Acceptability of peer learning and education approach on malaria prevention (PLEA-malaria) through primary schools communities in rural Ethiopia: peer educators' perspectives.

BACKGROUND: Evidence on peer educators' experiences of implementing the school-based educational interventions on malaria prevention would be used as inputs for malaria eliminating efforts. This study explored the acceptability of the school-based peer-learning and education approach on malaria prevention (PLEA-malaria) among peer educators in Ethiopia. METHODS: This process evaluation study was aimed to examine the success of the school-based PLEA-malaria that was implemented in 75 primary schools in Jimma from 2017 to 2019. A mixed research method was employed to collect post-intervention data from 404 peer educators and key stakeholders. Data were collected using a structured questionnaire and interview guide. Multivariable linear regression modelling was performed using SPSS software version 26.0. Atlas ti 7.5 for windows was used to analyse the qualitative data. The result was presented by triangulating the findings of the qualitative and quantitative methods. RESULTS: The mean score (M, range = R) of acceptability of PLEA-malaria was (M = 20.20, R = 6-30). The regression modelling showed that age; (ß = 0.264, 95% CI 0.266 to 0.632), GPA; (ß = 0.106, 95% CI 0.008 to 0.074), parental readiness for malaria education; (ß = 0.184, 95% CI 0.711 to 2.130), frequency of peer education; (ß = 0.232, 95% CI 1.087 to 2.514) and team spirit; (ß = 0.141, 95% CI 0.027 to 0.177) were positively associated with the acceptability while this relationship was negative for the number of ITN in the household; (ß = - 0.111, 95% CI - 1.182 to -0.13) and frequency of parent-student communication; (ß = - 0.149, 95% CI - 1.201 to - 0.293). The qualitative study identified facilitators of PLEA-malaria (e.g. team formation process, outcome efficacy, presence of schools' structures, schools priority, and support) and barriers (e.g. low commitments, threat appraisal, response efficacy, and PLEA-malaria implementation gaps). CONCLUSION: The results suggested that the acceptability of the school-based PLEA-malaria was higher implying the strategy is promising in promoting malaria prevention in primary schools. Considering factors related to personal, access to malaria preventive services, school system, and social support in education and behaviour change interventions would be important to improve the acceptability. The relationship about how an improvement in the level of acceptability would in turn influences malaria preventive behaviours among the students should be investigated.

Acceptability and feasibility of the school-engaged social and behavior change communication approach on malaria prevention in Ethiopia: implications for engagement, empowerment, and retention (EER) of education sectors in malaria elimination efforts.

BACKGROUND: Evidence on process outcomes such as acceptability, and feasibility of behavior change communication interventions are important in program evaluation to understand how, and why such a program works. However; documented evidence on the issue is not available as far as the social and behavior change communication (SBCC) on malaria is concerned. Enrolling the frontline providers this study measured the acceptability and feasibility of the school-engaged SBCC strategy on malaria prevention in malaria-endemic settings of Ethiopia. METHODS: A school-engaged SBCC strategy involving various communication and capacity-building interventions aimed to advance malaria preventive practices in primary schools in Jimma were implemented from 2017 to 2019. A cross-sectional study was conducted with 205 key stakeholders at the end of the intervention. Both acceptability and feasibility were measured using standardized tools. Data were collected using a structured questionnaire and filled by the study participants. The SPSS version 26 was used to analyze the data. Multivariate general linear modeling was performed to identify the predictors of acceptability and feasibility of the program. P-value < 5% was considered to decide statistical significance. RESULTS: The result showed the mean scores (M, range = R) of acceptability and feasibility of the program were (M = 25.63, R = 6 to 30) and (M = 19.35, R = 5 to 25) respectively. The multivariate linear modeling showed acceptability was affected by self-efficacy; (ß = 0.438, P < 0.001), community support; (ß = 0.417, P < 0.001), school climate; (ß = - 0.16; P = 0.003), perceived malaria threat; (ß = 0.40, P < 0.001) and knowledge; (ß = 0.229, P = 0.013). Similarly, feasibility was influenced by self-efficacy; (ß = 0.352, P < 0.001), community support; (ß = 0.591, P < 0.001), school climate; (ß = - 0.099, P-value < 0.030) and perceived malaria threat; (ß = 0.172, P = 0.002). CONCLUSION: With a considerably high level of acceptability, the school-engaged SBCC strategy to enhance malaria preventive practices seems feasible. The SBCC strategy targeting personal factors such as malaria threat perceptions, knowledge and skills on the program, and contextual factors that include school social climate and community support would be fruitful to facilitate the implementation of the program. The result implicates the benefit of intensifying such a strategy to engage, empower, and retain the education sectors in malaria elimination efforts and beyond.

Primary school students' poetic malaria messages from Jimma zone, Oromia, Ethiopia: a qualitative content analysis.

BACKGROUND: The engagement of schools in malaria control is an emerging strategy. Little is known about the involvement of students in the development of malaria messages. This study evaluated the message content of primary school students' malaria poems. METHODS: A qualitative content analysis was conducted to explore malaria messages conveyed in poems produced by students. Twenty poems were purposively selected from twenty schools across rural villages in five districts of the Jimma Zone. Data were analyzed using Atlas.ti version 7.1.4 software. The message contents were quantified in terms of frequency, and including metaphors, presented using central themes, categories, and supportive quotations. RESULTS: A total of 602 malarial contents were generated, and organized into 21 categories under five central themes. 1) Malaria-related knowledge (causation and modes of transmission, mosquito breeding and biting behavior, signs and symptoms, care for insecticide-treated nets (ITNs), and prevention methods), 2) Perceived threats from malaria, 3)The effectiveness of prevention methods (i.e., related to the adaption of ITNs, environmental cleaning, indoor residual spray (IRS), treatment for fever, and drug adherence practices), 4) Misconceptions, beliefs, and malpractices regarding the cause of malaria and drug use) and 5) Direct calls to the adopt ITN, IRS, clean surroundings, treatment, and drug use. The most commonly conveyed message contents were about the severity of malaria, distinguishable signs and symptoms, calls for community participation for malaria elimination, knowledge of preventive methods, and effectiveness of ITN use. Metaphoric expressions (war and death) were used to convey messages about the severity and the need to manage the prognosis of malaria through the active ITN use, which itself was metaphorically represented as 'a trap' to mosquitoes. CONCLUSIONS: The poetic analysis indicated that the students developed and disseminated rich malarial messages, especially on malarial knowledge, and perceptions, beliefs, norms and practices of the local community to prevent and control malaria. Therefore, primary school students can be a source of information and would effectively communicate knowledge, perceptions, and promote malaria related practices, particularly in rural settings.

Patients' healthcare, education, engagement, and empowerment rights' framework: Patients', caretakers' and health care workers' perspectives from Oromia, Ethiopia.

BACKGROUND: Successful health care and clinical services essentially depend on patients' realization of ones' rights, and health workers' and facilities' fulfillments and protections of these rights. However, little is documented about how patients and health workers perceive patients' rights during care-seeking practices. METHODS: A qualitative study was conducted in four hospitals in Ethiopia through 8 focus group discussions with patients and 14 individual interviews with diverse groups of patients, caretakers, and 14 interviews with health workers. Participants were recruited through a purposive sampling method to meet the saturation of ideas about patients' rights. The sampled patients, caretakers, and professionals were enlisted from various departments in the hospitals. The data analysis was assisted by ATLAS.ti 7.1.4. RESULTS: The study identified three major categories of healthcare rights (clinical, socio-cultural, and organizational), incorporating supporting elements of education, engagement, and empowerment. Study participants reported detailed rights the patients would have during hospital visits which included the right to timely access to care and treatment, adequate medications) with full respect, dignity, and without any discrimination. Patients widely perceived that they had the right to tell their illness history and know their illness in the language they can understand. It was also widely agreed that patients have the right to be educated and guided to make informed choices of services, procedures, and medications. Additionally, patients reported that they had the right to be accompanied by caretakers together with the right to use facilities and resources and get instructions on how to utilize these resources, the right to be protected from exposure to infections and unsafe conditions in hospitals, right to get a diet of their preference, and right to referral for further care. Nevertheless, there was a common concern among patients and caretakers that these rights were mostly non-existent in practice which were due to barriers related to patients (fear of consequence; a sense of dependency, feeling of powerlessness, perceptions of low medical literacy), health workers (negligence, lack of awareness and recognition of patient rights, undermining patients), and facilities' readiness and support, including lack of guiding framework. CONCLUSIONS: Perceived patients' rights in the context of hospital visits were profoundly numerous, ranging from the right to access clinical and non-clinical services that are humanely respectful, fulfilling socio-cultural contexts, and in a manner that is organizationally coordinated. Nonetheless, the rights were not largely realized and fulfilled. Engaging, educating, and empowering patients, caretakers, and health care providers supported with policy framework could help to move towards patient-centered and right-based healthcare whereby patients' rights are protected and fulfilled in such resource-limited settings.

Perceived sustainability of the school-based social and behavior change communication (SBCC) approach on malaria prevention in rural Ethiopia: stakeholders' perspectives.

BACKGROUND: Evidence on what makes the school-engaged social and behavior change communication (SBCC) interventions on malaria prevention more sustainable are limited in literature partly due to its recent emergence. Enrolling the key stakeholders, this study explored the perceived sustainability of the SBCC interventions on malaria prevention through primary school communities in rural Ethiopia. METHODS: The SBCC interventions were implemented from 2017 to 2019 in 75 primary schools and villages in rural Jimma to promote malaria preventive practices. As a part of program evaluation, this study employed a mixed-method to collect qualitative and quantitative data from 205 stakeholders following the end of the program. Data were collected using interview guides and structured questionnaires. The SPSS version 26 and Atlas ti7.1 software were used to analyze the data. Multivariable linear regression modeling was used to identify predictors of the perceived sustainability of the program (SOP). RESULTS: The mean score of SOP was 25.93 (SD = 4.32; range 6-30). Multivariable linear regression modeling showed that the perceived risk to malaria (ß = 0.150; P = 0.029), self-efficacy (ß = 0.192; P = 0.003), and perceived fidelity of implementation (ß = 0.292; P = 0.000) and degree of adoption (ß = 0.286; P = 0.000) were positively predicted the perceived SOP. The qualitative result identified various barriers and opportunities to sustaining the program that summarized under three themes which include perceptions about the quality of program delivery (e.g inadequate involvement of stakeholders and staffs, concerns over short project life, immature sustainability efforts), school settings (e.g schools' malaria priority, schools' climate and quality of coaching) and the outer settings (e.g existing structures in the health and education systems). CONCLUSION: The study identified key predictive variables such as stakeholders' perceived risk to malaria, self-efficacy, perceived fidelity of implementation and degree of adoption that could help to improve the sustainment of the school-based SBCC approach on malaria prevention and control. Further longitudinal study should be conducted to examine the rate of decline in program components over time and how improved sustainability would contribute to the effectiveness on malaria preventive behaviors among students.

Effectiveness of the school-based social and behaviour change communication interventions on insecticide-treated nets utilization among primary school children in rural Ethiopia: a controlled quasi-experimental design.

BACKGROUND: School-based behaviour change communication interventions could help to achieve behavioural changes in the school and enhance the enrollment of the students and teachers as health messengers to local communities. Evidence on the impacts of the school-engaged malaria preventive interventions are limited as far as the social and behaviour change communication (SBCC) is concerned. This study examined the effectiveness of the school-based SBCC approach on insecticide-treated nets (ITNs) utilization among primary school students in malaria-endemic settings of Ethiopia. METHODS: Various participatory, educational, and communication interventions were implemented from 2017 to 2019 in 75 primary schools and respective villages in Jimma to promote malaria preventive practices. A quasi-experimental design was conducted with randomly selected 798 students (i.e. 399 intervention and 399 control groups). Data were collected by trained interviewers using structured questionnaires. The SPSS version 26 software was used to analyse the data. Propensity score matching analysis was performed to control for possible confounding biases. The average effects of the intervention were estimated using multivariate general linear modelling to estimate for mean differences and odds ratio based on the nature of data. RESULTS: The result showed that the ITNs utilization was 6.857 folds in the intervention groups compared to the counterpart; (OR = 6.857; 95% CI: (4.636, 10.1430); effect size = 39%). A mean differences (MD) of self-efficacy (MD = 15.34; 95% CI: 13.73 to 16.95), knowledge (MD = 5.83; 95% CI: 5.12 to 6.55), attitude (MD = 6.01; 95% CI: 5.26 to 6.77), perceived malaria risk (MD = 2.14; 95% CI: 1.53 to 2.76), and perceived family supports (MD = 6.39; 95% CI: 5.57 to 7.22) were observed favoring the intervention. Multivariable logistic regression modelling results showed that knowledge (ß = 0.194, 95% CI: 1.09 to 1.35) and perceived family supports (ß = 0.165, 95% CI: 1.11 to 1.25) and self-efficacy (ß = 0.10, 95% CI: 1.22 to 2.32) predicted the ITN utilization among the school children. CONCLUSIONS: The finding of this study suggested that the school-based SBCC approach combined with peer education activities advanced the malaria-related knowledge, attitude, self-efficacy, risk perceptions, and family supports and ultimately improved the sustained use of ITNs among school-going children. Further research should be conducted to understand the mechanism of these effects given the influences of social, health services, and school systems are considered.

Why do women not prepare for pregnancy? Exploring women's and health care providers' views on barriers to uptake of preconception care in Mana District, Southwest Ethiopia: a qualitative study.

BACKGROUND: Preconception care has the potential to reduce maternal and child morbidities and mortalities. It is a window of opportunity to timely alter or eliminate risk factors for adverse pregnancy outcomes. However, despite strong evidence on the effectiveness of preconception care in safeguarding maternal and child health, its uptake remains low. Therefore, this study aimed to explore barriers to the uptake of preconception care. METHODS: A descriptive qualitative study was conducted in Mana district, Jimma Zone, Oromia region, Southwest Ethiopia from March 02 to April 10, 2019. A purposive sampling approach was used, and 13 key informant interviews (6 in rural and 7 in urban areas) were held with women of different age groups, health extension workers, and health care providers of different professions. In addition, 4 focused group discussions with women of reproductive age groups (two with rural women only and two with urban women only) were conducted. The data were collected by trained experts using semi-structured guides. An inductive process of thematic analysis was employed and the data were coded, categorized, and thematized using Atlas ti version 7.0.71 software. RESULTS: Four women of reproductive age groups, 1 older woman (grandmother), 2 health extension workers, and 6 health care providers of different professions were interviewed. In addition, a total of 38 women of reproductive age groups participated in the 4 focused group discussions: 20 in the two rural-focused group discussions and 18 in the two urban-focused group discussions. The findings indicated the presence of many barriers affecting the uptake of preconception care and organized into five themes: women-related barriers, husband-related barriers, community-related barriers, health-service-related barriers, and media-related barriers. CONCLUSIONS: This study found a diverse array of potentially modifiable barriers to the uptake of preconception care. The findings imply the importance of scaling up health education and counseling, establishing preconception care strategies and functional units that can address all the components at all levels of health care facilities. Therefore, we recommend all stakeholders, such as program planners and managers, non-governmental organizations, media personnel, and health care providers to work in collaboration to increase the uptake of preconception care.

What do women know before getting pregnant? Knowledge of preconception care and associated factors among pregnant women in Mana district, Southwest Ethiopia: a community-based cross-sectional study.

OBJECTIVE: To assess knowledge of preconception care and associated factors among pregnant women in Mana district, Jimma zone, Oromia Region, Southwest Ethiopia, in 2019. DESIGN: A community-based cross-sectional study was conducted from 2 March to 10 April 2019. SETTING: The study was conducted in Mana district. Eight rural Gandas and one urban Ganda were included in the study. PARTICIPANTS: Out of 715 pregnant women in the selected rural Gandas, 553 participated in the study, whereas 70 out of 88 were recruited from the urban Ganda. A total of 623 pregnant women participated in the study. PRIMARY AND SECONDARY OUTCOME MEASURES: Women's knowledge of preconception care was determined. Descriptive statistics were calculated as necessary. Logistic and linear regression analyses were used to identify the association of women's knowledge of preconception care with explanatory variables. RESULTS: Among 623 respondents, 133 (21.3%) of pregnant women had good knowledge of preconception care. Multivariable linear regression analysis showed that women who attended secondary and above education (ß=3.6; p<0.001) and those for whom their husbands attended secondary and above education (ß=2.3; p=0.001), planned pregnancy status (ß=1.2; p=0.005), being on follow-up for pre-existing medical illnesses (ß=1.5; p=0.014) and having four or more antenatal care visits (ß=0.4; p=0.016) were significantly associated with women's knowledge of preconception care. CONCLUSION: The findings imply that providing health education and health promotion for women is important to improve their level of knowledge of preconception care.

Nearly three in every five prisoners experience common mental disorders (CMDs) in Jimma correctional institution; south-West Ethiopia.

BACKGROUND: Millions of people are currently suffering from some form of mental disorders. The prevalence of common disorders is twofold higher in prison than general population and the condition is found to be worst in African in general and Ethiopia in particular. The aim of this study was to assess the prevalence of common mental disorders and its correlates among prisoners in Jimma town correctional institution; Ethiopia. METHODS: A cross sectional quantitative study was conducted enrolling 300 prisoners. The participants were recruited using systematic random sampling technique. The World health organization Self Reporting Questionnaire (SRQ-20) scale; was adapted to assess prevalence of mental disorders. Data were collected on interviewer administered basis by trained personnel. Statistical package for social sciences (SPSS) version 20 for widows was used for data analysis. Multivariate logistic regression modelling was conducted to identify the independent predictors of common mental disorders. P-value less than 5% was considered to indicate significant associations. RESULTS: The prevalence of common mental disorder was found to be 62.70, 95% CI; [57.30, 68.50]. Prisoners who had monthly income of 1500-3000birr, AOR = 3.30, 95% CI; [1.25, 8.69] and above 3000birr; AOR = 4.75, 95% CI; [1.57, 14.33], family history of mental illness; AOR = 6.14, 95% CI; [1.65, 22.79] and who ever used Khat; AOR = 4.33, 95% CI; [2.02, 9.27] were more likely to experience common mental disorders. Conversely; having some sort of work in prison; AOR = 0.25, 95% CI; [0.12, 0.54], perceived moderate social support; AOR = 0.094, 95% CI; [0.04-0.215] and perceived moderate strong; AOR = 0.025, 95% CI; [0.009, 0.07] were found to be protective factors. CONCLUSION: Prevalence of common mental disorder was considerably high as nearly more than three in every five prisoner experience some form of the disorder. Early screening of prisoners up on their arrival, appropriate treatment and follow up should be done. Furthermore; creating prison based jobs that could bring prisoners together and encouraging positive relationships to build social supports as coping strategy is required.

Psychographic predictors of intention to use cervical cancer screening services among women attending maternal and child health services in Southern Ethiopia: the theory of planned behavior (TPB) perspective.

BACKGROUND: Detection of the premalignant forms cervical cancer through screening in the target age group is one of the effective strategies in the prevention of the disease. Nevertheless, the cervical cancer screening service use remains considerably low in Ethiopia. Indeed; promoting screening behaviors requires understanding the factors influencing women's motivation towards the service. Our study has explored the psycho-graphic factors associated to intention to use cervical cancer screening among women visiting maternal and child health services in Southern Ethiopia, 2017. METHODS: Institution based cross-sectional study was used employing 422 women's age between 30 and 49 years old. A structured questionnaire was used to collect data on interviewer-administered basis. All assumptions of theory of planned behavior (TPB) were considered to measure intention, attitude, perceived social pressure and perceived ability to control circumstances against cervical cancer screening. Data were analyzed using statistical package for social sciences version 21.0. Multiple linear regression models were conducted to identify factors associated to intention to use cervical cancer screening. P-value less than 5% was considered to indicate significant association. RESULT: Four hundred and two (95%) of the respondents completed the interview. Knowledge of the disease signs, symptoms, risk factors and prevention methods was 162(41.4%). Knowledge about the disease and past screening experience were positively associated with intention to use cervical cancer screening (ß = 0.145, 95% CI = [0.047, 0.170]) and (ß = 0.098, 95% CI = [0.093, 1.001]) respectively. Further; standardized regression coefficient showed that all dimensions of TPB were positively associated to intention to use the services with perceived behavioral control (ß = 0.297, 95% CI = [0.172, 0.343]), perceived social pressure (ß = 0.248, 95% CI = [0.131, 0.301]) and attitude towards screening (ß = 0.110, CI = [0.018, 0.158]). CONCLUSION: Overall; the intention to use cervical cancer screening was a function of attitude, perceived social pressure and perceived behavioral control confirming the hypothesis of the study. None of the socio-demographic variables were associated to intention. Health behavior change interventions should focus on increasing knowledge and empowering women that enable them to evaluate their control beliefs and develop ability against social norms and circumstances that compete with the use of cervical cancer screening services.

Seroprevalence and risk factors of Toxoplasma gondii infection in pregnant women following antenatal care at Mizan Aman General Hospital, Bench Maji Zone (BMZ), Ethiopia.

BACKGROUND: The intracellular parasite, Toxoplasma gondii (T.gondii) is found worldwide. Infection with T. gondii during pregnancy can result in fetal and neonatal death or various congenital defects. A serological survey during pregnancy represents a valuable tool for the effective diagnosis and treatment of infected neonates. The aim of this study was to assess the sero-prevalence and risk factors of T.gondii in pregnant women following ante natal care (ANC) services at Mizan Aman General Hospital, Bench Maji zone (BMZ), Ethiopia. METHODS: An institution based cross-sectional study was conducted enrolling a sample of 232 pregnant women attending antenatal care at Mizan Aman General Hospital during 01 December, 2014 to 18 February, 2015. Systematic random sampling technique was used to obtain the required sample. About 5 ml of blood sample was collected aseptically by using properly labeled plain tube with the necessary information. The blood samples centrifuged at 3000 rpm for 10 min to separate serum. The serum was stored at a temperature of 20 °C below zero until the serological analysis was done for the presence of anti T.gondii antibodies (i.e. Immune globulin 'M' (IgM) and Immune globulin 'G' (IgG)) using enzyme linked immunosorbent assay (ELISA). Exit interview was conducted with eligible mothers to obtain socio-demographic and behavioral data using structured questionnaires. Multivariate logistic regression modeling was employed to identify the potential predictor variables for T.gondii infection. P-value less than 5 % was considered to declare a sound significant association. RESULTS: The response rate of the study was 100 %. The overall sero-prevalence for T.gondii infection was 85.3 % (198/232). About 191 (82.3 %) of the pregnant women were reactive only for IgG anti-bodies. While about 7 (3.0 %) of them were seropositive for both IgG and IgM anti-bodies. None of the mothers were positive for IgM anti-bodies exclusively. On multivariate logistic regression analysis, contact with cat and gardening soil were significantly associated with T.gondii infection (AOR =2.37, 95 % CI = [1.16, 3.57] and AOR = 2.49, 95 % CI = [1.53, 3.86] respectively. CONCLUSIONS: Sero-prevalence of T. gondii antibodies for IgM was relatively high among pregnant women. Contact with cat and soil were risk factors for T.gondii case. Creating awareness on the source of infection, modes of transmission and prevention of T. gondii should be given for pregnant women. Routine screening services for T. gondii infection should be integrated with other ANC services to identify potential infections of the parasite.

Predicting intention to use voluntary HIV counseling and testing services among health professionals in Jimma, Ethiopia, using the theory of planned behavior.

BACKGROUND: To endorse involvement in voluntary HIV counseling and testing (VCT), it is essential to recognize factors that influence people in deciding whether to access VCT services and their underlying route factors. Theory of planned behavior (TPB) constitutes a proficient framework for predicting behaviors and intentions. OBJECTIVE: The aim of the study reported here was to assess the predicting ability of TPB in determining the intended use of VCT services among health professionals in Jimma, southwest Ethiopia. METHODS: This was an institution-based cross-sectional quantitative study of a sample of 336 health professionals in 12 selected districts of Jimma, southwest Ethiopia between February 5 to March 28, 2012. Data were collected using structured questionnaire self-administered by the study participants. A hierarchal multivariable linear regression model was used to predict the role of TPB constructs that can influence the intention to use VCT services. RESULTS: The constructs of TPB explained the variability in intention to use VCT by 27% (R (2) adjusted = 0.27). The standardized regression coefficients showed that the strongest predictor of intention to use VCT was subjective norms (ß = 0.32, P < 0.0005) followed by attitude (ß = 0.21, P < 0.002). Perceived behavioral control was not a significant predictor of intention to use VCT among the study group (P = 0.12). CONCLUSION: The study revealed the possibility of describing the intention to use VCT among health professionals using TPB, with perceived social pressure being the leading predictor. In light of this, health intervention programs should be designed to develop health professionals' ability to resist norms that oppose the use of VCT and to change community-held norms against VCT use, provided they help individuals develop a positive attitude toward the services.

Intention to voluntary HIV counseling and testing (VCT) among health professionals in Jimma zone, Ethiopia: the theory of planned behavior (TPB) perspective.

BACKGROUND: Voluntary HIV Counseling and Testing (VCT) forms one of the cornerstones of HIV prevention strategies. It is imperative to understand HIV testing correlates and their theoretical underpinnings in order to promote VCT uptake. The aim of this study was to predict the intention to VCT and associated factors among health professionals in Jimma zone, Ethiopia using the theory of planned behavior. METHODS: An institution based cross-sectional quantitative study among a sample of 336 health professionals in 12 selected districts of Jimma, Ethiopia was conducted in 2012. The constructs and principles of the theory of planned behavior (TPB) were measured. Data were collected using structured questionnaire on self administered basis. A multivariable linear regression model was used to predict the role of independent variables/TPB constructs on the intention to use VCT using SPSS version 16.0. RESULTS: The components of TPB independently explained the variance in intention to VCT by 30.3%. Both components of TPB and socio-demographic characteristic in the final model explained 32.7% of variance in the intention to use VCT services. Significant proportions (33.0%) of the respondents have never been tested for HIV. The respective indirect components of the TPB predicted the direct components. The strongest predictors of intention to VCT were subjective norm (ß=0.39, p<0.001) and attitude (ß= 0.19, p<0.001) whereas, none of the socio-demographic variables were significantly predicted the intention to use VCT. Past VCT experience did not have significant statistical association with VCT use intention. CONCLUSIONS: Behavioral intention to use VCT was a function of attitude and perceived social pressure. Demographic related social determinants were not barriers for VCT use intention. Most health workers test their blood by themselves. Strategies to empower health professionals on social pressure resistance and programs targeted at changing negative attitude on VCT use can enhance intention of health professionals to use VCT.