contributing to the overall well-being and health outcomes of youth in North Ethiopia. Therefore study aimed to asses Client Satisfaction and Contributing Factors towards in sexual and reproductive health services delivery system among youth at Family Guidance Association of North Ethiopia (FGAE) Clinics, 2023. METHOD: The study was conducted within the clinics of the Family Guidance Association of Ethiopia (FGAE), spanning Dessie, Kombolcha, and Woldia city administrations, involving a participant cohort of 416 clients. Facility-based concurrent type mixed method study design both quantitative and qualitative techniques were applied. Quantitative research employed a simple random sampling technique and conversely, the qualitative study utilized a heterogeneous type of purposive sampling strategy to recruit participants The collected data underwent a rigorous process of entry, cleaning, and coding using Epi-Data 4.6 software, followed by analysis in STATA V17. Descriptive statistics and binary logistic regression were employed to highlight the impact of independent variables on the dependent variable. A more comprehensive examination was provided through multivariable logistic regression. Crude and adjusted odds ratios, along with a 95% confidence interval, were computed, with significance set at a p-value ≤ 0.05. RESULT: Nearly more than half of the clients 194 (47.8%) came to receive family planning services followed by maternal and child health 107 (26.4%). Sixty patients (14.8%) didn't receive all the services they wanted or came for. Half of the participants 30 (50%) raised the unavailability of the service as a reason for not taking the service followed by not having enough time in the clinic 12 (20%). About 65.52% (60.74-70.00%) of the participants were satisfied with the Sexual and Reproductive Health services provided by the clinics of FGAE in northeast Ethiopia. Clients in the age group of 25-34 (AOR = 2.04; 95%CI: 1.11-3.72). Clients who had primary and secondary education (AOR = 2.49; 95%CI: 1.03-6.02) and (AOR = 3.05; 95%CI: 1.25-7.49) respectively. Clients who responded that physicians show respect (AOR = 5.59; 95%CI: 1.89-16.49). clients who received an explanation about the side effects of the utilized methods and follow-up dates (AOR = 4.59;95%CI:1.68-12.53) and (AOR = 2.89;95%CI:1.53-5.49) respectively. CONCLUSION: The proportion of client satisfaction with Client Satisfaction in the Services delivery system at Family Guidance Association of Ethiopia (FGAE) Clinics was low as compared to the previous study. Age group 25-34 years, primary and secondary education, showing respect, explaining side-effects and follow-up visits were significant associated factors of client service satisfaction. Enhancing service delivery at Family Guidance Association of Ethiopia (FGAE) Clinics by targeting specific areas identified in the study. Strategies should focus on improving communication regarding side effects, ensuring respectful interactions, and prioritizing follow-up visits, particularly for clients aged 25-34 with primary and secondary education backgrounds.

Anthropometric failures and its predictors among under five children in Ethiopia: multilevel logistic regression model using 2019 Ethiopian demographic and health survey data.

BACKGROUND: Composite Index of Anthropometric Failure (CIAF) combines all three forms of anthropometric failures to assess undernutrition status of children. There is no study on CIAF to identify the real and severe form of under nutrition among Ethiopian children that addressed community level factors. So, this study determined CIAF and identified important factors which helps to design appropriate intervention strategies by using multi-level advanced statistical model. METHODS: The study included 5,530 under five children and utilized a secondary data (EMDHS 2019) which was collected through community-based and cross-sectionally from March 21 to June 28, 2019. Composite index of anthropometric failure among under five children was assessed and a two-stage sampling technique was used to select the study participants. Descriptive summary statistics was computed. A multi-level binary logistic regression model was employed to identify important predictors of CIAF in under five children. Adjusted odds ratio with its 95% CI was estimated and level of significance 0.05 was used to determine significant predictors of CIAF. RESULTS: The prevalence of composite index of anthropometric failure (CIAF) was 40.69% (95% CI: 39.41, 42.00) in Ethiopia. Both individual and community level predictors were identified for CIAF in under five children. Among individual level predictors being male sex, older age, short birth interval, from mothers who have not formal education, and from poor household wealth quintile were associated with higher odds of CIAF among under five children. Low community women literacy and being from agriculturally based regions were the community level predictors that were associated with higher odds of CIAF in under five children in Ethiopia. CONCLUSIONS: The burden of composite index of anthropometric failure in under five children was high in Ethiopia. Age of child, sex of child, preceding birth interval, mother's education, household wealth index, community women literacy and administrative regions of Ethiopia were identified as significant predictors of CIAF. Therefore, emphasis should be given for those factors to decrease the prevalence of CIAF in under five children in Ethiopia.

Child growth monitoring and promotion practice and associated factors among health care workers at public health facilities in south Wollo Zone, Northeast Ethiopia: a facility-based cross-sectional study.

BACKGROUND: Growth monitoring and promotion (GMP) is one of the health care priorities to assess and follow the growth pattern of children under 2 years old. Appropriate GMP services enable health care workers to control growth faltering early and child mortality. However, there is limited information showing the practice and associated factors of GMP service among health care workers in Ethiopia. Therefore, this study aimed to assess the practice and identify associated factors of GMP service among health care workers at public health facilities of the South Wollo Zone, northeast Ethiopia. METHODS: A facility-based cross-sectional study was conducted on 397 randomly selected health care workers in the South Wollo Zone, northeast Ethiopia, from May 25 to July 7, 2020. A pretested self-administered questionnaire and in-depth interview were used to collect the quantitative and qualitative data, respectively. Quantitative data were entered using Epi data Version 3.1 and exported to statistical software for social sciences (SPSS) version 20.0 software for further analysis. Binary logistic regression analyses were used to identify factors associated with GMP practice. Statistical tests at a P value < 0.05 with a 95% confidence interval were taken as a cutoff point to determine the statistical significance. Qualitative data were analyzed by using thematic analysis. RESULTS: In this study, the proportion of GMP practice among health care workers was 58.4% (95% CI: 54.0-63.0). Being a holder of first degree (AOR = 2.25; 95% CI: 1.01, 5.05), being a holder of a diploma (AOR = 3.52; 95% CI: 2.04, 6.09), work experience with GMP (AOR = 3.13; 95% CI: 1.58, 6.20), receiving GMP training (AOR = 4.83; 95% CI: 2.89, 8.06), availability of GMP equipment (AOR = 2.75; 95% CI: 1.64, 4.58) and having a positive attitude toward GMP (AOR = 3.70; 95% CI: 2.23, 6.17) were factors significantly associated with GMP practice. CONCLUSIONS AND RECOMMENDATIONS: The proportion of GMP practice among health care workers was still low. Educational level, work experience with GMP, GMP training, GMP equipment and attitude toward GMP were positively associated with GMP practice. Availability of GMP equipment brings positive attitudes toward GMP, and GMP training for health care workers with less experience should be strengthened to improve GMP practice.

The role of nutrition-sensitive agriculture combined with behavioral interventions in childhood growth in Ethiopia: An adequacy evaluation study.

Objective: The study aimed to investigate the role of nutrition-sensitive and specific interventions along with nutrition education on child stunting during the first 1000 days in Ethiopia. Methods: An adequacy evaluation study was used to see changes between the baseline and end-line data after following for 1 year. A sample of 170 mother-child pairs who had a 1-year followed up was used to detect differences. We performed structural equation modeling to elucidate changes in feeding behaviors, socioeconomic status, water, sanitation and hygiene on child linear growth. Furthermore, the independent effect of covariates on child linear growth was handled using a general linear model. Results: A total of 170 and 270 mother-child dyads were interviewed at baseline and end-line surveys, respectively. After about 1 year of intervention, the annual rate of stunting prevalence declined from 29.3% (95% confidence interval [CI] = 18.6, 42.7) to 16.4% (95% CI = 10.7, 24.2). There was a significant change in the mean of length-for-age Z-score which changed from -1.18 to -0.45 (P < .034). Adjusting for the different constructs of the health belief model, child sex, age, feeding behaviors, and dietary diversity, one egg consumption per day was responsible for the most significant variability explained (36%) for stunting reduction. Conclusions: Sustainable access to egg consumption for children below 2 years experienced a substantial reduction in childhood stunting. A combination of nutrition-sensitive agricultural and direct nutrition interventions along with behavioral-based education is a sustainable strategy in reducing and preventing child growth from faltering in the early life stages.

Knowledge and practice regarding the behavioural risks of cancer among college students in Ethiopia.

In recent years, morbidity and mortality due to cancer has been increasing in Ethiopia, putting it among the most important public health issues. Cancer and associated complications can be prevented provided that effective interventions are put in place to control risk factors. Therefore, this study aimed to assess the level of knowledge and practice of preventable behavioural risk factors of cancer. We conducted a cross-sectional study among 200 college students in Northeast Ethiopia utilising quantitative methods of data collection. Data on socioeconomic characteristics, health belief variables, knowledge and behavioural risk factors (alcohol consumption, tobacco smoking, physical activity and dietary practice) were collected. The level of knowledge and practice was summarised using descriptive statistics. To investigate the variation in knowledge and practice across sociodemographic characteristics, we performed Pearson Chi-square test or Fisher's exact test. The majority (81.0%) of participants was male and 82.0% were in the age group of 18-24 years. More than half (61.0%) of them had poor knowledge about the behavioural risk factors of cancer. Nearly one-third (30.5%) consume alcohol, whereas 16.0%, 18.0% and 20.0%, respectively, smoke tobacco, consume street food and packed-fried snacks daily. Alcohol consumption (p = 0.02) and level of vigorous physical activity (p = 0.001) were significantly higher among males than females. Alcohol consumption, tobacco smoking and unhealthy dietary practice were remarkably high, whereas knowledge towards the behavioural risk factors was low. Therefore, health education and collaborative action between different sectors are needed to counter the emerging problem. The trial is registered in ClinicalTrials.gov (https://register.clinicaltrials.gov) NCT04269018.

Individual level and community level factors affecting exclusive breast feeding among infants under-six months in Ethiopia using multilevel analysis.

BACKGROUND: Exclusive breastfeeding (EBF) is the safest and healthiest option of feeding among infants in the first 6 months throughout the world. Thus, promotion of EBF is essential to prevent complex infant health problems even at the adulthood level. But majority of previous studies focused on individual level determinants of EBF by using basic regression models in localized areas. This study aims to identify individual level and community level determinants of EBF which would be helpful to design appropriate strategies in reducing infant mortality and morbidity. METHODS: It is a secondary data analysis using the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of 1185 infants under 6 months of age were included in the analysis. Multilevel logistic regression model was employed to investigate factors significantly associated with EBF among under-six month's infants in Ethiopia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to measure the association of variables whereas Intra cluster correlation (ICC), median odds ratio (MOR), and proportional change in variance (PCV) were used to measure random effects (variation). RESULT: In multilevel logistic regression; 4-5 months age infant (AOR = 0.04, 95%CI:0.02-0.07), female infants (AOR = 2.51, 95%CI:1.61-3.91), infant comorbidities (AOR = 0.35, 95%CI: 0.21-0.57), household wealth index (AOR = 10.34, 95%CI: 3.14-34.03) and antenatal care (AOR = 2.25, 95%CI:1.32-3.82) were determinants of EBF at individual level. Whereas, contextual region (AOR = 0.30, 95% CI: 0.10-0.87), community level of postnatal visit (AOR = 2.77, 95% CI: 1.26-6.58) and community level of maternal employment (AOR = 2.8, 95% CI: 1.21-6.47) were determinants of EBF at community level. The full model showed up with higher PCV; that is, 46.8% of variation of exclusive breastfeeding was explained by the combined factors at the individual and community levels. Similarly, it showed that the variation in EBF across communities remained statistically significant (ICC = 8.77% and variance = 0.32 with P < 0.001). The MOR at final model indicates there was significant cluster difference for EBF indicating the heterogeneity was explained by both individual and community level factors. CONCLUSION AND RECOMMENDATION: Our study showed that both individual and community level determinants were significantly associated with EBF practice. Based on our findings it is strongly recommended to promote and enhance antenatal and postnatal care services utilization of mothers and more emphasis should be given for infants with comorbid conditions and those who live in the pastoralist regions.