Quality of Chronic Disease (Diabetes & Hypertension) Care in Health Care Facilities in High Disease Burden Areas in Sidama Region: Cross-Sectional Study.

Background: Diabetes and hypertension are major synergistic risk factors for microvasculopathy, microangiopathy, and neuropathy problems among patients with chronic disorder. Control of hypertension and diabetes have significant value in delaying these complications. The key for delaying complications in diabetes and hypertension is the quality of care. Objective: This study explored the quality of diabetes-hypertension care in health care facilities with high disease burden in Sidama region. Methodology: An institution-based cross-sectional study was carried out. Patients with diabetes and hypertension were included in the study. In this study, we included 844 patients were included in the study. For data collection, the application software Kobo Collect was utilized. For data analysis, SPSS version 25 was used. Logistic regression was used to identify factors associated with quality of care. To measure quality, we employed patient outcome indicators focusing on long-term complications of the eye, heart, fasting blood pressure, and neuropathic complications. Ethical approval clearance was obtained from Hawassa University, College of Medicine and Health Sciences ethical review board. Results: The mean age of patients was 47.99 ± 15.26 years, with a range of 18-90 years, while men make up 62% of the overall number of respondents. In terms of marital status, 700 (82.9%) were married. Concerning place of residence; 433 (51.3%) were from rural area. The primary diagnosis is diabetes for 419 (49.6%) patients, and nearly 23% of patients have both diabetes and hypertension. In terms of blood pressure, the average systolic pressure was 129.6 mmHg and the average diastolic pressure was 82.6 mmHg. Among the study participants, 391 (46.33%) patients received poor quality of chronic disease care. Patients living alone, patients who have professional work, fasting blood glucose in normal range, patients with higher education, and patients with serum creatinine receive relatively good chronic illness care.

'I am struggling to survive' - limited living conditions increase the burden of HIV: A qualitative study.

The human immunodeficiency virus (HIV) continues to have life-limiting health consequences for many individuals and remains a significant threat to global public health. This qualitative study explores the experiences of people living with HIV in Sidama, Ethiopia. Interviews with 19 adults recruited from an HIV outpatient clinic were conducted using a semi-structured interview guide. The analysis method used was systematic text condensation. The results reveal that an HIV diagnosis triggered strong emotions. Economic concerns, stigma, and discrimination also increased the burden of a diagnosis, which could lead to a loss of income or housing. Consequently, informants' ability to maintain a regular life and receive social and psychological support was reduced. Religious faith provided strength to informants, though they stated that some religious leaders do not support antiretroviral therapy. Understanding the everyday challenges of people living with HIV is crucial for health professionals and health programme developers working to promote health and enable people to follow their recommended course of treatment. Person-centred care is recommended. In particular, the poorest should receive attention. It is also crucial to reduce stigma and discriminatory attitudes towards people living with HIV and to motivate faith leaders to prevent HIV stigma and support antiretroviral therapy.

Nurses benefit from international clinical placement as nurse students: A qualitative study.

BACKGROUND: A goal of studying abroad is increased cultural knowledge as well as strengthening the participants' disposition for active participation in society and in future careers. Empirical studies have shown a positive impact on nursing students', but little is known about the effects of international clinical placement on professional nursing. The aim was to investigate nurses' experiences after participating in international clinical placement as students, and how the stay influences their future career as professional nurses. DESIGN: Qualitative design, and a hermeneutic phenomenological approach. METHODS: Individual semi-structured interviews were conducted with a sample of eight nurses who had participated in an international clinical placement as nursing students and worked for at least two years as nurses. The participants were students at one University College in Norway. The data analysis method was inspired by Max van Manen's thematic analysis. RESULTS: The international clinical placement promoted personal and professional development of importance to professional nursing practice. The informants benefited from increased global and cultural awareness and noted that mastering the emotional challenges during the placement strengthen their ability to manage demanding situations in nursing work. The students evaluated guided reflection before, during and after the stay to contributing to learning outcome. CONCLUSION: The potential for increased global and cultural competence and personal and professional development is high in international clinical placements. If the opportunity is taken, the participants' future careers can be affected in a way that benefits patients and colleagues. We recommend that educators and supervisors of students on international clinical placements should facilitate guided reflection to the participating students.

Prevalence of anemia among adults at Hawassa University referral hospital, Southern Ethiopia.

INTRODUCTION: Anemia is a public health problem in Ethiopia. In spite of the fact that anemia is a common health burden with much severe consequences, the prevalence of the different types of anemia and its severity have not yet been well documented in different parts of the country. The study aimed to assess the prevalence of different types of anemia, including severity and association with age and sex of study population. MATERIALS AND METHODS: Four hundred anemic patients who are men and non-pregnant women above 15 years of age were selected from patients visiting the laboratory for Complete Blood Count (CBC) investigation. The type and severity of anemia were assessed based on red cell indices and haemoglobin levels respectively. Data was analyzed using SPSS version 19. Chi square was used at 95% confidence interval, considering P < 0.05 statistically significant for association among categorical variables. RESULT: The overall prevalence of anemia in the study was 13%. Majority of cases had mild anemia 58.5%, while 19.0%, and 22.5% of the patients had moderate and severe anemia respectively. Overall, the prevalence of mild anemia increases with age, while the prevalence of moderate and severe anemia decreases as age increases. In the present study, the most common anemia was normocytic, which mostly occur in the elderly (61-85) years of age. CONCLUSION: The CBC parameters help to diagnose and classify anemia in to major components, which might help for a better treatment practice in developing countries, where additional investigations are not available for a reliable diagnosis and classification of anemia. Despite resource limitations in developing countries, additional anaemia work up such as iron studies and markers of inflammation, will provide a more efficient diagnosis of anaemia.

An exploratory study of knowledge, attitudes, and beliefs related to tobacco use and secondhand smoke among women in Aleta Wondo, Ethiopia.

BACKGROUND: By 2030, the Sub-Saharan African region is projected to be the epicenter of the tobacco epidemic. While smoking prevalence is currently low among women (< 2%), the prevalence among men (7.7% overall and up to 27% depending on region) makes exposure to secondhand smoke a pressing concern for women and children. To prevent the uptake of smoking among women and address tobacco-related risks, including secondhand smoke exposure, a greater understanding of women's related perceptions is needed. The purpose of this study was to explore Ethiopian women's knowledge, attitudes, and beliefs related to tobacco use and secondhand smoke exposure, and the potential influence of contextual factors including; khat use, exposure to pro- and anti-tobacco messaging, and religious affiliation. METHODS: A cross-sectional study using a systematic household sampling technique and an adapted interviewer-administered survey was conducted in Southern Ethiopia. The survey was administered to 353 women, 18-55 years of age, in Aleta Wondo town and surrounding districts between August-October 2014 (95.2% cooperation rate). RESULTS: General awareness of harm associated with personal tobacco use and exposure to secondhand smoke was high (> 94%); however, specific knowledge of associated health-risks was limited. More than 96% perceived female tobacco use as socially unacceptable. At the same time, more than 70% were able to name potential benefits of using tobacco for both personal consumption and non-personal use. Respondents reported greater experimentation with khat versus tobacco and 73% reported that their religion significantly influenced their tobacco-related attitudes. Overall, there were higher reports of exposure to anti-tobacco (70%) versus pro-tobacco (49%) messaging, in the last 30 days. CONCLUSIONS: The high level of awareness of health risks associated with tobacco use and SHS exposure and the high exposure to anti-tobacco messaging are community-level strengths that can proactively be built on to prevent the projected disease burden associated with tobacco. Findings have implications for the development of contextualized gender-specific tobacco control interventions, particularly in relation to the promotion of smoke-free homes.

Factors associated with secondhand tobacco smoke in the home: an exploratory cross-sectional study among women in Aleta Wondo, Ethiopia.

BACKGROUND: In Ethiopia, female smoking rates are currently low (1 %). However, because of male smoking rates (overall 7.7 % and up to 27 % depending on region), women and children's risk of second hand smoke (SHS) exposure is a pressing concern. In order to develop effective public health interventions that prevent the uptake and exposure to smoking, thereby averting the projected increase in tobacco-induced disease, an understanding of Ethiopian women's practices regarding tobacco is needed. The purpose of this study was to explore Ethiopian women's tobacco use and prevalence of SHS exposure, and to identify covariates associated with SHS exposure. METHODS: We conducted an exploratory cross-sectional study in Southern Ethiopia between August and October 2014, and systematically sampled households in Aleta Wondo town and surrounding districts. Trained interviewers verbally administered surveys to women 18-55 years of age. Descriptive statistics and multiple logistic regression analyses were performed. RESULTS: None of the 353 participants reported current tobacco use and less than 1 % reported ever use, however, 11 % reported ever use of the stimulant leaf khat. Twenty-seven women (7.6 %) reported living with a tobacco user, however, twice that number (14.4 %) overall, and 22 % of urban participants reported that smoking occurred daily in their home. When controlling for other factors, living with a tobacco user (OR = 9.91, 95 % CI [3.32, 29.59]), allowing smoking in the home (OR = 5.67, 95 % CI [2.51, 12.79]), place of residence (OR = 2.74, 95 % CI [1.11, 6.74)]), and exposure to point-of-sale advertising within the last 30 days (OR = 2.87, 95 % CI [1.26, 6.54]) contributed significantly to a model predicting the likelihood of reporting daily occurrence of smoking/SHS in the home. CONCLUSIONS: While few women reported having ever used tobacco, one in seven women in this study reported that smoking/SHS occurred daily in their homes. Therefore SHS exposure is a potential health concern for women and children in this rural community. Findings from this study provide baseline data for monitoring tobacco control policies in Ethiopia, particularly in relation to the promotion of smoke-free homes, and could be used to inform prevention program development.