Sexual and Reproductive Health Problems and Needs of Street Youths in East Gojjam Zone Administrative Towns, Ethiopia: Exploratory Qualitative Study.

Background: About 600,000 children are estimated to depend on street life in Ethiopia. Estimates conclude that about 65% of street children hardly have any access to sexual and reproductive health (SRH) services. However, sexually transmitted infections including HIV/AIDS among street children have been reported as being very high and some studies showed that it can be higher than that of female sex workers, truck drivers and prisoners. Objective: The aim of this study is to explore the sexual and reproductive health problems of street youths and their need in East Gojjam Zone, Ethiopia, 2019. Methods: An explanatory qualitative study design was conducted on street youths residing in East Gojjam Zone town administrations from February to March, 2019. Purposively selected street youths and positioned individuals who were residing in East Gojjam Zone town administrates were included in the study. The data were collected through focus group discussion and in-depth interview and analyzed thematically. Result: A total of 85 street youths and 8 individuals who were working with street children participated in this study. Most street youths had no clear information towards sexual and reproductive health. The existing reproductive health problems were sexual violence, sexually transmitted infection, unplanned pregnancy, abortion and substance abuse. Most street youths were interested in getting sexual and reproductive health information and other services by concerned bodies similar to the general population. Accessibility of job opportunities was also one of their needs to prevent the existing sexual and reproductive health problems. Conclusion and Recommendation: Most street youths were sexually active and attempted unsafe sexual practice which exposed them to sexually transmitted infections, unplanned pregnancies and abortions. So a special reproductive health service is needed to avert these problems.

Food hygiene practice and its associated factors among food handlers working in food establishments during the COVID-19 pandemic in East Gojjam and West Gojjam Zones, North West Ethiopia.

OBJECTIVES: This study was aimed to assess the food hygiene practice and associated factors among food handlers working in food establishments during the COVID-19 pandemic in East Gojjam and West Gojjam Zones, North West Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 845 food handlers working in 423 selected food establishments of East and West Gojjam Zones from 22 September to 2 November 2020. The food handlers were categorized as a cooker and a waiter based on their responsibility. A data collection tool was adapted from the literature and validated by conducting a pre-test prior to the study. Binary logistic regression was done to identify the factors associated with food hygiene practice among food handlers. RESULTS: The prevalence of poor food hygiene practices among food handlers working in food establishments was 51.2% (95% confidence interval = 47.8, 54.6%). Being both a cooker and waiter (adjusted odds ratio = 2.98; 95% confidence interval = 1.02, 8.66), availability of personal protective equipment (adjusted odds ratio = 2.67; 95% confidence interval = 1.75, 4.08), presence of pipe water in the kitchen (adjusted odds ratio = 2.73; 95% confidence interval = 1.84, 4.06), presence of a supervisor (adjusted odds ratio = 2.26; 95% confidence interval = 1.41, 3.62), and separate dressing room (adjusted odds ratio = 2.69; 95% confidence interval = 1.84, 3.93) were significantly associated with food hygiene practice among food handlers. CONCLUSION: The prevalence of poor food hygiene practices among food handlers working in food establishments during the COVID-19 pandemic was high. Therefore, improving food hygiene practice focusing on availing personal protective equipment, pipe water in the kitchen, and ensuring the presence of a supervisor as well as a separate dressing room in the food establishment is recommended.

Quality disparity in terms of clients' satisfaction with selected exempted health care services provided in Ethiopia: Meta-analysis.

Introduction: In Ethiopia; even though utilization of health care services has been improved after the introduction of user fee exemption, little is known about the quality of the services. There are fragmented studies on the output dimension of quality of health care services particularly on clients' satisfaction. Therefore this study aims to assess overall quality (in terms of clients' satisfaction) and its disparity among users of selected exempted health care services provided in Ethiopia. Methods: The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline was used to undertake this study. Both published and unpublished articles conducted in Ethiopia on the quality of health care services in terms of clients' satisfaction dimensions were searched. A total of 750 articles were retrieved through international databases (Scopus, MEDLINE/PubMed, Science Direct, Google Scholar and Cochrane Library) and national digital library repositories (Addis Ababa University's digital library repository); 703 of which were excluded while only 47 articles were included in the meta-analysis. The search for articles was conducted during the period 03 December 2019 to 28 January 2020. For methodological qualities of the included articles assessment, a modified version of the Newcastle-Ottawa Scale adapted for cross-sectional studies was used. R version 3.6.1 and stata version 14 soft wares were used for analysis. A random-effects model was used to calculate pooled estimates. The I2 tests were used to assess the heterogeneity of the studies. Results: The pooled overall prevalence of included 47 studies revealed that clients' satisfaction among users of selected exempted health care services in Ethiopia was 70% (95% CI: 64, 74%). In subgroup analysis; the lowest prevalence of clients' satisfaction was observed among users of obstetrics maternal health care services with the prevalence of 65.04% (95% CI: 57.50, 72.58). Conclusion: This study found that more than one-third of respondents; was not satisfied with exempted health care services. There is slight difference in satisfaction of clients across type of exempted health care services and regions. Policy and decision makers in Ethiopia shall design strategies to optimize quality of health care services besides exemption of its costs.it is also strongly recommend that a special emphasis shall be given to obstetric health care services provision. Moreover, concerned stakeholders' (ministry of health, etc.) should strengthen compassionate respectful care provision in public health facilities; beside to removing user fees.

Effect of Community-Based Health Insurance on Healthcare-Seeking Behavior for Childhood Illnesses Among Rural Mothers in Aneded District, East Gojjam Zone, Amhara Region, Northwest Ethiopia.

BACKGROUND: Community-based health insurance (CBHI) schemes have been implemented in developing countries to facilitate modern medical care access. However, studies conducted on the effect of CBHI on healthcare-seeking behavior (HSB) have been limited and revealed inconsistent results. Therefore, this study aimed to assess the effect of CBHI on mothers' HSB for common under-five childhood illnesses. METHODS: A community-based comparative cross-sectional study was conducted among 410 rural mothers (205 insured and 205 non-insured), and a multistage random sampling technique was used to select the study participants. Binary logistic regression and propensity score matching were used to identify factors associated with the mothers' HSB, and estimate the effect of CBHI on mothers' HSB, respectively. RESULTS: The overall mother's HSB for childhood illnesses was 48.8% (200/410). From those mothers who visited healthcare, 92.0% were married, 86.0% were unable to read and write, 94.5% were farmers, and 54.5% were from low wealth status, 58.50% had a family size of ≤5, 54.0% had children less than 24 months of age. Besides, 63.0% were members of CBHI, 37.0% perceived their child's illness as severe, 78.0% made a shared decision to visit a health facility, and 67.5% lived within less than five Kms from the nearby health facilities. Being a member of CBHI, the child's age, decision to visit a health facility, and perceived disease severity were predictors of HSB. The CBHI had a significant effect on the HSB for childhood illnesses with ATT of 28.7% (t = 3.959). CONCLUSION: The overall mothers' HSB for common childhood illnesses was low though the CBHI has a significant effect. CBHI should be strengthened to improve the mothers' HSB. It is also crucial to strengthen awareness creation regarding joint decision-making and educate mothers to visit the health facilities regardless of children's age and disease severity.

Mothers' health care seeking behavior and associated factors for common childhood illnesses, Northwest Ethiopia: community based cross-sectional study.

BACKGROUND: Substantial progress has been made in reducing child mortality over the last decades, however the magnitude of the problem is yet high globally Appropriate health care-seeking behavior of mothers/guardians for common childhood illnesses could prevent a significant number of child deaths and complications due to childhood illnesses, currently, there is few of studies in Ethiopia. Therefore, this study aimed to assess mothers/caregivers health care seeking behavior for their children in Northwest Ethiopia. METHODS: Community based cross-sectional study of rural mothers living in Aneded district from February to March 2016. Data were collected using structured questionnaire by an interviewer. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with health care seeking behavior. Variables having P value ≤0.2 in the bivariate analysis were considered for multivariable analysis. P-value less than 0.05 was used to declare that there was statistically significant association. Odds Ratio (OR) with 95% confidence interval (CI) was used to determine the strength and direction of association. RESULT: A total of 410 mothers participated in this study. Among 48.8% (95% CI: 44, 53.6%) had sought health care, only 27% sought health care within a day. Having awareness of childhood illness (AOR = 3.8, 95% CI: 2.18-6.72), perceived importance of early treatment (AOR = 3.5, 95% CI: 2.00-6.07) and child age <  24 months (AOR = 1.7, 95% CI: 1.08-2.68) and illness not being perceived as severe (AOR:= 0.17, 95% CI: 0.09-0.30) were all factors associated with mothers healthcare seeking behavior during their child illness. CONCLUSION: Overall health care seeking behavior level was low. Awareness, perceived illness severity, perceived early treatment and having young children were predictors of mothers' health care seeking behavior. The Woreda health office administrators and health professionals should work to improve mothers' awareness and perception towards childhood problems and the importance of early seeking appropriate health care using the existed structures (one-to-five women networking and health developmental army).