Risk factors of induced abortion among preparatory school student in Guraghe zone, Southern region, Ethiopia: a cross-sectional study.

BACKGROUND: Induced abortion is a common undergo in many societies of the world. Every year, around 20 million unsafe abortions are done worldwide. From fragmented studies conducted in Ethiopia, the prevalence of induced abortion and its adverse effects are increasing over time. The aim of this study was to assess factors associated with induced abortion among female preparatory school students in Guraghe zone. METHODS: A cross-sectional study was conducted among female students of preparatory schools in April 2017. Systematic random sampling technique was employed to select 404 students from the total of 3960 female preparatory school students in the study area. Data was collected through self-administered questionnaires. Descriptive summary, binary and multivariate analyses were underwent to identify factors associated with induced abortion. The study was ethically approved by institutional review board of Wolkite University. RESULTS: The response rate of this study was 98.3%. The lifetime prevalence of induced abortion among young preparatory schools students whose age range from 15 to 22 years was 13.6% [95% CI (10.4, 17.1)]. The odds of induced abortion undergo was 2.3 times more likely in rural family residents [AOR = 2.3, 95% CI (1.1, 4.8)] as compared to that of urban family residents. Students without sexual health education were 6.4 times more likely to undergo induced abortion as compared to those who got sexual health education at sc0000hool [AOR = 6.4, 95% CI (3.1, 13.1)]. Furthermore, students who drank alcohol often were 4 times [AOR = 4.0, 95% CI (1.1, 14.2)] more likely to undergo induced abortion and students who consumed alcohol sometimes had 3.3 times [AOR: 3.3, 95%CI (1.4, 8.1)] the risk of induced abortion compared with girls with no history of alcohol consumption. CONCLUSION: A high lifetime prevalence of induced abortion among young adolescent was observed. Being rural residence, not having reproductive health education, and alcohol consumption were found to be independent predictors of induced abortion undergo. Therefore, IEC/BCC programs with special emphasis on youth friendly sexual and reproductive health services should be strengthened to reduce induced abortion.

The impact of community-based health insurance on health-related quality of life and associated factors in Ethiopia: a comparative cross-sectional study.

BACKGROUND: Quality of life can be used to measure the effect of intervention on health related conditions. Health insurance contributes positive effect on availability of medical supplies and empowerment of women and children on financial healthcare. Therefore, the study was aimed to measure the impact of Community-Based Health Insurance on HRQoL and associated socio-demographic factors. METHODS: A comparative community based cross-sectional study was employed. Data was collected by trained enumerators using World Health Organization QoL-BREF tool from a sample of 1964 (982 CBHI insured and 982 un-insured) household heads selected by probability proportional to size. A descriptive summery, simple and multiple linear regression analysis was applied to describe the functional predictors of HRQoL. The study was ethically approved by IRB of Wolkite University. RESULTS: The HRQoL score among CBHI insured family heads was 63.02 and 58.92 for un-insured family heads. The overall variation in HRQoL was explained due to; separated marital condition which reduced the HRQoL by 4.30% than those living together [ß = - 0.044, 95% CI (- 5.67, - 0.10)], daily laborer decreased HRQoL by 7.50% [ß = - 0.078, 95% CI (- 12.91, - 4.10)], but employment increased by 5.65% than farmers [ß = 0.055, 95% CI (2.58, 17.59)]. QoL increased by 6.4 and 6.93% among primary and secondary level educated household heads than those household heads who could not read and write [ß = 0.062, 95% CI (0.75, 4.31)] and [ß = 0.067, 95% CI (1.84, 7.99)], respectively. As family size increased by one households' head, HRQoL decreased by 18.21% [ß = - 0.201, 95% CI (- 2.55, - 1.63)], as wealth index increased by one unit, HRQoL decreased by 32.90% [ß = - 0.306, 95% CI (- 5.15, - 3.86)] and QoL among CBHI insured household heads increased by 12.41% than those un-insured family heads [ß = 0.117, 95% CI (2.98, 6.16)]. CONCLUSIONS: The study revealed that significant difference in quality of life was found among the two groups; health insurance had positive effect on quality of life. Triggered, the government shall expand the scheme into other similar areas' and further efforts should be made on the scheme service satisfaction to ensure its continuity.

Risk factors of diarrhoeal disease in under-five children among health extension model and non-model families in Sheko district rural community, Southwest Ethiopia: comparative cross-sectional study.

BACKGROUND: Worldwide diarrheal disease is the second leading cause of death in under-five year's children. In Ethiopia diarrhoea kills half million under-five children every year second to pneumonia. Poor sanitation, unsafe water supply and inadequate personal hygiene are responsible for 90% of diarrhoea occurrence; these can be easily improved by health promotion and education. The Ethiopian government introduced a new initiative health extension programme in 2002/03 as a means of providing a comprehensive, universal, equitable and affordable health service. As a strategy of the programme; households have been graduated as model families after training and implementing the intervention packages. Therefore the aim of the study was to assess risk factor of diarrheal disease in under-five children among health extension model and non-model families. METHOD: A community based comparative cross-sectional study design was employed in 2012 at Sheko district. Multi-stage sampling technique was employed to select 275 model and 550 non-model households that had at least one under-five children. Data was collected using structured questioner and/or checklist by trained data collectors. A summery descriptive, binary and multivariate logistic regression was computed to describe the functional independent predictors of childhood diarrhoea. RESULT: The two weeks diarrhoea prevalence in under-five children among health extension model and non-model households were 6.4% and 25.5%, respectively. The independent predictors of childhood diarrhoea revealed in the study were being mothers can't read and write [OR: 1.74, 95% CI: (1.03, 2.91)], monthly family income earn less than 650 Birr [OR: 1.75, 95% CI: (1.06, 2.88)], mothers hand washing not practice at critical time [OR: 2.21, 95% CI: (1.41, 3.46)], not soap use for hand washing [OR: 7.40, 95% CI: (2.61, 20.96)], improper refuse disposal [OR: 3.19, 95% CI: (1.89, 5.38)] and being non-model families for the health extension programme [OR: 4.50, 95% CI: (2.52, 8.03]. CONCLUSION: The level of diarrheal disease variation was well explained by maternal education, income, personal hygiene, waste disposal system and the effect of health extension programme. Thus encouraging families to being model families for the programme and enhancing community based behavioural change communication that emphasize on personal hygiene and sanitation should be strengthening to reduce childhood diarrhoea.

Depression and Burnout among Health Extension Workers in Ethiopia: A Cross-Sectional Study.

Background: Depression and burnout are common among healthcare workers (HCWs) and negatively affect their well-being and the quality of the service they provide. However, the burden of depression and burnout among health extension workers (HEWs) in Ethiopia and their relationship has not been documented well.The objective of this study was to estimate the prevalence of depression and burnout among HEWs in Ethiopia and to investigate the relationship between these conditions. Materials and Methods: We used a cross-sectional study design and collected data from 584 rural and 581 urban HEWs in Ethiopia, as part of the 2019 national health extension program assessment. The Patient Health Questionnaire (PHQ-9) and Burnout Self-Test were used to screen HEWs for depression and burnout, respectively. We used descriptive statistics to estimate the magnitude of depression and burnout, and logistic regression to examine their relationship. Result: Based on PHQ-9 cutoff scores of 10, the prevalence of major depression was 16.5% among rural and 8.9% among urban HEWs, whereas burnout risk was 39.8% among rural and 12.6% among urban HEWs. The odds of having depression among HEWs with burnout risk was relatively higher compared to those without burnout risk [For rural HEWs, the adjusted odds ratio (AOR) is 11.88 at a 95% confidence interval (CI; 5.27, 26.80), and for urban HEWs, the AOR is 11.49 at a 95% CI (5.35, 24.63)]. Conclusion: The prevalence of depression and burnout is high among HEWs in Ethiopia, with a significant rural-urban difference, and burnout is a significant predictor of depression. Mental health interventions that enable prevention, early detection, and management are needed especially for rural HEWs who are in charge of preventive health service delivery for the disadvantaged rural communities.

Essential in-vitro laboratory diagnostic services provision in accordance with the WHO standards in Guragae zone primary health care unit level, South Ethiopia.

INTRODUCTION: Laboratory services are crucial parts of the health system having a great contribution to disease prevention and management. The importance of accurate and reliable laboratory test results is less recognized in developing countries like Ethiopia where most medical decisions are based on clinical judgment. It is time for countries like Ethiopia to not only increase health care coverage but also improve access to essential diagnostic tests. Hence, this proposed study aims to assess essential in-vitro laboratory service provision in accordance with the WHO standards in Guragae Zone primary health care unit level, South Ethiopia. METHODS: Health institution-based cross-sectional study was carried out. 30% randomly selected primary health care units were recruited. Each facility was visited with a WHO checklist by a trained data collector to assess the availability of essential diagnostics service provision. The proportion of available in-vitro diagnostics services was calculated. Results were presented as percentages in tables and figures. RESULT: Twenty-one primary health care facilities located in Guragae Zone were assessed between May and July 2019. All surveyed facilities had major gaps in essential test availability. Among essential diagnostic tests listed with WHO like C-reactive protein, lipid profile, Amylase and Lipase, TroponinT/I, hepatitis B e-antigen, IgM-specific antibodies to hepatitis B core antigen, Glucose-6-phosphate dehydrogenase activity, and anti-HIV/p24 rapid test were not provided in any facilities. However, essential diagnostic services like urine dipstick testing, random blood sugar, smear microscopy, and few serological tests were provided at all primary health care units. All surveyed facilities had limited major laboratory equipment and consumables. CONCLUSION AND RECOMMENDATION: The present study shows limited access to essential laboratory tests at the primary health care level. Hence, the responsible body should invest to make essential tests accessible at the primary care unit level within the framework of universal health coverage in the study area. The fact that access to essential diagnostic tests is the first key step in improving quality of care; such study has its own efforts to enable the implementation of essential diagnostic lists, and improve access to diagnostics in the country.

Impact of annual preventive mass chemotherapy for soil-transmitted helminths among primary school children in an endemic area of Gurage zone: a prospective cross-sectional study.

BACKGROUND AND AIM: School-based preventive mass chemotherapy has been a key component of Ethiopia's national plan for the control of soil-transmitted helminths. Without an impact evaluation on the impact of a deworming program on infection levels, it is unclear whether the deworming program warrants levels of environmental transmission of infection. This study aimed to determine the impact of annual preventive mass chemotherapy for soil-transmitted helminths among schoolchildren in an endemic area of Gurage zone, south-central Ethiopia. METHODS: A repeated school-based quantitative prospective cross-sectional method was employed. Data were collected from study participants selected using systematic sampling with probability proportional to size at baseline and after annual treatment. Fresh stool samples were collected and processed using the Kato─Katz technique at the Wolkite University parasitology laboratory. SPSS-21 was used for data management and analysis. Changes in parasitological variables after treatment were estimated. RESULTS: Overall, 41.1% prevalence and 22.3% mean geometric infection-intensity reduction were found. Reductions in prevalence of Schistosoma mansoni and hookworms were 13.2% and 15.3%, respectively. Similarly, decreases in prevalence were seen in Ascaris lumbricoides and Trichuris trichiura, representing 94.4% and 80.0% reduction rates, respectively, while 25.9% of the children had heavy S. mansoni (≥400 eggs per gram) infections at baseline, which were reduced to 4.5% after annual treatment. Geometric mean infection intensity-reduction rates for hookworms, A. lumbricoides, and T. trichiura were 80.8%, 20.2%, and 96.7%, respectively. CONCLUSION: Annual mass chemotherapy failed to clear soil-transmitted helminths completely in the present study. However, it resulted in a substantial reduction in overall prevalence and infection intensity. Therefore, other than deworming for school children, interventions such as access to improved personal hygiene and environmental hygiene in school should be emphasized to interrupt transmission.

Perceived behavioural predictors of late initiation to HIV/AIDS care in Gurage zone public health facilities: a cohort study using health belief model.

OBJECTIVE: The study was aimed to measure incidence density rate and identify perceived behavioural believes of late initiation to HIV/AIDS care in Gurage zone public health facilities from September 2015 to November 2016. RESULTS: The incidence density rates of late initiation to HIV/AIDS care were 2.21 per 100 person-months of observation. HIV positive individuals who did not perceived susceptibility were 8.46 times more likely delay to start HIV/AIDS care than their counter parts [OR = 8.46 (95% CI 3.92, 18.26)]. HIV infected individuals who did not perceived severity of delayed ART initiation were 6.13 time more likely to delay than HIV infected individuals who perceived its severity [OR = 6.13 (95% CI 2.95, 12.73)]. HIV positive individuals who didn't have self-efficacy were 2.35 times more likely delay to start HIV/AIDS care than HIV positive individuals who have self-efficacy [OR = 2.35 (95% CI 1.09, 5.05)]. CONCLUSIONS: The study revealed that high incidence density rates of delayed initiation for HIV care and variations were explained by poor wealth, and perceived threat and benefit. Therefore, interventions should be designed to initiate care at their diagnosis time.

Nutritional Status and Effect of Maternal Employment among Children Aged 6-59 Months in Wolayta Sodo Town, Southern Ethiopia: A Cross-sectional Study.

BACKGROUND: Childhood malnutrition remains common in many parts of the world; the magnitude of worldwide stunting, underweight and wasting in children under five years of age were 24.7 %, 15.1 % and 7.8 %, respectively. More than 150 million children under the age of five years in the developing world are malnourished. Ethiopia is one of the countries in sub-Saharan Africa with the highest rates of malnutrition. In Ethiopia, 44.4% and 9.7% of children under-five years old were stunted and wasted, respectively. This study was aimed to assess nutritional status and effect of maternal employment among children aged 6-59 months. METHODS: A cross-sectional study was conducted in Wolayta Sodo Town, Southern Ethiopia. Socio-demographic characteristics, child feeding and healthcare seeking practice of mothers, and child's anthropometric status were assessed. Probability proportional to size sampling approach was used to select a sample of 316 mothers having children aged 6-59 months. The study was ethically approved by Institutional Review Board of Health Science College, Hawasa University. RESULT: The overall result revealed that the prevalence of stunting was 22.2%, of which 21.8% and 22.6% were in children of employed and unemployed mothers, respectively. Low-weight-for age was 10.8% for children of employed mothers and 13.4% for children of unemployed mothers. Wasting was 8.8% and 10.8% for children of employed and unemployed mothers, respectively. There was no statistically significant association between maternal employment and nutritional status of their children. However, chronic malnutrition (stunting) was influenced by being educated mother (OR: 0.37) child age group of 24-59 months (OR: 0.36) and households' fifth wealth quintile (OR: 0.28). CONCLUSION: Low prevalence of stunting was observed. Stunting is a public health concern in the study area. Furthermore, stunting is significantly influenced by mothers' education, household wealth and child age. However, maternal employment was not statistically associated with child nutritional status. Thus, nutritional intervention initiatives should focus on improving household food security, maternal education and agricultural diversification.