Exploring barriers of health literacy on non-communicable disease prevention and care among patients in north wollo zone public hospitals; Northeast, Ethiopia, 2023: application of socio-ecological model.

BACKGROUND: Health literacy is the important for the prevention of non-communicable disease to make informed health decisions, and practice healthy and protective behaviours. Therefore, application of socioecological model to this study aimed to identify multilevel factors on health literacy among patients and develop scientific health communication interventional strategies to improve health literacy on non-communicable disease prevention and care. OBJECTIVE: To explore barriers of health literacy on non-communicable disease prevention and care among patients in north wollo zone public Hospitals, Northeast Ethiopia, 2023. METHOD: In this study phenomenological study design was conducted from February 5 to 30/2023.We have used purposive sampling technique to select study participants from chronic follow up clinics. Data were collected using in-depth interview and focused group discussion in which audio was recorded, transcribed verbatim and translated to English. Thematic analysis was performed with atlas ti. 7 software. RESULT: In this study four main themes with seven subthemes were developed. The main themes were factors at the organizational, community, interpersonal, and intra-personal factors. The poor knowledge, lack of enough money for transportation and medication at the hospital were identified as barrier to get early diagnosis and treatment. Some participants explored that they have no any support from family or others. The cultural norms like weeding and funeral ceremonies enforce patients to consume prohibited substances like alcohol and salty foods. CONCLUSION: In this study different barriers of health literacy were explored. Lack of knowledge, economic problems, lack of social support, poor communication with health care providers, cultural influences, lack of regular health education, lack of access to health care services and poor infrastructure were main barriers of health literacy in patients with NCD. Therefore, we recommended all concerned bodies to work on social and behavioral change communication intervention focusing on awareness creation, supply of drugs and create supportive environment to get accessible and affordable health care service to decrease the impact of non-communicable disease at personal, community and national level.

Motivation and associated factors of health development army in the implementation of health extension packages in Northwest Ethiopia: a cross-sectional study.

INTRODUCTION: Health development army is a network of women volunteers organised to promote health and prevent disease through community empowerment and participation. OBJECTIVE: To assess the level of motivation and associated factors of the health development army in the implementation of health extension packages in Northwest Ethiopia. DESIGN: Data were from a community-based cross-sectional study. SETTING: This study was conducted in Mecha district, Northwest Ethiopia. The district is located around 30 km from Bahir Dar, the capital city of Amhara National Regional State, Ethiopia. PARTICIPANTS: A total of 624 health development army members were interviewed using a structured questionnaire from 20 April 2020 to 20 May 2020. OUTCOME MEASURES: Motivation was assessed using a five-item Likert scale statement ranging from 1 to 5. Data were collected using a structured questionnaire and analysed using a binary logistic regression model. RESULTS: The proportion of health development army members, who had motivation in the implementation of the health extension package, was 47.8% (95% CI (43.90 to 51.80)). The odds of having motivation were higher among health development army members who lived in urban areas ((adjusted OR, AOR 2.47; 95% CI (1.21 to 5.03)), were less than 30 years ((AOR 2.42; 95% CI (1.22 to 4.78)), had more than 4 years work experience ((AOR 4.72; 95% CI (2.54 to 8.76)), had high intrinsic job satisfaction ((AOR 2.31; 95% CI (1.51 to 3.55)), had good community support ((AOR 2.46; 95% CI (1.34 to 4.51)), received supportive supervision ((AOR 1.85; 95% CI (1.24 to 2.77)) and were recognised for their efforts ((AOR 1.52; 95% CI (1.01 to 2.30)). CONCLUSION: The proportion of motivation among health development army members was low. To increase the motivation of health development army members in the implementation of the health extension package, measures or strategies may consider targeting members who live in rural areas, are older than 30 years, have less than 4 years of work experience, report low job satisfaction, have low community support, do not have supportive supervision and are not recognised.

Lived Experience of People with Type 1 Diabetes in North East Ethiopia; Psycho-Social and Economical Perspective, a Phenomenological Study.

Objective: To explore lived experience of people with type 1 diabetes in North East Ethiopia; psycho-social and economical perspective. Methods: A descriptive phenomenological study was conducted to explore the lived experience of people with type 1 diabetes in North East Ethiopia; psycho-social and economical perspective from March 02 to March 25, 2020. A heterogeneous purposive sample method was used to choose the participants. The lead investigator used an in-depth interview to collect data, using an audio recorder and an interview guide. The data were analysed using the thematic analysis method. Atlas. ti software version 7 was used to facilitate the data analysis process. Results: A total of 13 participants were enrolled in this study. The participants age range were 14 to 70 years and their duration of diabetes since diagnosis were from 8 months to 16 years. The three interconnected themes that emerged from the analysis are: (1) psychological experience with two sub-themes (psychological problems due to diabetes including fear and coping strategies for psychological problems), (2) social experience, which has five categories (influence on intimate relationships, influence on social participation, disclosure status, social isolation and stigma, social support, and influence on education); and (3) economic experience. Conclusion: Fear was one of the psychological experiences felt by people with type 1 diabetes. Although type 1 diabetes is a biomedical problem, it is also accompanied by other psychological and socio-economic issues, that require a holistic approach to address it. So, health professionals should strengthen health information dissemination programs.

Formula Feeding Practice and Associated Factors Among Mothers Who Visited Health Facilities for Their Infants Aged Below 6 Months in Bahir Dar City, Northwest Ethiopia, 2020.

Background: Even though breastfeeding for infants and young children provides the ideal food for healthy growth and development, nowadays the use of infant formula feeding has increased worldwide. In developing countries, 1.3 million to 1.45 million childhood deaths are attributed to suboptimal breastfeeding practices. Objective: This study aimed to assess infant formula feeding practice and associated factors among mothers who visited health facilities for their infants aged less than 6 months in Bahir Dar city in 2020. Methods: An institution-based cross-sectional study was conducted in March-May 2020. Data were collected from 593 randomly selected mothers with infants less than 6 months of age. A multivariable logistic regression analysis was performed to identify associated factors of formula feeding practice with an a p-value of less than 0.05 and an adjusted odds ratio of 95% confidence interval. Results: The prevalence of infant formula feeding practices was 25%. Maternal age group of 25-34 years [AOR = 2.388; 95% CI: 1.295, 4.406], mother's occupation of private employee [AOR = 6.726; 95% CI: 2.756, 16.413], government employee [AOR = 4.726; 95% CI: 1.895, 8.700] and merchant [AOR = 2.798; 95% CI: 1.066, 7.345], positive attitude to infant formula [AOR = 2.10; CI: 1.09, 4.06], delayed breast milk initiation after delivery [AOR = 3.73; 95% CI: 1.504, 9.252], mothers who had 3 antenatal care [AOR = 2.294; 95% CI: 1.317, 3.997] and source of formula milk information from supermarket/pharmacy [AOR = 6.57; 95% CI: 1.48, 29.16] and from families/friends [AOR = 2.24; 95% CI: 1.24, 4.03] were independent predictors of infant formula feeding practice. Conclusion: This study's findings revealed that one-fourth of mothers fed infant formula before the age of 6 months. Therefore, we recommended promoting behavior change communication, focusing on attitude change in formula feeding practice and its health consequences, promoting exclusive breastfeeding practice, and strengthening ANC service provision.

The association between HIV infection and precancerous cervical lesion. A systematic review and meta-analysis of case-control studies.

Background: The effect of human immunodeficiency virus (HIV) on precancerous cervical lesion is not consistent across studies. Besides to the variability in the presence of a significant association between HIV and precancerous cervical lesion, the reported strengths are inconsistent among studies that report a significant association. Therefore, we sought to determine the impact of HIV on women's risk of precancerous cervical lesion by conducting a systematic review and meta-analysis of case-control studies in Ethiopia. Methods: Relevant articles were systematically searched on African Journals Online, Cochrane Library, Science Direct, Google Scholar, and PubMed from January 1, 2023, to February 20, 2023. After critical appraisal, pertinent data were extracted into an Excel spreadsheet and then exported to STATA 14 for further statistical analysis. The pooled effect size was estimated using the random-effect model. The Egger's regression test and I 2 statistics were employed to assess publication bias and heterogeneity among included studies, respectively. Results: Ten case-control studies with a total of 3035 participants (992 cases and 2043 controls) were involved in this meta-analysis. According to our analysis, HIV-infected women were 2.86 times more likely to develop precancerous cervical lesion as compared with their counterparts (odds ratio: 2.86, 95% confidence interval: 1.79, 4.58). Conclusion: We found that HIV-infected women have a higher risk of precancerous cervical lesion. Thus, targeted screening programs should be considered to reduce the burden of cervical cancer among HIV-infected women in Ethiopia.

Prevalence of undernourishment and associated factors among adults with major depressive disorder at two public hospitals in Northwest Ethiopia: a cross-sectional study.

OBJECTIVE: Undernourishment is overlooked in people with major depressive disorder (MDD); however, it could have huge impacts on recovery, functioning and quality of life. This study aimed to assess the prevalence of undernourishment and associated factors among adults with MDD attending two public hospitals in Northwest Ethiopia. DESIGN: Institution-based cross-sectional study was used. SETTING: This study was conducted in two public hospitals-a tertiary-level specialised care hospital (Felege-Hiwot Comprehensive Specialized Hospital) and a secondary-level referral hospital (Debre Markos Referral Hospital). Both hospitals are located around 200 km apart and are the busiest hospitals in Western Amhara region. PARTICIPANTS: A total of 396 participants were included in the study using a stratified sampling technique. The study participants were recruited from psychiatry units. Adults with MDD were recruited from both hospitals proportionally between September and November 2019. OUTCOME MEASURES: Undernourishment was assessed using a body mass index measurement. Data were collected using a structured questionnaire and anthropometric measurements, and analysed using a binary logistic regression model. RESULTS: The overall prevalence of undernourishment was 28.5% (95% CI: 23.7% to 33.4%) among adults with MDD attending psychiatric care in the two public hospitals in Northwest Ethiopia. Female gender (adjusted Odds Ratio (AOR)=2.18, 95% CI=1.20 to 3.96, p=0.01), rural residence (AOR=2.41, 95% CI=1.23 to 4.70, p=0.01), illiteracy (AOR=2.86, 95% CI=1.01 to 8.07, p=0.047), antidepressant side effects (AOR=2.04, 95% CI=1.08 to 3.88, p=0.028) and having HIV/AIDS (AOR=4.12, 95% CI=1.46 to 11.57, p=0.007) had a statistically significant association with undernourishment. CONCLUSION: The prevalence of undernourishment was high among adults with MDD in Northwest Ethiopia. This study suggests the need to include nutritional interventions for people with MDD in psychiatric care facilities.