Practice of breast self-examination and associated factors among women of reproductive age in the North Shoa Zone, Oromia, Ethiopia, 2022: a convergent mixed-methods study.

OBJECTIVE: To assess practice of breast self-examination (BSE) and associated factors among women of reproductive age in the North Shoa Zone, Oromia, Ethiopia. DESIGN: Community-based cross-sectional study with a convergent mixed-methods approach. SETTING: The study was conducted in the North Shoa Zone of Oromia, Central Ethiopia, between 1 May 2022 and 30 June 2022. PARTICIPANTS: 1076 women of reproductive age were selected using simple random sampling technique for the quantitative study. For the qualitative part, a total of 46 women were approached purposively to elicit rich ideas and insight into the issue. The quantitative data were collected using an interviewer-administered questionnaire, and focus group discussions were used for the qualitative part. Quantitative data were analysed using SPSS V.26. An adjusted OR with a 95% CI was employed. Thematic analysis approach was applied for the qualitative data analysis. OUTCOME MEASURES: Participants were interviewed to respond whether they practised BSE. RESULTS: Overall, 192 (18.2%; 15.7%-20.5%) of the participants had ever performed BSE. Having a family history of breast cancer (BC) (adjusted OR (AOR)=6.9, 95% CI 4.6 to 10.3), being knowledgeable on BSE (AOR=3, 95% CI 1.9 to 4.3), having high perceived susceptibility (AOR=1.7, 95% CI 1.2 to 2.5), having high self-efficacy (AOR=1.5, 95% CI 1.1 to 2.3) and having a high perceived benefit to BSE (AOR=1.5, 95% CI 1.1 to 2.3) were significantly associated with increased odds of BSE practice.Four main themes emerged from the qualitative analysis: BC and BSE-related knowledge, perceived benefits of treatment, barriers to BSE practice and enablers of BSE practice. CONCLUSION: The practice of BSE in this area was considerably low. The North Shoa Zonal Health Office and other stakeholders should disseminate instructional materials that cover the techniques and benefits of regularly performing BSE. Healthcare professionals should engage in the community to address the obstacles women face in practising BSE.

Exploring enablers and barriers to breast self-examination among women in the North Shewa Zone, Oromia, Ethiopia: a qualitative study.

Breast cancer (BC) is the leading cause of cancer death worldwide and the second most common cancer overall. Breast self-examination (BSE) is one of the cheapest methods used for the early detection of BC in asymptomatic women. More than 90% of cases of BC can be detected by women themselves. This reality stresses the importance of BSE as the key BC detection mechanism. However, in Ethiopia, most of the BE studies were not conducted among women in the general population. Therefore, this study aimed to explore enablers and barriers to breast self-examination among women in the North Shewa Zone, Oromia. A descriptive qualitative study design was conducted from August 1, 2022, to September 30, 2022. Five focus group discussions (FGDs) were conducted with 46 women from one selected district in the North Shewa Zone, Oromia. A Purposive sampling technique was used to select participants for FGD. The audio-recorded data were transcribed verbatim to "Afan Oromo". Transcribed data were translated into English. The data were manually coded into themes and analyzed manually by using inductive thematic analysis. The findings of the study were discussed under five themes of enablers and three themes of barriers. The five themes of enablers were knowledge about BC, knowledge about BSE, experience of BSE practice, perceived susceptibility, and perceived benefit of BSE practice. The four themes of barriers were low knowledge of BSE practice, misconceptions about BSE practice, and fear of detecting BC. These findings suggest that targeted health education programs, collaboration between healthcare providers and local stakeholders, and the availability of support services can play a crucial role in overcoming barriers and encouraging BSE practice for early detection of breast abnormalities.

Health related quality of life of HIV-positive women on ART follow-up in north Shewa zone public hospitals, central Ethiopia: Evidence from a cross-sectional study.

Background: Evidence revealed that there is a statistically significant gender difference in Health-related quality of life (HRQoL) among HIV-positive people on Antiretroviral therapy (ART). Consequently, HIV-positive women have low scores in all HRQoL domains than men. Despite this fact, previous studies in Ethiopia focused on general HIV-positive people and paid less attention to HIV-positive women. Therefore, this study was intended to measure HRQoL and associated factors among HIV-positive women on ART follow-up in north Shewa zone public hospitals, central Ethiopia. Methods: An institution-based cross-sectional study was conducted from February 01-April 30, 2022. Four hundred twenty-six women on ART were included using a systematic random sampling technique. Face-to-face interviews and medical record reviews were used to collect data. Both bivariable and multiple linear regressions were computed to identify the factors associated with HRQoL. A p-value <0.05 was used to assert statistically significant variables in multiple linear regression analysis. Results: The overall mean (SD) score of the HRQoL was 11.84 (2.44). And, 44.7% [95% CI: 40.3, 49.5] of the women have poor HRQoL. In multiple linear regression analysis, factors like depression (ß = -0.35), Post-Traumatic Stress Disorder (PTSD) (ß = -0.16), age (ß = -0.07), rural residence (ß = -0.52), and bedridden functional status (ß = -1.02) were inversely associated with HRQoL. Oppositely, good treatment adherence (ß = 0.46) was positively associated with overall HRQoL, keeping other factors constant. Conclusion: This study reveals a high magnitude of poor HRQoL among HIV-positive women. Therefore, as HRQoL domains are comprehensive indicators of living status, healthcare service providers should be dedicated to screening and supporting HIV-positive women with poor HRQoL. Additionally, healthcare providers should also pay special attention to routine PTSD screening and management for HIV-positive women due to its detrimental effect on HRQoL.

The practice of early mother-newborn skin-to-skin contact after delivery of healthy term neonate and associated factors among health care professionals at health facilities of Southwestern Oromia, Ethiopia: A cross-sectional study.

INTRODUCTION: Skin-to-skin contact between a mother and her new-born baby after birth is beneficial for both the mother and her baby. Although mother-newborn skin-to-skin contact after birth is an essential practice, it is limited to a small proportion of premature babies in low-income countries including Ethiopia. The aim of this study was to assess the practice of early mother-new-born skin-to-skin contact after the delivery of healthy term neonates and associated factors among health care professionals in Southwestern Oromia, Ethiopia. METHODS: An institutional-based cross-sectional study was conducted to assess the practice of 286 health care practitioners towards early mother-new-born skin-to-skin contact after delivery. Data was collected using a pre-tested observational checklist and a self-administered questionnaire from March to April 2017. Epi Info 3.5 was used for data entry, while SPSS version 20 was used for cleaning and analyzing the data. To determine the association between outcome variable and independent variables, bivariate and multivariable logistic regressions were used with a 95% confidence interval and P <0.05. Frequency tables and charts were used to present the findings. RESULTS: Only 128 (44.8%) of the study participants practiced mother-newborn skin-to-skin contact within the first hour of life after birth. Mother newborn skin-to-skin contact after birth was found to be significantly associated with health professional's knowledge (AOR = 4, 95% CI = 1.7, 10), training (AOR = 7, 95% CI = 2.2, 21), complicated delivery (AOR = 0.12, 95% CI = 0.04, 0.4), and maternal chronic illness (AOR = 0.13, 95% CI = 0.03, 0.6). CONCLUSION: In general, the practice of health care providers on mother-newborn skin-to-skin contact in the first one hour after birth was low. Knowledge, training, childbirth related maternal complication, and maternal chronic illness were significant factors associated with the practice of mother-newborn skin-to-skin contact immediately after birth. Policies should be revised and enforced, with monitoring and awareness building through training among health care workers, to improve the practice of skin-to-skin contact between mothers and newborns shortly after birth.

Impact of COVID-19 on HIV services and anticipated benefits of vaccination in restoring HIV services in Ethiopia: A qualitative assessment.

Background: HIV services were inevitably disrupted and affected due to COVID-19. There are many challenges in implementing appropriate HIV services, particularly in the provision of health care and the link between people living with HIV/AIDS and retention in care. The study investigated the impact of COVID-19 on HIV services and the anticipated benefit of the COVID-19 vaccination on HIV service restoration in North Shewa, Oromia, Ethiopia. Methods: A qualitative descriptive study approach was used to explore how healthcare delivery evolved during the outbreak of COVID-19 in Ethiopia. Sixteen antiretroviral therapy (ART) clinics were selected from 13 districts and one administrative town in Ethiopia. From them, 32 ART providers were purposively selected based on their experience in ART provision. Data were collected from June to July 2021 using in-depth interviews. A thematic analysis approach was used to analyze the data, based on themes and subthemes emerging from the data. ATLAS.ti software was used for coding. Results: Healthcare for people living with HIV was interrupted due to the COVID-19 pandemic. Medical appointments, HIV testing and counseling services, opportunistic infection treatment, medicine supply, and routine viral load and CD4 T-cell count tests were interrupted. Due to a shortage of healthcare staff, outreach testing services and home index testing were discontinued and HIV testing was limited only to hospitals and health centers. This has substantially affected accessibility to HIV testing and reduced the quality of HIV service delivery. Telehealth and less frequent visits to health facilities were used as alternative ways of delivering HIV services. The COVID-19 vaccination campaign is expected to restore healthcare services. Vaccination may also increase the confidence of healthcare providers by changing their attitudes toward COVID-19. Conclusions: The COVID-19 pandemic has substantially impacted HIV services and reduced the quality of HIV care in Ethiopia. Health facilities could not provide routine HIV services as they prioritize the fight against COVID-19, leading to an increase in service discontinuation and poor adherence.

Safe menstrual hygiene management practice and associated factors among female adolescent students at high schools in central Ethiopia: A mixed-method study.

Background: Menstrual Hygiene Management (MHM) is a much-neglected issue in developing countries, including Ethiopia. Menstruating women and girls are forced into isolation, prevented from movement, dietary restrictions, and can be prevented from participating in daily routine activities. Furthermore, the way almost all previous studies conducted in Ethiopia measured the practice of MHM did not meet standard definition of safe MHM. This study aimed to assess safe management of menstrual hygiene practice and associated factors among female adolescent students in public high schools in central Ethiopia. Methods: A mixed-methods approach was employed in this study. Systematic random sampling technique was used to select 846 study participants. The collected data were entered through EPI INFO version 7 and exported to SPSS version 23 for cleaning and analysis. Bivariate and multivariate logistic regression analysis were performed to identify the association between MHM and independent variables. Finally, AOR, 95% CI, and p-value < 0.05 were considered statistically significant. The qualitative data was analyzed by ATLAS.ti in order to extract the main themes and categories. Direct quotations were presented with a thick description of the findings. Results: The safe management of menstrual hygiene was 28.20%. Living with parents (AOR = 2.51, 95% CI:1.11-5.68), living with relatives (AOR = 7.41, 95% CI:2.55-21.54), having a merchant mother (AOR = 1.81, 95% CI:1.14-2.9), having a mother who has private work (AOR = 4.56, 95% CI:1.31-5.90), having a farmer father (AOR = 1.53, 95% CI:1.1-2.31), rural resident (AOR = 1.61, 95% CI: 1.17-2.21) and realizing the absence of container for storing sanitary napkins in the toilet of the school latrine (AOR = 1.44, 95% CI: 1.1-0.94) were factors associated with MHM. Findings from a qualitative study were discussed under four themes to explore barriers to menstrual hygiene management, and three themes emerged as enablers to menstrual hygiene management. Conclusions: The safe management of menstrual hygiene was low among adolescent girls. People with whom adolescent girls live, the occupational status of mother and father, residence, the availability of a container to dispose of sanitary napkins in school toilets were factors associated with menstrual hygiene management. Behavioral change communications must be provided to female students about menstrual hygiene.

Exploring Enablers and Barriers to Utilize Printed Information, Education, and Communication Materials Among Healthcare Providers of North Shoa Zone, Oromia, Ethiopia.

Background: Information, education, and communication (IEC) materials have paramount relevance in primary health care which mainly focused on disease prevention and control. They are a cost-effective approach for achieving better health outcomes in all clinical and public health interventions. This study aimed to explore enablers and barriers to utilize printed IEC materials among healthcare providers of North Shoa Zone, Oromia, Ethiopia, 2020. Methods: A descriptive, qualitative study was conducted from December 1, 2020, to December 30, 2020, among health care providers. A judgmental sampling technique was used and 20 key informants were recruited considering their educational level, professional categories, working units, work experience, and types of health facilities. The data were collected by using a semi-structured interview guide. The transcribed data were uploaded into ATLAS. ti version 7.5.18 software. Then, the inductive process of thematic analysis was employed and the data were coded, categorized, and thematized. Direct quotations were presented with a thick description of the findings. Results: The findings of the study were discussed under four themes of enablers and four themes of barriers. The four themes of enablers were availability of printed IEC materials, distribution of printed IEC material, perceived usefulness of printed IEC materials, and support from the non-government organization. The four themes of barriers were printed IEC materials-related factors, patients related factors, health care provider's related factors, and government-related factors. Conclusion: In this study, we found that the utilization of IEC materials was influenced by a number of facilitators and barriers. Thus, all concerned bodies need to give due attention to IEC materials and work towards the improvement of the quality of IEC materials, provide training for health care providers, work to increase the availability of IEC materials, and distribute them to the health facilities.

Level of Adequate Knowledge of Non-communicable Diseases and Associated Factors Among Adult Residents of North Shewa Zone, Oromia Region, Ethiopia: A Mixed-Method Approach.

Background: Non-communicable diseases (NCDs) are currently the leading cause of morbidity and mortality, posing significant challenges to global healthcare systems. Particularly, the prevalence of NCDs is rising in Ethiopia, resulting in a triple burden of diseases on the health system that disproportionately affects all age groups. Hence, this study aims to determine the level of adequate knowledge of NCDs and associated factors among adult residents of the North Shewa zone, Oromia region, Ethiopia. Methods: A community-based cross-sectional study with a concurrent mixed-method approach was conducted from April 1, 2021 to May 30, 2021 among 846 residents using the multistage sampling technique. Interviewer administered questionnaire was used to collect quantitative data and a guiding checklist was used to collect qualitative data. Bivariable and multivariable logistic regressions were fitted to compute the association between explanatory variables and knowledge of NCDs. Adjusted odds ratios at 95% confidence interval with a p-value < 0.05 were used to decree statistical significance in multivariable analysis. Also, a thematic framework analysis was used for qualitative data analysis. Results: A total of 823 subjects have participated in this study making a response rate of 97.3%. The level of adequate knowledge was 33.9% (95%CI: 30.67, 37.13). Higher-income, receiving information from health professionals, owning a TV, having a family member with NCD(s), and marital status were factors significantly associated with adequate knowledge of NCDs. Conclusion: This study reveals a high level of inadequate knowledge of NCDs despite its foundational ability in tackling the burden of NCDs. As a result, broadening a wider and more comprehensive health promotion strategy for the prevention of triple burden of NCDs would benefit the population. Additionally, special efforts are needed both at the practice and policy levels targeting the disadvantaged groups, such as low-income people, those who do not receive information from health professionals, those who do not own a television, and those who are widowed/divorced, who were found to have less knowledge of NCDs.

Intimate partner violence in the postpartum period and its associated factors among women attending a postnatal clinic in Central Ethiopia.

Objective: Intimate partner violence may affect women at any stage of their lives, including during pregnancy and after childbirth, and can have major health consequences for both the mother and the child. Therefore, the study was aimed to assess Intimate partner violence against postpartum women and its associated factors among women attending the postpartum clinic in Central Ethiopia, 2021. Methods: The hospital based cross-sectional study design was implemented among postpartum women attending Sendafa Beke Hospital from September to October 2021. Systematic random sampling procedure was used to select 414 eligible postpartum women. Data were collected using a structured interviewer administered questionnaire. The data were entered into Epi Info and exported to SPSS version 24 for analysis. All variables with p-value < 0.05 under adjusted odds ratio were taken as statistical significant associated factors with postpartum intimate partner violence. Results: A total of 414 postpartum women participated in the study with a 97% of response rate. The prevalence of postpartum intimate partner violence was 31.4%. The study identified that monthly income 1000-5000 birr (adjusted odds ratio = 3.4; 95% confidence interval = 1.08, 10.5), partners' alcohol consumption (adjusted odds ratio = 0.17, 95% confidence interval = 0.06, 0.45), decision-maker of household affairs (adjusted odds ratio = 4.8; 95% confidence interval = 1.5, 15.1), and infant's sex (adjusted odds ratio = 0.03; 95% confidence interval = 0.02, 0.063) were significantly associated with postpartum intimate partner violence. Conclusion: According to the findings of this study, nearly one-third of postpartum women were violated by their intimate partner after childbirth. Postpartum intimate partner violence was found to be associated with monthly income, partners' alcohol intake, decision-maker of household affairs, and infant's sex. To reduce the magnitude of the problem, different efforts should require from health professional, community, and government. The policy makers, planners and other concerned bodies establish appropriate strategy to prevent and control violence against women.

Return of Sexual Activity Within Six Weeks of Childbirth Among Married Women Attending Postpartum Clinic of a Teaching Hospital in Ethiopia.

Introduction: Postpartum sexual health gets very little attention compared to pregnancy and childbirth, even though most maternal deaths and disabilities occur during this time. Therefore, the study aimed to assess return of sexual activity within 6 weeks of childbirth among married women attending postpartum clinic of a teaching hospital in Ethiopia, 2021. Methods: The hospital-based cross-sectional study design was implemented from September to October 2021. Eligible postpartum women were sampled by systematic random sampling technique. The data was entered into EPI-info and exported to SPSS version 24 for further analysis. All variables with a p-value < 0.05 in multivariable analyses were taken as associated factors with the return to sexual activity before 6 weeks of childbirth. Results: A total of 421 postpartum women participated in the study. The prevalence of women who return to sexual activity 6 weeks after childbirth was 31.6%. The study revealed that monogamy (Adjusted Odds Ratio (AOR) = 4.4, 95% Confidence Interval (CI) (2.1, 9.4)), parity (AOR= 0.11, 95% CI (0.02-0.81)) and (AOR = 0.1, 95% CI (0.015-0.72)), postnatal care (AOR= 1.8, 95% CI (1.01-3)) and infants feeding status (AOR=2.3, 95% CI (1.3-4)) were significantly associated with return of sexual activity before 6 weeks of childbirth. Conclusion: The findings of this study suggested that, nearly one-third of postpartum women engaged to sexual activity within 6 weeks of childbirth. Return of sexual activity within 6 weeks of childbirth associated with monogamy type of marriage, parity, postnatal care, and child feeding status. Strengthening postpartum counseling regarding the appropriate time to resume sexual activity is crucial. Regular postpartum visits following deliveries should also be encouraged by health care providers.

What Factors Encourage Young People to Engage in Substance Use? Substance Use and Associated Factors Among Youth in Southwest Ethiopia: A Community-Based Study.

Background: Substance use indicated the use of psychoactive substances such as alcohol, cigarettes, khat, and illegal drugs. Substance use has varying impacts on the health and socio-economics of countries, and is a major public health concern globally. Currently, substance use is a common public health problem among Ethiopian youth mainly in the city of Jimma. Therefore, this study aimed to assess the magnitude of Cigarette smoking, alcohol drinking, khat chewing, and associated factors among the youth of Jimma town in 2019. Methods: A community-based cross-sectional study was conducted among youth of Jimma town from March 2019 to April 2019. A simple random sampling technique was used to select 423 study participants. Data were collected using a structured interviewer-administered questionnaire. The collected data were entered into EPI data manager version 4.4.1 and transported to SPSS version 23 for data cleaning and analyses. The disruptive study was carried out to determine the prevalence of cigarette smoking, alcohol consumption, and khat chewing. Binary and multivariable analyses were carried out to identify factories associated with cigarette smoking, alcohol consumption, and khat chewing. Finally, adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to determine the presence and strength of association. Results: The current prevalence of cigarette use, alcohol use, and khat use was 16.0, 30.6, and 45.7%, respectively. Factors associated with current smoking use were substance use by siblings, subjective norm factors, and perceived benefits of substance use. Factors associated with current alcohol consumption were youth who highly perceived substance use as important. Factors associated with current khat use were male, substance use by siblings, out-of-school youth, and subjective norms. Concussion: The study findings indicated that the prevalence of khat, alcohol, and cigarettes was high among the youth of the city of Jimma. To reduce the prevalence of khat, alcohol, and cigarettes among youth, coordinated efforts from the youth, the government, health professionals, and the community at large are needed.

Evaluation of the Knowledge, Attitude, and Practice of COVID-19 Prevention Methods Among Hypertensive Patients in North Shoa, Ethiopia.

Introduction: The occurrence of coronavirus diseases 2019 (COVID-19) has affected more than 247 million populations around the world. People with comorbidities such as hypertension, diabetes mellitus, congestive heart failure, kidney disease, elderly people, and people with weak immunity develop severe types of COVID-19 if exposed to the disease. Therefore, this study aimed to assess knowledge, attitude, and practice of COVID-19 prevention methods among hypertensive patients in North Shoa, Oromia region, Ethiopia. Methods: An institutional-based cross-sectional study was conducted from May 5/2020 to June 5/2020 in public hospitals in the North Shoa zone, Ethiopia. Data were collected using a structured questionnaire and study participants were recruited using a simple random sampling technique. The data were checked for completeness and entered into the EpiData manager version 4.4.1 and transferred to SPSS version 23 for analysis purposes. Bivariate and multivariate logistic regression were computed and a significant association was declared with a p-value less than 0.05. Results: A total of 360 (97.0%) hypertension patients responded. This study revealed that 210 (58.3%) study participants had good knowledge of COVID-19 prevention methods, 199 (55.3%) had a favorable attitude towards COVID-19 prevention methods, and 210 (58.3%) hypertension patients at follow-up practiced COVID-19 prevention methods. Respondents who received less than two thousand Ethiopian birrs monthly and respondents who followed electronic news media were significantly associated with the use of sanitizer, respondents who had a favorable attitude towards the COVID-19 prevention method were significantly associated with mask-wearing, and respondents who received less than two thousand Ethiopian birrs monthly were significantly associated with maintaining a physical distance. Conclusion: Generally, this study finding revealed that the level of knowledge, attitude, and practice towards COVID-19 prevention among hypertension patients was low. Therefore, increasing knowledge, attitude, and practice on COVID-19 among hypertension patients requires a coordinated effort from the government, non-government, and health professionals.

Why are Youth Engaged in Substance Use? A Qualitative Study Exploring Substance Use and Risk Factors Among the Youth of Jimma Town, Southwest Ethiopia.

INTRODUCTION: Substance use refers to the use of psychoactive substances such as khat, alcohol, cigarettes, and illicit drugs. Young people are more vulnerable to substance use than older people. Substance use has varying impacts on the health and socio-economics of countries, and is a major public health concern globally. Currently, substance use is a common public health concern among the youth of Ethiopia, mainly in Jimma town. Therefore, this study aimed to explore the substance use and risk factors among the youth of Jimma town in 2019. METHODS: The study was conducted in Jimma town among youth who were engaged in substance use, from March to April 2019. A descriptive qualitative study design was employed and the study participants were acquired using purposive/judgmental sampling techniques. In total, 20 interviews were conducted with young people using in-depth and key informant interview methods. The data were analyzed by using ATLAS.ti version 7. Thematic analyses were performed in order to extract the main themes and categories. Direct quotations were presented with a thick description of the findings. RESULTS: The findings of this study were discussed under six themes and 12 categories, which emerged from thematic analysis of the data: substance use setting, time and means of distribution, substance-related factors, social and economic factors, individual factors, psychological factors, and legal and policy factors. CONCLUSION: The study indicated that khat, alcohol, cigarettes and shisha or water pipes were the most commonly used substances. Different factors that drive the youth to engage in substance use were identified; individual factors, social and economic factors, substance-related factors, and legal and policy factors were most common. Generally, to overcome this problem, the community, lawyers, and policemen should participate in the implementation and enforcement of rules and regulations on substance use. Family should monitor their children and need to act as good role models by avoiding substance use.

Anxiety and depression symptoms in older adults during coronavirus disease 2019 pandemic: A community-based cross-sectional study.

OBJECTIVES: The coronavirus disease 2019 pandemic has caused high morbidity and mortality in older adults over the world. Because the coronavirus disease 2019 pandemic greatly affects older adults who have a preexisting health condition, they are generally susceptible to a high incidence of severe symptoms of anxiety and depression. Therefore, we aimed to assess the prevalence of anxiety and depression symptoms in older adults during the coronavirus disease 2019 pandemic. METHODS: Community-based cross-sectional study was completed in August 2020. Standardized and pretested General Anxiety Disorder-7 and Geriatric Depression Scale were used to screen the symptoms of anxiety and depression, respectively. Data were entered into EpiData (version 4.3.2) and transferred to SPSS (version 24) for further analysis. Bivariate and multivariate logistic regression analyses were carried out to determine the significantly associated variables with a 95% confidence interval at p < 0.05. RESULTS: Of the total older adults interviewed, 68.7% had developed symptoms of anxiety and 59.9% had symptoms of depression during the coronavirus disease 2019 pandemic. Female participants, having a chronic disease and poor knowledge of the coronavirus disease 2019 pandemic, were significantly associated with anxiety symptoms. Age category of 81 to 90 and above 90, lack of social support, and having a chronic disease were significantly associated with symptoms of depression. CONCLUSION: The symptoms of anxiety and depression among older adults in the North Shoa Zone during coronavirus disease 2019 were higher than before the coronavirus disease 2019 happened. The results were evidence points for developing a psychological intervention to tackle the older adults' mental health needs in the community during and after the coronavirus disease 2019 pandemic.

Psychological Distress, Early Behavioral Response, and Perception Toward the COVID-19 Pandemic Among Health Care Workers in North Shoa Zone, Oromiya Region.

Background: The coronavirus disease 2019 (COVID-19) pandemic has had a significant psychological impact on health care workers (HCWs). Therefore, this study inspects the mental health status, behavioral response, and perception among HCWs (nurses, physicians, and medical laboratory workers) during the COVID-19 pandemic in public health care facilities. Methods: A facilities-based cross-sectional study was conducted in July 2020. A simple random sampling technique was used to select study participants. Data were collected by self-report administered questionnaires using Patient Health Questionnaire-9 (PHQ-9) for depression, General Anxiety Disorder-7 (GAD-7) for anxiety, Insomnia Severity Index (ISI) for insomnia, Impact of Event Scale-Revised (IES-R) for psychological distress, Perceived Threat Scale for perception, and Behavioral Response Inquiry for the behavioral response. Moreover, bivariable and multivariable logistic regressions analysis was used to identify the association between dependent and independent variables at p-value <0.05. Results: A total of 417 (98.6%) HCWs responded to a self-administered questionnaire. The proportion of HCWs who had moderate to severe symptoms of psychological distress, depression, anxiety, and insomnia during the COVID-19 pandemic were 58, 16.3, 30.7, and 15.9%, respectively. Three-fifth of the nurses, medical laboratory professionals (62.2%), and physicians (59.2%) had reported good behavioral responses toward the COVID-19 pandemic. More than three-fifths of the nurses had reported poor perception toward the COVID-19 pandemic. Conversely, 61.2% of physicians and three-fourths (75.5%) of medical laboratory professionals had reported good perception toward the COVID-19 pandemic. Female and married participants, those working in the emergency unit, those with poor behavioral responses, and those with poor perception toward the COVID-19 pandemic were significantly associated with symptoms of psychological distress, depression, anxiety, and insomnia. Conclusions: Psychological impacts among physicians, nurses, and medical laboratory professionals are high during the COVID-19 pandemic. The Ethiopian Federal Ministry of Health should aim to protect all HCWs' psychological well-being during the COVID-19 pandemic with appropriate interventions and accurate information response.

Self-Reported Symptoms of Depression, Anxiety, and Stress Among Healthcare Workers in Ethiopia During the COVID-19 Pandemic: A Cross-Sectional Study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency that has affected many world nations, including Ethiopia. Aside from its implications on the community as a whole, COVID-19 has also been associated with a variety of mental health problems among healthcare workers (HCWs). In this study, we aim to assess the prevalence of self-reported symptoms of depression, anxiety, and stress during the COVID-19 pandemic among HCWs in central Ethiopia. METHODS: An institutional-based cross-sectional study was conducted using an online survey from June 25, 2020, to July 25, 2020, in Ethiopia. Data were collected using a self-reported Depression, Anxiety, and Stress Scale (DASS-21). Data were cleaned, coded, and analysed using SPSS Version 23. A multivariable logistic regression analysis was done to identify the associated factors for mental health outcomes at a p-value of less than 0.05. RESULTS: A total of 816 HCWs completed the self-report questionnaire. The percentage of HCWs who had moderate to extremely severe symptoms of depression, anxiety, and stress were 60.3%, 78%, and 33.8%, respectively. Female participants, HCWs in the Oromiya Special Zone, medical laboratory professionals, and HCWs working in the COVID-19 treatment isolation centers were significantly more likely to have symptoms of depression, anxiety, and stress. CONCLUSION: In this study, HCWs reported a high prevalence of depression, anxiety, and stress symptoms. Female participants, HCWs in the Oromiya Special Zone, medical laboratory professionals, and HCWs working in the COVID-19 treatment isolation centers were significantly more likely to have symptoms of depression, anxiety, and stress. It is imperative that the Ethiopian Federal Ministry of Health should develop psychological interventions to address the specific needs of HCWs who have been impacted by the COVID-19 pandemic.

COVID-19 Pandemic Preparedness and Response of Chronic Disease Patients in Public Health Facilities.

BACKGROUND: The Coronavirus Diseases 2019 (COVID-19) causes a unique threat and a great challenge to chronic disease patients. Apart from its severity for all communities, a chronic disease patient is highly vulnerable to the current COVID-19 pandemic. Therefore, this study aimed to assess preparedness and response against the COVID-19 among chronic diseases patients who had follow-up at healthcare facilities. METHODS: An institutional-based cross-sectional study was conducted in the North Shoa Zone from May 5, 2020, to June 5/2020. A pre-tested and semi-structured questionnaire was used to collect data. The study participants were selected by simple random sampling technique. The data were entered into the Epi-data and exported to SPSS for cleaning and analysis. Bivariable and multivariable logistic regressions were used to identify the factors associated with the COVID-19 preparedness and response. RESULTS: A total of 410 (97%) patients were responded to face to face interview administered questionnaire. Nearly two-thirds of the respondents had good knowledge, 54% were well prepared, and 63% had a good response to the COVID-19 pandemic. Male participants, news media (TV & Radio), social media, tuberculosis, hypertension, and diabetes mellitus were significantly associated with a good preparedness. Informal education, news media (TV & Radio), and having hypertension were significantly associated with good response to the COVID-19 pandemic. CONCLUSION: The prevalence of preparedness and response to the COVID-19 pandemic among chronic disease patients was low. Male participants, source of information, educational status, and having chronic diseases were significantly associated with the COVID-19 prevention preparedness and response. It should be continued to provide awareness creation for chronic patients through news media (TV and radio) and social media to increasing the preparedness and response to the COVID-19 pandemic.

Patient Satisfaction and Associated Factors During COVID-19 Pandemic in North Shoa Health Care Facilities.

BACKGROUND: Patient satisfaction is an indicator of healthcare quality service and involved as an outcome measure. Quality of healthcare service and patient satisfaction has been affected by the current coronavirus disease 2019 (COVID-19) pandemic. It induced uncertainness and shortage of medical supplies due to a limited global movement. Therefore, this study aimed to assess patient satisfaction and associated factors among chronic patients who had a follow-up in North Shoa healthcare facilities. METHODS: An institutional-based cross-sectional study was used to select 410 study participants through a systematic random sampling technique. Data were collected by a structured interviewer-administered questionnaire, entered into Epi Info version 7, and transported to SPSS version 23 for analysis. Bivariable and multivariable logistic regressions were used to identify the factors associated with satisfaction. The odds ratio with a 95% confidence interval was computed, and p-value <0.05 was considered statistical significance in the multivariable model. RESULTS: The overall level of patient satisfaction was 44.6%. The presence of sign and direction indicators (AOR=3.26, 95% CI=1.1, 9.92), obtaining some ordered drugs (AOR=3.7, 95% CI=1.1, 12.54), getting alcohol for hand cleaning (AOR=2.66, 95% CI=1.1,6.65), obtaining sanitizer for hand cleaning (AOR=4.45, 95% CI=1.72,11.52), and maintaining social distancing (AOR=2.63, 95% CI=1.21, 5.70) were factors associated with patient's satisfaction. CONCLUSION: The level of patient satisfaction was very low during a COVID-19 pandemic. The presence of sign and direction indicators, availability of drugs, social distancing, availability of alcohol, and sanitizer were factors associated with patient satisfaction. The intervention targeted at increasing patient satisfaction and improving the quality of service during COVID-19 through maintaining social distancing and availing alcohol or sanitizers is necessary.