Determinants of defaulter to full vaccination among children aged 12-23 months in Siraro district, West Arsi zone, Oromia, Ethiopia: a case-control study.

BACKGROUND: Vaccination is one of the most cost-effective global public health interventions to reduce childhood morbidity and mortality. Defaulters to full vaccination can put children at greater risk of acquiring vaccine-preventable disease outbreaks. The reason for not receiving full vaccination is not well explored, and hence, there is limited evidence about defaulters of vaccination in Ethiopia. OBJECTIVES: To identify determinants of defaulter to full vaccination among children aged 12-23 months in Siraro District, West Arsi Zone, Oromia Region, Ethiopia. METHODS: A community-based unmatched case-control study was conducted among children aged 12-23 months from March 20 to April 30, 2022, with a total sample size of 444 (148 cases and 296 controls). Cases were children aged 12-23 months who had missed at least one routine vaccination dose, while controls were children who had received all of the recommended routine vaccinations. Consecutive sampling and simple random sampling techniques were used to select representative cases and controls respectively. Data were collected using a structured questionnaire, entered into Epi-data version 4.6, and exported to Statistical Package for Social Sciences version 26 for analysis. Logistic regression was used to identify determinants of the defaulter to full vaccination and the variables with p-value < 0.25 were recruited for multivariable analysis, and an adjusted odds ratio with a 95% confidence interval and a p-value of ≤ 0.05 was used to declare the statistical significance of the association. RESULT: Of the assessed determinants of the defaulter to full vaccination; inadequate knowledge of mothers/caretakers (AOR = 4.32, 95% CI:2.78-6.70), educational status of a father unable to read and write (AOR = 3.66, 95% CI:1.29-10.39), time to reach health facility ≥ 30 minutes (AOR = 2.45, 95% CI:1.51-3.97), not told about the type of vaccine received (AOR = 2.37, 95% CI;1.27-4.45), no parents discussion on vaccination (AOR = 2.16, 95% CI:1.24-3.79), home delivery (AOR = 2.43, 95% CI:1.39-4.25) and not participated in pregnant mother conference (AOR = 2.47, 95% CI = 1.35-4.49) were the identified determinants of the defaulter to full vaccination. CONCLUSION: Mother's' knowledge, father's education, place of delivery, time to reach a health facility, health workers who told the type of vaccine received, participation in pregnant mother conference, and parents' discussion on vaccination were the determinants of the defaulter to full vaccination status. Thus, the district health office should work on defaulters of vaccination by strengthening immunization service delivery and improving maternal knowledge on vaccination through pregnant mother conference participation.

Does the perception of HIV risk among Female sex workers affect HIV prevention behavior? application of the Health Belief Model (HBM).

BACKGROUND: High prevalence of Human Immune virus/Acquired immunodeficiency syndrome (HIV/AIDS) in Female Sex Workers (FSWs) is identified as a bottleneck in fighting against HIV/AIDS. To this end, the international community planned a strategy of 'Ending inequality' and 'Ending the AIDS epidemic' by 2030. This could not be achieved without due attention to FSWs. Thus, this study attempted to assess HIV prevention behavior and associated factors among FSWs in Dima district of Gambella region, Ethiopia by using the Health Belief Model. METHODS: A community-based cross-sectional study was conducted from March to May 2019 among 449 FSWs selected using the snowball sampling technique. Socio-demographic features, knowledge about HIV, attitude toward HIV prevention methods, and Health Belief Model (HBM) constructs (perceived susceptibility to and severity of HIV, perceived barriers, and benefits of performing the recommended HIV prevention methods, self-efficacy, and cues to practice HIV prevention methods) were collected using face to face interview. Data were entered into Epi-data 3.1 and analyzed using SPSS version 23. Bivariable and multivariable binary logistic regression analysis was done to identify the association between dependent and independent variables. P-value < 5% with 95 CI was used as a cutoff point to decide statistical significance of independent variables. RESULTS: In this study, 449 FSWs participated making a response rate of 98.90%. Of these, 64.8% had high HIV prevention behavior. Age (AOR = 1.911, 95% CI: 1.100, 3.320), knowledge of HIV (AOR = 1.632, 95% CI: 1.083, 2.458), attitude towards HIV prevention methods (AOR = 2.335, 95% CI: 1.547, 3.523), perceived barriers (AOR = .627, 95% CI: .423, .930), and self-efficacy (AOR = 1.667, 95% CI: 1.107, 2.511) were significantly associated with high HIV prevention behavior. CONCLUSION: The study identified that about two third of FSWs practiced the recommended HIV prevention methods. Age of respondents, knowledge of HIV, favorable attitude towards the recommended HIV prevention methods, high self-efficacy, and low perceived barrier were associated with high HIV prevention behavior. Therefore, focusing on these factors would be instrumental for improving effectiveness of the ongoing HIV prevention efforts and attaining the 'Sustainable Development Goals of 'Ending inequality' and 'Ending the AIDS epidemic' by 2030.

Sociodemographic Factors Predicting Exclusive Breastfeeding in Ethiopia: Evidence from a Meta-analysis of Studies Conducted in the Past 10 Years.

OBJECTIVES: To investigate the association between EBF and educational status, household income, marital status, media exposure, and parity in Ethiopia. METHODS: PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases were searched using key terms for all studies published in English between September 2009 and March 2019. The methodological quality of studies was examined using the Newcastle-Ottawa Scale (NOS) for cross-sectional studies. To obtain the pooled odds ratio (OR), extracted data were fitted in a random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ2, and I2 statistics. In addition, Jackknife sensitivity analysis, cumulative meta-analysis, and meta-regression analysis were conducted. RESULTS: Out of 553 studies retrieved, 31 studies fulfilled our inclusion criteria. Almost all included studies were conducted among mothers with newborn less than 23 months old. Maternal primary school education (OR 1.39; 95% CI 1.03-1.89; I2 = 86.11%), medium household income (OR 1.27; 95% CI 1.05-1.55; I2 = 60.9%) and being married (OR 1.39; 95% CI 1.05-1.83; I2 = 76.96%) were found to be significantly associated with EBF. We also observed an inverse dose-response relationship of EBF with educational status and income. However, EBF was not significantly associated with parity, media exposure, and paternal educational status. CONCLUSIONS: In this meta-analysis, we showed the relevant effect of maternal education, income, and marital status on EBF. Therefore, multifaceted, effective, and evidence-based efforts are needed to increase the national level of exclusive breastfeeding in Ethiopia.

Knowledge Toward Cervical Cancer and Its Determinants Among Women Aged 30-49 in Jimma Town, Southwest Ethiopia.

BACKGROUND: Cervical cancer is one of the common causes of premature death and disability in women worldwide. It is preventable through vaccination, and screening for precancerous lesions and early treatment. However, screening service uptake and treatment for cervical cancer face significant challenges in low-income countries due to poor information systems. The aim of this study was to assess knowledge of cervical cancer and its determinants among women aged 30-49 years living in Jimma Town, Southwest Ethiopia. METHODS: A community-based cross-sectional study was undertaken from March 20 to April 15, 2017. The data were collected using a structured interviewer-administered questionnaire and analyzed by SPSS version 21. Multivariable logistic regression anaysis was done and variables with a p-value < 0.05 were considered statistically significant. RESULTS: Of the interviewed women, only 321(43.6%) had adequate knowledge about cervical cancer and screening. Attending secondary school or above (AOR = 2.42, 95% CI: 1.24-4.74), using modern contraceptives (AOR = 6.31, 95% CI: 2.86-13.89), knowing somebody with cervical cancer (AOR = 2.24, 95% CI: 1.35-3.71) and knowing someone screened for cervical cancer (AOR = 2.23, 95% CI: 1.30-3.80) were associated with knowledge of cervical cancer. CONCLUSION: Knowledge of cervical cancer is low in the current study area even if appropriate knowledge regarding the disease is important in decreasing the incidence and prevalence of cervical cancer through screening and human pappiloma virus vaccination. Increasing awereness regarding the disease and prevention strategies are the key issue.

Breast and complementary feeding in Ethiopia: new national evidence from systematic review and meta-analyses of studies in the past 10 years.

PURPOSE: The aim of this systematic review and meta-analysis was to provide a national estimate of breast and complementary feeding practices and its predictors in Ethiopia. METHODS: PubMed, SCOPUS, EMBASE, CINHAL, Web of Science and WHO Global Health Library electronic databases were searched for all available literature published until April 2018. Observational studies including cross-sectional, case-control and cohort studies were included. Newcastle-Ottawa Scale was used to assess the quality of studies. Heterogeneity of studies was quantified using Cochran's Q χ2 statistic and Higgins's method (I2). A meta-analysis using a weighted inverse variance method was performed. Subgroup analysis was carried out based on region and study area. RESULTS: In total, 70 studies that involved > 55,000 women from nine regions and two chartered cities in Ethiopia were included. The pooled national prevalence for timely initiation of breastfeeding (TIBF), exclusive breastfeeding (EBF) and timely initiation of complementary feeding was 66.5%, 60.1% and 62.5%, respectively. Guidance and counselling on breastfeeding, vaginal delivery and health institution delivery significantly increased the odds of TIBF and EBF. In addition, TIBF significantly associated with high EBF practice. Maternal occupational status significantly associated with low EBF practice, but not TIBF. CONCLUSIONS: Based on the WHO standard, the current breast and complementary feeding practice in Ethiopia is good and improving. Integrated intervention is still required for further improvement and minimizing the effect of occupational status.

Determinants of poor glycemic control among adult patients with type 2 diabetes mellitus in Jimma University Medical Center, Jimma zone, south west Ethiopia: a case control study.

OBJECTIVE AND BACKGROUND: In 2015 approximately 5.0 million people were estimated to have died from diabetes. Poor glycemic control is the most determinant of diabetes-related complication and death. The percentage of patients whose blood glucose level are not well controlled remains high yet. The aim of this study is to identify the determinants of poor glycemic control at the diabetes clinic of the Jimma University Medical Center from April 01 to June 30/2017. METHODS: Facility-based case-control study design was conducted on patients with type 2 diabetes mellitus on follow-up at the diabetes clinic of Jimma University medical center. The consecutive sampling technique was employed and data were collected from April to June 2017. The data were entered using Epidata manager version 4.0.2 and exported to SPSS Version 21 for analysis. Logistic regression analysis was performed and variables with the p-value of less than 0.05 were considered as statistically significant determinants of poor glycemic control. RESULT: The study was conducted on 410 patients, of which 228 males and 182 females. The determinants of poor glycemic control were comorbidities [Adjusted odd ratio(AOR) = 2.56, 95%CI = 1.10-5.96], lack of self-monitoring blood glucose [AOR = 3.44,95%CI = 1.33-8.94], total cholesterol level of 200 mg/dl or more [AOR = 3.62, 95%CI = 1.46-8.97], diabetes duration of greater than 7 years [AOR = 3.08, 95%CI = 1.33-7.16], physical activity of three or less than three days [AOR = 4.79, 95%CI = 1.70-13.53], waist to hip ratio of 0.9 or greater for male and 0.85 or greater for female [AOR = 3.52, 95%CI = 1.23-10.11], being on metformin plus insulin [AOR = 9.22, 95%CI = 2.90-29.35] and being on insulin [AOR = 4.48, 95%CI = 1.52-13.16]. CONCLUSION: Lack of Self-monitoring blood glucose, presence of comorbidities, duration of diabetes mellitus, physical activity of three or less than three days, total cholesterol of 200 mg/dl or more, waist to hip ratio of 0.9 or greater for male and 0.85 or greater for female, and types of antidiabetic medication were the independent predictors of poor glycemic control. Effort should be made towards reducing these factors by the concerned body.

Prevalence of sexual dysfunction and related factors among diabetes mellitus patients in Southwest Ethiopia.

BACKGROUND: Diabetes mellitus causes multiple medical, psychological and sexual problems in both men and women. Sexual dysfunction is one of those problems that lead to a strong social and psychological problem which adversely affect marital relation and treatment outcome. The issue has not been well studied in Ethiopia; therefore, this study aimed to evaluate the prevalence and factors related to sexual dysfunction in adult patients with diabetes mellitus. METHODS: Facility-based cross-sectional study was conducted among adults with diabetes mellitus on follow-up at diabetic clinics of Mizan-Tepi University Teaching Hospital and Tepi General Hospital. A consecutive sampling technique was employed to select 423 study participants, and data were collected through interviewer-administered questionnaire and patients' medical chart review. Changes in Sexual Functioning Questionnaire-fourteen items (CSFQ-14) was used to measure sexual dysfunction. Descriptive statistics and binary logistic regression analyses were performed. Two tail tests at α of less 0.05 were used as a level of significance. RESULTS: A total of 398 diabetic patients were interviewed, with a 94% response rate. The prevalence of sexual dysfunction was 53.3%. Age of above 41 years (AOR: 3.98, 95% CI 2.32-6.85), lack of formal education (AOR: 3.20, 95% CI 1.60-6.39), divorced or widowed (AOR: 5.28, 95% CI 2.35-11.86), type 2 DM (AOR: 4.52, 95% CI 2.17-9.42), depression (AOR: 4.05, 95% CI 2.32-7.10), complications or co-morbidity (AOR: 2.05, 95% CI 1.18-3.58), and not doing physical activity (AOR: 1.62, 95% CI; 1.47-1.77) were significantly associated with sexual dysfunction among diabetes patients. CONCLUSIONS: The prevalence of sexual dysfunction was as high as reports from other studies. Therefore, health care providers should include the issue of sexual health in their routine discussions with adult diabetes mellitus patients. Presence of depression, not doing physical activity and having complications or co-morbidity are modifiable factors associated with sexual dysfunction; therefore, they should be attended during care addressing sexual dysfunction.

Cervical cancer screening service utilization and associated factors among age-eligible women in Jimma town using health belief model, South West Ethiopia.

BACKGROUND: Cervical cancer is the second most common gynecologic cancer affecting the lives of women. It causes hundreds of thousands of death among women annually worldwide. When a woman is screened for cervical cancer at least once in her life between the ages of 30 and 40, the risk of getting cervical cancer can be decreased by 25-36%. Despite this advantage, the coverage of cervical cancer screening is limited in low and middle-income countries including Ethiopia. OBJECTIVE: To assess cervical cancer screening service utilization and associated factors among age-eligible women in Jimma town, South West Ethiopia, 2017. METHODS: Community based cross-sectional study was used. Seven hundred thirty-seven women were selected using systematic random sampling. Data were collected using a structured interview administered questionnaire. Data were collected on socio-demographic, reproductive factors, knowledge of cervical cancer as well as constructs of Health belief model and practice related variables. Logistic regression analysis was performed, and variables with a p-value of less than 0.05 in the multivariable analysis were taken as statistically significant predictors of cervical cancer screening service utilization. RESULTS: Of the 737 women, only 15.5% were screened for cervical cancer. The independent predictors of cervical cancer screening utilization were: being government employee [AOR = 3.00, 95% CI: 1.49-6.01], knowing someone who has ever screened [AOR = 3.61, 95% CI: 2.07-6.29], having history of gynecologic examination for any reason (having previous examination that expose women genitalia for physician like examination during child birth, abortion procedure and examination for STI) [AOR =2.84, 95% CI: 1.48-5.45], not preferring gender of physician for gynecological examination [AOR = 3.57, 95% CI: 1.98-6.45], getting advice from health care providers [AOR = 4.45, 95% CI: 2.57-7.70], having good knowledge of cervical cancer screening [AOR = 3.46, 95% CI: 1.47-8.21] and having perceived susceptible for cervical cancer [AOR = 3.03, 95% CI: 1.64-5.56]. CONCLUSIONS: The utilization of cervical cancer screening services was low in Jimma town. Strengthening the screening service is important through raising the awareness of the community towards cervical cancer and screening services.

Evaluation of public health surveillance system performance in Dangila district, Northwest Ethiopia: a concurrent embedded mixed quantitative/qualitative facility-based cross-sectional study.

BACKGROUND: Evaluation of a surveillance system should be conducted on regular bases to ensure that the system is working as envisioned or not. Therefore, we evaluated Dangila district's public health surveillance system performance in line with its objectives. METHODS: In August 2017, a concurrent embedded mixed quantitative/qualitative, facility-based cross-sectional study was conducted in Dangila district among 12 health facilities/sites. The qualitative part involved 12 purposively selected key stakeholders interview. A semi-structured questionnaire adapted from updated CDC guideline for evaluating public health surveillance system was used for data collection through face to face interview and record review. The major qualitative findings were narrated and summarized based on thematic areas to supplement the quantitative findings. The quantitative findings were analyzed using Microsoft Excel 2007. RESULTS: All necessary surveillance guidelines, registers and reporting formats were distributed adequately to health facilities. Only the district health office has Emergency Preparedness and Response Plan (EPRP), but not supported by the budget required to respond in case an emergency occurred. There were no regular data analysis and interpretations in terms of time, place and person. Weekly report completeness and timeliness were 100 and 94.6% respectively. The information collected was considered relevant by its users to detect outbreaks early with high acceptability. All stakeholders agreed that the system is simple, easy to understand, representative and can accommodate modifications. Written feedbacks were not obtained in all health facilities. The supervision checklist obtained in the district was not adequate to assess surveillance activities in detail. The calculated positive predictive value for malaria was 11%. CONCLUSIONS: The surveillance system was simple, useful, flexible, acceptable and representative. Report completeness and timelines were above the national and international targets. However, the overall implementation of the system in the district was not satisfactory to achieve the intended objective of surveillance for public health action due to the lack of regular data analysis and feedback dissemination. To create a well-performing surveillance system, regular supervision and epidemiologically analyzed and interpreted feedback system is mandatory.

Role of maternity waiting homes in the reduction of maternal death and stillbirth in developing countries and its contribution for maternal death reduction in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Every family expect to have a healthy mother and new born baby after pregnancy. Especially for parents, pregnancy is a time of great anticipation. Access to maternal and child health care insures safer pregnancy and its outcome. MWHs is one the strategy. The objective was to synthesize the best available evidence on effectiveness of maternity waiting homes on the reduction of maternal mortality and stillbirth in developing countries. METHODS: Before conducting this review non-occurrences of the same review is verified. To avoid introduction of bias because of errors, two independent reviewers appraised each article. Maternal death and stillbirth were the primary outcomes. Review Manager 5 were used to produce a random-effect meta-analysis. Grade Pro software were used to produce risk of bias summary and summary of findings. RESULT: In developing countries, maternity waiting homes users were 80% less likely to die than non-users (OR = 0. 20, 95% CI [0.08, 0.49]) and there was 73% less occurrence of stillbirth among users (OR = 0.27, 95% CI [0.09, 0.82]). In Ethiopia, there was a 91% reduction of maternal death among maternity waiting homes users unlike non-users (OR = 0.09, 95% CI [0.04, 0.19]) and it contributes to the reduction of 83% stillbirth unlike non-users (OR = 0.17, 95% CI [0.05, 0.58]). CONCLUSION: Maternity waiting home contributes more than 80% to the reduction of maternal death among users in developing countries and Ethiopia. Its contribution for reduction of stillbirth is good. More than 70% of stillbirth is reduced among the users of maternity waiting homes. In Ethiopia maternity waiting homes contributes to the reduction of more than two third of stillbirths.

Determinants of home delivery among reproductive age women in Bore District, East Guji Zone, Ethiopia: a case-control study.

Introduction: Home delivery, which is the process of childbirth at one's residence rather than in a health facility, is a major reason for maternal mortality caused by obstetric complications, such as sepsis, hypertensive disorders, and hemorrhage. Maternal and child mortality remains high in developing countries despite efforts made to reduce these outcomes. This is mainly due to poor utilization of institution-based healthcare services. Moreover, there is a limited number of studies that have addressed the determinants of home delivery in Ethiopia, including the study area. This study aims to identify the determinants of home delivery in Bore District, East Guji Zone, Southern Ethiopia, in 2022. Methods: A community-based unmatched case-control study was conducted from 18 May to 5 July 2022 among 498 women (249 cases and 249 controls) who gave birth in Bore District. The case group included women who gave birth at home, while the control group included those who gave their last birth at health institutions. A multistage sampling technique was employed to select the study participants. Data were collected using the KoboToolbox digital software and exported to SPSS Version 26.0 for analysis. A multivariable logistic regression analysis was done to declare the statistical significance of the association of the the independent variables and home delivery. Results: The study included a total of 496 respondents with a mean age of 32.5 (SD = ±5.5) for the case group and 33.7 (SD = ±5.2) for the control group. Among the assessed determinants of home delivery were not attending antenatal care (ANC) visits [adjusted odds ratio (AOR) = 5.6, 95% CI: 2.0-15.16], missing pregnant women's conferences (AOR = 3.2, 95% CI: 1.65-8.32), not receiving health education on pregnancy-related complications (AOR = 2.2, 95% CI: 1.1-4.3), inadequate knowledge of pregnancy-related danger signs (AOR = 6.0, CI: 3.0-11.9), inadequate knowledge about pregnancy-related complications (AOR = 3.0, CI: 1.55-6.13), and unfavorable attitude (AOR = 6.9, 95% CI: 2.16-22.6). Conclusion: In this study, not attending ANC visits, missing pregnant women's conferences, not receiving health education on pregnancy-related complications, inadequate knowledge of pregnancy-related danger signs, inadequate knowledge about pregnancy-related complications, and unfavorable attitudes were identified as determinants of home delivery. The district health office and other stakeholders should work on strengthening maternal health service delivery through appropriate ANC visits and participation in pregnant women's conferences and improving community awareness about pregnancy at all levels.

Utilization of immediate postpartum intrauterine device and its associated factors among women who gave birth in public hospitals in West Wollega Zone, Oromia, Ethiopia.

Background: The utilization of an immediate postpartum intrauterine device (IPPIUD) during the postpartum period helps women to realize their desire for birth spacing and prevent unplanned pregnancies. However, many postpartum mothers do not undergo immediate postpartum family planning in developing countries, including Ethiopia, which consequently increases the risk of unplanned pregnancies and pregnancy-related complications. Objective: To assess the utilization of an IPPIUD and its associated factors among women who gave birth in public hospitals in the West Wollega Zone in 2022. Methods: An institutional-based cross-sectional study was conducted among 605 postpartum mothers who delivered their baby between 15 April and 15 May 2022 at public hospitals in the West Wollega Zone, Ethiopia. A systematic random sampling technique was used to select study subjects, and the data were collected using an interviewer-administered structured questionnaire, which was then entered into EpiData Entry version 4.6 and exported to the Statistical Package for Social Science version 26 for analysis. The variable with a p-value of ≤ 0.05 with an adjusted odds ratio and 95% confidence intervals was used to declare statistically significant association. Result: The prevalence of the utilization of the IPPIUD among respondents who gave birth in West Wollega public hospitals within 48 h was 27.2% (95% CI, 23.7-30.9). Age ranging between 25 and 34 years (AOR = 4.27, 95%CI:1.68-10.85), early initiation of antenatal care (ANC; AOR = 1.91, 95%CI: 2.8-10.01), adequate knowledge of IPPIUD (AOR = 4.71, 95%CI: 2.63-6.63), favorable attitude toward family planning (AOR = 3.35, 95%CI: 2.07-5.44), planning of pregnancy (AOR = 2.21, 95%CI: 1.37-4.11), and counseling (AOR = 4.14, 95%CI: 2.60-6.68) were factors that were significantly associated with the utilization of IPPIUD. Conclusion: According to the 2019 Ethiopia Mini Demographic and Health Survey (mini EDHS 2019), the utilization of an immediate postpartum intrauterine device was low, that is, 35%. Age of respondents, early initiation of antenatal care, favorable attitude toward, planning of pregnancy, adequate knowledge of, and counseling on IPPIUD utilization were significantly associated with the mother's utilization of immediate postpartum intrauterine device. Thus, the zonal health office and health professionals should work toward encouraging all the women who gave birth at public hospitals to the utilization of immediate postpartum intrauterine devices by improving awareness among the women in that specific zone through counseling to increase the uptake of IPPIUD.

Exploring barriers of childhood full vaccination among children living in Siraro District, West Arsi Zone, Oromia region, Ethiopia: A qualitative study.

Background: Childhood immunization is one of the most effective global public health interventions to reduce childhood morbidity and mortality. However, some children remain not fully vaccinated in developing countries due to defaulting from full vaccination, which can put them at risk of acquiring vaccine-preventable disease outbreaks. The barriers to full vaccination were well explored in Ethiopia using a qualitative approach. The study aimed to explore barriers to full childhood vaccination in Siraro District, West Arsi Zone, Oromia, Ethiopia. Methods: A qualitative study was conducted in Siraro District through 15 key informant health workers interviews and 6 in-depth interviews with children's mothers from April 20 to May 15, 2022. Data were collected by semi-structured questionnaires and captured using audio tape recorders and field note-taking. A heterogeneous purposive sampling technique was used to select representative study participants. Data transcription and translation were done according to the respondents' verbatim from the local language to English. Data coding and key categories were identified and analyzed using thematic analysis. Finally, data were presented in narrative forms using respondents' own words as an illustration. Result: Twenty-one study participants were interviewed and included in this study. Of the explored barriers to full childhood vaccination, the evidence from the respondents was integrated from subcategories and presented as a whole within each thematic area. Five thematic areas emerged from interviews of the participants through thematic analysis of the data. The identified barriers were forgetting the next vaccination schedule, migration of parents, work overload, lack of knowledge and awareness, rumors, and misinformation. Additionally, vaccination service delivery-related barriers such as vaccine vials not being opened for a few children, fear of vaccine side effects, closed health posts during visits by mothers for vaccination, and absence of health extension workers at health posts were the key barriers to full childhood vaccination. Conclusion: Forgetting vaccination schedule, migration of parents, work overload, rumors, and misinformation, fear of vaccine side effects, vaccine vial not opened for few children, closed health posts during visiting by mothers, absence of health extension workers from health posts were the key barriers to the full vaccination status of children. Thus, the district health office should work on barriers to full vaccination by strengthening vaccination service delivery and improving vaccination awareness through a health extension program.

Health related quality of life of HIV-positive women on ART follow-up in north Shewa zone public hospitals, central Ethiopia: Evidence from a cross-sectional study.

Background: Evidence revealed that there is a statistically significant gender difference in Health-related quality of life (HRQoL) among HIV-positive people on Antiretroviral therapy (ART). Consequently, HIV-positive women have low scores in all HRQoL domains than men. Despite this fact, previous studies in Ethiopia focused on general HIV-positive people and paid less attention to HIV-positive women. Therefore, this study was intended to measure HRQoL and associated factors among HIV-positive women on ART follow-up in north Shewa zone public hospitals, central Ethiopia. Methods: An institution-based cross-sectional study was conducted from February 01-April 30, 2022. Four hundred twenty-six women on ART were included using a systematic random sampling technique. Face-to-face interviews and medical record reviews were used to collect data. Both bivariable and multiple linear regressions were computed to identify the factors associated with HRQoL. A p-value <0.05 was used to assert statistically significant variables in multiple linear regression analysis. Results: The overall mean (SD) score of the HRQoL was 11.84 (2.44). And, 44.7% [95% CI: 40.3, 49.5] of the women have poor HRQoL. In multiple linear regression analysis, factors like depression (ß = -0.35), Post-Traumatic Stress Disorder (PTSD) (ß = -0.16), age (ß = -0.07), rural residence (ß = -0.52), and bedridden functional status (ß = -1.02) were inversely associated with HRQoL. Oppositely, good treatment adherence (ß = 0.46) was positively associated with overall HRQoL, keeping other factors constant. Conclusion: This study reveals a high magnitude of poor HRQoL among HIV-positive women. Therefore, as HRQoL domains are comprehensive indicators of living status, healthcare service providers should be dedicated to screening and supporting HIV-positive women with poor HRQoL. Additionally, healthcare providers should also pay special attention to routine PTSD screening and management for HIV-positive women due to its detrimental effect on HRQoL.

The Effect of Multimodal Non-pharmacological Interventions on Cognitive Function Improvement for People With Dementia: A Systematic Review.

Introduction: Dementia is a progressive brain degeneration characterized by a progressive deterioration in cognition and independent living capacity. Since dementia is a complex syndrome, multimodal non-pharmacological interventions (MNPIs) are highly recommended. Currently, there is less available evidence to describe the content, length, and frequency of multimodal interventions for cognitive function improvement for people with dementia (PWD). Method: A comprehensive search was performed in PubMed, EMBASE, CINAHL, Web of Science, and Medline international databases. The quality appraisal of the studies was done by the Cochrane risk of bias assessment tools. Results: A total of 19 controlled trial studies were included. Most of the included studies reported that MNPIs resulted in improvement, stability, or attenuation of decline in cognitive function of PWD. The reported effectiveness of MNPIs on cognitive function ranged from medium (0.29 Cohen's d) to large (2.02 Cohen's d) effect sizes. The median duration of intervention was 12 weeks for a 1-h session. Conclusion: This systematic review showed that MNPIs might improve people's cognitive functions for PWD. Physical exercise, music, and cognitive interventions were used in the content of multimodal interventions in a majority of the studies. Therefore, high-quality randomized controlled trial (RCT) studies with repeated-measured design on the combined effect of physical exercise, music, and cognitive intervention on cognitive function for PWD are recommended. Systematic Review Registration: http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020222065.

What is the community's knowledge and understanding regarding epilepsy? Epilepsy knowledge and its determinants among residents of Debub Bench District, Bench Sheko Zone, Southwest Ethiopia, 2019: a cross-sectional study.

OBJECTIVE: Epilepsy is a neurological condition marked by recurring seizures. People with epilepsy, particularly in low-income and middle-income countries, are stigmatised due to a lack of understanding and a negative attitude towards the disease. Increased public awareness of epilepsy will aid in the search for therapy and the quality of life of the patients. The study aimed to assess knowledge about epilepsy and the associated factors among residents of Debub Bench District, Bench Sheko Zone, Southwest Ethiopia in 2020. SETTING: This community-based, cross-sectional study triangulated with qualitative method was conducted from 25 April 2020 to 20 May 2020. Multistage sampling technique was used to select 601 participants. A structured and interviewer-administered questionnaire was used to collect data. Data were entered in EpiData Manager V.4.0.2.101 and exported to SPSS V.23 for analyses. Multivariable logistic regression was carried out to identify the factors associated with knowledge of epilepsy. A p value of <0.05 was taken to indicate statistical significance. RESULTS: A total of 601 respondents participated, of whom 340 (56.6%) were male. The mean age of the respondents was 34.84±11.42 years. The proportion with good knowledge of epilepsy was 55.1%. Factors associated with good knowledge of epilepsy were attending primary education (adjusted OR (AOR)=2.06, 95% CI 1.27 to 3.34), secondary education (AOR=5.01, 95% CI 2.62 to 9.58), above secondary education (AOR=5.67, 95% CI 2.35 to 13.69), being in high wealth index (AOR=1.74, 95% CI 1.09 to 2.78), being a government employee (AOR=3.69, 95% CI 1.39 to 9.83), being a merchant (AOR=3.16, 95% CI 1.80 to 5.54) and being an urban resident (AOR=2.15, 95% CI 1.36 to 3.42). CONCLUSION: Only 55% of the residents have sufficient knowledge about epilepsy. Factors associated with knowledge of epilepsy were educational status, wealth index, occupation and residence.

Factors Associated With HIV Preventive Behavior Among Adults in Majang Zone of Gambella Region, Southwest Ethiopia.

Background: HIV-positive people can spread the virus through unprotected sex; however, HIV can be avoided if populations are educated about the risks. In underdeveloped nations, evidence suggests that the ABC method for HIV prevention is quite effective. As a result, the goal of this study was to determine the magnitude of HIV prevention behavior among adults in the Majang zone of Southwest Ethiopia, as well as the factors that influence it. Methods: A community-based cross-sectional study was carried out from March 1st to May 31st, 2019. The data were collected through a face-to-face interview using a modified validated questionnaire among systematically selected study participants. The collected data were coded and entered using Epidata manager version 4.0.2.101 and analyzed using SPSS version 21. A logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. The level of significance was declared at a p-value less than 0.05. Results: Of the 772 adults interviewed, the proportion of adults who had good HIV preventive behavior was 51.8%, 95% CI [48.3-55.3%]. Two hundred forty (31.9%) were used abstinence as a type of HIV preventive behavior followed by being faithful (16.1%) and consistent condom use (7.3%). The study also found that respondents with the age group ≥27 years old (AOR = 1.56, 95% CI [1.3-3.12]), marital status (being married (AOR = 6.30, 95% CI [4.48-11.4]), and divorced/widowed (AOR = 5.50, 95% CI [2.60-12.4]) and having good knowledge of HIV prevention methods (AOR = 2.18, 95% CI [1.71-4.00]) were the factors associated with good HIV preventive behavior. Conclusion and Recommendation: In the study area, overall HIV prevention behavior was average. The characteristics linked with successful HIV prevention behavior among adults in the Majang community included increasing age, being married or divorced/widowed, and having a solid understanding of HIV prevention approaches. As a result, policy-level and multi-sectorial intervention approaches from all stakeholders are necessary to develop short- and long-term strategies to address the problem and improve the community's quality of life.

Does knowledge of non-communicable diseases risk factors influence screening service utilization? The finding from North Shewa Zone, Central Ethiopia.

Enhanced Non-communicable Diseases (NCDs) screening efforts are emphasized as opportunities to reduce premature mortalities due to the diseases. Nevertheless, the utilization of NCDs screening is affected by the knowledge of the risk factors. This study aimed to assess the relationship between knowledge of non-communicable diseases risk factors and screening service utilization. This community-based cross-sectional study was conducted among randomly selected adult residents of North Shewa Zone, Oromia Region, Central Ethiopia. Descriptive statistics were used to describe the background variables and multivariable logistic regression analysis was conducted to identify the factors associated with screening utilization. A total of 823 respondents completed the survey. The proportion of screening utilization was found to be 34.5 %; 95 % CI: 31.3, 37.9. Age < 25 [Adjusted Odds Ratio (AOR) = 0.10; 95 % CI: 0.04, 0.25] compared with age above 34, attaining secondary school [AOR = 5.28; 95 % CI: 2.28, 12.21], college/above [AOR = 3.41; 95 % CI: 1.53, 7.61] compared with those who had no formal education, presence of family member/s with NCDs [AOR = 1.85; 95 % CI: 1.14, 3.00] and knowledge of NCDs risk factors [AOR = 11.71; 95 % CI: 7.08, 19.35] were significantly associated with screening utilization. This study found that the use of NCD screening was very low. Knowledge of NCD risk factors was strongly associated with screening utilization. This highlights the importance of improving adult knowledge of noncommunicable disease risk factors in Ethiopia.

Level of Adequate Knowledge of Non-communicable Diseases and Associated Factors Among Adult Residents of North Shewa Zone, Oromia Region, Ethiopia: A Mixed-Method Approach.

Background: Non-communicable diseases (NCDs) are currently the leading cause of morbidity and mortality, posing significant challenges to global healthcare systems. Particularly, the prevalence of NCDs is rising in Ethiopia, resulting in a triple burden of diseases on the health system that disproportionately affects all age groups. Hence, this study aims to determine the level of adequate knowledge of NCDs and associated factors among adult residents of the North Shewa zone, Oromia region, Ethiopia. Methods: A community-based cross-sectional study with a concurrent mixed-method approach was conducted from April 1, 2021 to May 30, 2021 among 846 residents using the multistage sampling technique. Interviewer administered questionnaire was used to collect quantitative data and a guiding checklist was used to collect qualitative data. Bivariable and multivariable logistic regressions were fitted to compute the association between explanatory variables and knowledge of NCDs. Adjusted odds ratios at 95% confidence interval with a p-value < 0.05 were used to decree statistical significance in multivariable analysis. Also, a thematic framework analysis was used for qualitative data analysis. Results: A total of 823 subjects have participated in this study making a response rate of 97.3%. The level of adequate knowledge was 33.9% (95%CI: 30.67, 37.13). Higher-income, receiving information from health professionals, owning a TV, having a family member with NCD(s), and marital status were factors significantly associated with adequate knowledge of NCDs. Conclusion: This study reveals a high level of inadequate knowledge of NCDs despite its foundational ability in tackling the burden of NCDs. As a result, broadening a wider and more comprehensive health promotion strategy for the prevention of triple burden of NCDs would benefit the population. Additionally, special efforts are needed both at the practice and policy levels targeting the disadvantaged groups, such as low-income people, those who do not receive information from health professionals, those who do not own a television, and those who are widowed/divorced, who were found to have less knowledge of NCDs.

Safe menstrual hygiene management practice and associated factors among female adolescent students at high schools in central Ethiopia: A mixed-method study.

Background: Menstrual Hygiene Management (MHM) is a much-neglected issue in developing countries, including Ethiopia. Menstruating women and girls are forced into isolation, prevented from movement, dietary restrictions, and can be prevented from participating in daily routine activities. Furthermore, the way almost all previous studies conducted in Ethiopia measured the practice of MHM did not meet standard definition of safe MHM. This study aimed to assess safe management of menstrual hygiene practice and associated factors among female adolescent students in public high schools in central Ethiopia. Methods: A mixed-methods approach was employed in this study. Systematic random sampling technique was used to select 846 study participants. The collected data were entered through EPI INFO version 7 and exported to SPSS version 23 for cleaning and analysis. Bivariate and multivariate logistic regression analysis were performed to identify the association between MHM and independent variables. Finally, AOR, 95% CI, and p-value < 0.05 were considered statistically significant. The qualitative data was analyzed by ATLAS.ti in order to extract the main themes and categories. Direct quotations were presented with a thick description of the findings. Results: The safe management of menstrual hygiene was 28.20%. Living with parents (AOR = 2.51, 95% CI:1.11-5.68), living with relatives (AOR = 7.41, 95% CI:2.55-21.54), having a merchant mother (AOR = 1.81, 95% CI:1.14-2.9), having a mother who has private work (AOR = 4.56, 95% CI:1.31-5.90), having a farmer father (AOR = 1.53, 95% CI:1.1-2.31), rural resident (AOR = 1.61, 95% CI: 1.17-2.21) and realizing the absence of container for storing sanitary napkins in the toilet of the school latrine (AOR = 1.44, 95% CI: 1.1-0.94) were factors associated with MHM. Findings from a qualitative study were discussed under four themes to explore barriers to menstrual hygiene management, and three themes emerged as enablers to menstrual hygiene management. Conclusions: The safe management of menstrual hygiene was low among adolescent girls. People with whom adolescent girls live, the occupational status of mother and father, residence, the availability of a container to dispose of sanitary napkins in school toilets were factors associated with menstrual hygiene management. Behavioral change communications must be provided to female students about menstrual hygiene.