Demand for health care service and associated factors among patients in the community of Tsegedie District, Northern Ethiopia.

BACKGROUND: Demand-side barriers are as important as supply factors in deterring patients from obtaining treatment. Developing countries including Ethiopia have been focusing on promoting health care utilization as an important policy to improve health outcomes and to meet international obligations to make health services broadly accessible. However, many policy and research initiatives focused on improving physical access rather than focusing on the pattern of health care service utilization related to demand side. Understanding of determinants of demand for health care services would enable to introduce and implement appropriate incentive schemes to encourage better utilization of health care services in the community of Tsegedie district, Northern Ethiopia. METHODS: A community based cross sectional study design was conducted from March1-30/2016 in Northern Ethiopia. Systematic random sampling technique was used to select 423 participants from 2189 patients of the one-month census. A pretested and standardized semi-structured interviewer administered questionnaire was used to collect the data. The data were entered using Epi-info version 7 and analysed by STATA version 11. Multinomial logistic regression model was used to identify the determinants of demand for health care service. RESULTS: A total of 423 (with a response rate of 98.3%) study participants were included in the study. The finding indicates that 72.5% (95%CI = 61.6, 81.1) of the participants demanded modern health care services. The multinomial logistic regression econometric model revealed that perceived severity of illness (ß = 1.27; 95% CI = 0.74, 1.82), being educated household head (ß = 0.079; 95% CI = 0.96, 1.74), quality of treatment (ß = 0.99; 95% CI = 0.47, 1.5), distance to health facility ß = 1.96; 95%CI = 0.11, 0.27), cost of treatment (ß = - 1.99; 95% CI = 0.85, 3,13) were significantly and statistically associated with demand for health care service. CONCLUSION: This study revealed that in Tsegedie district, majorities (72.5%) of the patients demanded modern health care service. Distance to health care facility, user-fees, educational status of household, quality of service, and severity of illness were found to be significantly associated with demand for health care service. Out of pocket, payments should be changed by prepayment schemes like community-based insurance than to depend on user fees and appropriate health information dissemination activities should strengthen to create awareness about modern care.

Determinants of delay in timely treatment seeking for diarrheal diseases among mothers with under-five children in central Ethiopia: A case control study.

BACKGROUND: Delays in seeking timely appropriate care contributes to a large number of deaths from diarrhea in children. This study aimed to identify determinants of delays in seeking timely treatment by mothers/caregivers of under-five children with diarrheal diseases. METHODS: We used an unmatched case-control study from February-March 2017 among 316 children: 158 cases and 158 controls. Cases were mothers/caregivers with under-five children who had signs/symptoms of diarrhea and sought treatment after 24 hours onset of symptom. Controls sought treatment within 24 hours. Field workers collected data using a pre-tested standardized questionnaire. Multivariate logistic regression was conducted to identify determinants of delay in timely diarrhea treatment seeking. Statistical significance was declared by using a p-value<0.05 and 95% of confidence interval (CI) for an adjusted-odds ratio (AOR). RESULTS: The determinants of delay in timely treatment seeking of mothers/caregivers of under-five children with diarrheal diseases were children <24months (AOR = 1.9,95%CI:1.1-3.4); fail to attend school (AOR = 2.4, 95%CI:1.2-4.6); being female children (AOR = 1.7,95%CI:1.05-2.9); preferring government health facility for the treatment of children with diarrheal diseases (AOR = 2.9, 95%CI, 1.3-6.7); lack of past history taking children to health facility and lack of counseling (AOR = 4.8, 95%CI:2.0-12.1); being in the15-25 years age (AOR = 1.7, 95%CI:1.1-3.0) and taking children to a health facility as a first response to diarrhea (AOR = 0.1, 95%CI:0.01-0.8). CONCLUSIONS: Age of the child, maternal age, and disease related determinants were determinants for seeking timely treatment to diarrheal diseases. Providing skilled based health education and counseling to mothers/caregivers on seeking timely treatment and taking children with diarrheal diseases to a health facility as a first response to diarrhea is a paramount intervention to reduce morbidity and mortality of children.

Human Resource Information System implementation readiness in the Ethiopian health sector: a cross-sectional study.

BACKGROUND: Health workforce information systems in low-income countries tend to be defective with poor relationship to information sources. Human Resource Information System (HRIS) is currently in a pilot implementation phase in the Federal Ministry of Health and Regional Health Bureaus of Ethiopia. Before scaling up the implementation, it is important to understand the implementation readiness of hospitals and health departments. The aims of this study were to assess the readiness for HRIS implementation, identify associated factors, and explore the implementation challenges in public hospitals and health departments of the Amhara National Regional State, Ethiopia. METHODS: An institution-based cross-sectional study supplemented with a qualitative study was conducted from the 15th of February to the 30th of March 2016 in 19 public hospitals and health departments of the Amhara National Regional State, Ethiopia. A self-administered questionnaire was used to collect the data. The questionnaire includes items on socio-demographic characteristics and questions measuring technical, personal, and organizational factors adapted from the 32-item questionnaire of the Management Science for Health (MSH) HRIS readiness assessment tool. The data were entered and analyzed with statistical software. Descriptive statistics and bivariate and multivariable logistic regression analyses were performed. Odds ratios with 95% confidence interval were computed to identify the factors statistically associated with readiness of HRIS implementation. In-depth interviews and observation checklists were used to collect qualitative data. Thematic content analysis was used to analyze the qualitative data. RESULT: A total of 246 human resource (HR) employees and 16 key informants have been included in the study. The HR employee's level of readiness for HRIS implementation in this study was 35.8%. Employee's Internet access (AOR = 2.59, 95%CI = 1.19, 5.62), availability of separate HR section (AOR = 8.08, 95%CI = 3.69, 17.70), basic computer skills (AOR = 6.74, 95%CI = 2.75, 16.56), and fear of unemployment (AOR = 2.83, 95%CI = 1.27, 6.32) were associated with readiness of HRIS implementation. Poor logistic supply, lack of competency, poor commitment, and shortage of finance were the challenges of HRIS implementation. CONCLUSION: In this study, readiness of HRIS implementation was low. Strategies targeting to improve skills, awareness, and attitude of HR employees would facilitate the implementation process.

Psychoactive substances use and associated factors among Axum University students, Axum Town, North Ethiopia.

BACKGROUND: The use of substances such as alcohol, khat leaves and tobacco have long been recognized as one of the leading causes of human suffering and become one of the rising major public health and socio-economic problems worldwide. Even though substances use occurs in all segments of all societies, it is more spreading in an alarming rate among the young generation. This study aimed to establish the prevalence and associated factors of substances use among undergraduate students in Axum University. METHODS: Institution based quantitative cross sectional study design was conducted among Axum University students in April 2012. A sample of 764 students was selected by using multi- stage sampling technique. Data were collected using pre- tested self- administered questionnaires. The data were cleaned, coded, entered into EPI-INFO version 3.5.1 and transferred and analysed using SPSS computer soft ware package version 20. RESULTS: The lifetime prevalence of khat chewing, alcohol drinking and cigarette smoking among the study participants were 28.7%, 34.5% and 9.5% respectively. Similarly, the current prevalence of khat chewing, alcohol drinking and cigarette smoking were 27.9%, 32.8% and 9.3% respectively. The commonest reasons for khat, alcohol and cigarette using were to keep alert while reading 40.6%, for relaxation 65.5% and to relief stress 37.7% respectively. Having peer friends who chew khat was strongly and positively associated with khat use [AOR: 10.18, 95%CI: (5.59, 18.54)].Family members and peer friends alcohol use were strongly associated with alcohol drinking [AOR: 2.61, 95%CI: (1.56, 4.34) and [AOR: 14, 95%CI: (8.09, 24.24)] respectively. Ever alcohol use was strongly associated with cigarette smoking [AOR: 6.54, 95%CI: (2.66, 16.05)]. CONCLUSION: This study revealed that psychoactive substances use became an urgent problem among undergraduate university students. Universities need to monitor and teach their students with special focus on fresh man students, about the health risks and socioeconomic problems associated with psychoactive substances use.