An Evaluation of Community Health Workers' Knowledge, Attitude and Personal Lifestyle Behaviour in Non-Communicable Disease Health Promotion and Their Association with Self-Efficacy and NCD-Risk Perception.

Community health workers, also known as health extension workers (HEWs), play an important role in health promotion. This study evaluates HEWs' knowledge, attitude, and self-efficacy for non-communicable diseases (NCD) health promotion. HEWs (n = 203) completed a structured questionnaire on knowledge, attitude, behaviour, self-efficacy and NCD risk perception. Regression analysis was used to determine the association between self-efficacy and NCD risk perception with knowledge (high, medium, low), attitude (favourable/unfavourable) and physical activity (sufficient/insufficient). HEWs with higher self-efficacy were more likely to have high NCD knowledge (AOR: 2.21; 95% CI: 1.21. 4.07), favourable attitude towards NCD health promotion (AOR: 6.27; 95% CI: 3.11. 12.61) and were more physically active (AOR: 2.27; 95% CI: 1.08. 4.74) than those with lower self-efficacy. HEWs with higher NCD susceptibility (AOR: 1.89; 95% CI: 1.04. 3.47) and perceived severity (AOR: 2.69; 95% CI: 1.46, 4.93) had higher odds of NCD knowledge than their counterparts. Moreover, sufficient physical activity was influenced by HEWs' perceived NCD susceptibility and perceived benefits of lifestyle change. Therefore, HEWs need to adopt healthy lifestyle choices to become effective role models for the community. Our findings highlight the need to include a healthy lifestyle when training HEWs, which might increase self-efficacy for NCD health promotion.

Cultural Adaptation and Validation of the Amharic Version of the World Health Organization's Self Reporting Questionnaire (SRQ-20) Screening Tool Among Pregnant Women in North West Ethiopia, 2022: A Psychometric Validation.

Background: The prevalence of prenatal common mental disorders afflicting the global community, including Ethiopia, is thriving. Therefore, a time-efficient and valid screening tool is required. This study aimed to culturally adapt and validate the self-reporting questionnaire-20 tool developed by the World Health Organization among pregnant mothers in Ethiopia. Methods: A total of 310 pregnant women completed the questionnaire at two selected health centers in the regional state of Amhara. The World Health Organization's Self Reporting Questionnaire-20 tool was first translated into Amharic by two experts. The back translation was done by two English experts. Internal consistency and reliability were assessed using Cronbach's alpha. Convergent and discriminant validity were assessed using composite reliability and extracted mean variance. SRQ-20 was tested for reliability and validity using principal components analysis and the Kaiser-Meyer-Olkin measure of sample adequacy with a cutoff value of 0.50 for each item. Results: The Kaiser-Meyer-Olkin measure (KMO = 0.733) for sample adequacy and the Bartlett's sphericity test for the identity matrix indicated that the data were amenable to exploratory factor analysis. Principal components analysis identified six factors that explained 64% of the variation in the self-report questionnaire 20. Cronbach's alpha was 0.817 for the entire scale and the extracted mean variance was greater than 0.5 for all factors, indicating convergent validity. The extracted mean variance, composite reliability, and factor loadings were all greater than 0.75 for all factors in this study, indicating that convergent validity was satisfactory and that discriminatory validity was also satisfied. The composite factor reliability scores ranged from 0.74 to 0.84, and the square roots of the mean variances were greater than the factor correlation scores. Conclusion: The interview-based, culturally-adapted 20-item Amharic version of the SRQ-20 tool demonstrated good cultural adaptation and was also found to be valid and reliable in the present context.

Contraceptive dynamics among women with disabilities in low- and middle-income countries: a scoping review protocol.

INTRODUCTION: Contraceptive dynamics is the use of contraception, unmet need, discontinuation, and/or switching of contraception. Women with disabilities (WWDs) in low- and middle-income countries (LMICs) face a common problem: a low prevalence of contraceptive usage and a high unmet need. Even though certain studies have been conducted in high-income countries, research is scarce on the degree of contraceptive method mix, unmet needs, contraception discontinuation, and switching among WWDs in LMICs. As a result, the scoping review's goal is to investigate, map available evidence, and identify knowledge gaps on contraceptive dynamics within LMICs WWDs. METHODS: The scoping review is guided by the six-stage Arksey and O'Malley methodology framework. Published articles will be retrieved from databases such as PubMed (MEDLINE), the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Global Health. Grey literature databases will be searched using electronic search engines such as Google Scholar, Google, OpenGrey, and Worldcat. In addition, a manual search of reference lists from recognized studies will be conducted, as well as a hand search of the literature. Any type of study design (e.g., randomized controlled trials, quasi-experimental studies, prospective and retrospective cohort studies, case-control or nested case-control studies, qualitative, cross-sectional studies) will be included in this scoping review. There will be no restrictions on publication year. Two independent reviewers will screen relevant publications, and data will be charted accordingly. The Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist and reporting guidelines will be used to report all parts of the protocol and scoping review. DISCUSSION: When compared to non-disabled women, WWDs had a lower prevalence of contraceptive usage and a higher unmet need in LMICs. Despite these facts, they are the most marginalized people on the planet. This is, therefore, critical to map available evidence and identify knowledge gaps on contraceptive dynamics. As a result, the findings of this scoping review will be significant in terms of the contraceptive dynamic among WWDs in LMICs. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework (OSF), with registration number; DOI/10.17605/OSF.IO/XCKPT.

Modeling Eragrostis tef Zucc and Hordeum vulgare L cropland in response to food insecurity in the Southwestern parts of Ethiopia.

On a global scale, there is consensus to double food production as a means to address food and nutrition insecurity, yet the capacity of available resources and technologies to gratify the demands of this growing population and the price of agricultural commodities remains uncertain in Sub-Saharan Africa, particularly in Ethiopia. Despite the availability of fertile agricultural land, inappropriate use of that resource leads to reduced agricultural productivity, yet little is known about food insecurity and impacts on commodities in southwestern Ethiopia. This study was aimed at spatial modeling of land suitability evaluation for Eragrostis tef Zucc and Hordeum Vulgare L crops in the Misha district. About 11 variables related to topography, climate, and soil have been considered and resampled to 10 m resolution. The spatial analysis result indicated that, about 33.4% and 21.8% of the total area is found to be highly suitable, about 54% and 63% of the total study area is categorized into moderately suitable for Eragrostis tef Zucc and Hordeum Vulgare L crop cultivation, respectively, whereas 12.7% and 15.3% of the study area is not suitable for the above mentioned crops. The spatial decision support system reflects that Misha has mammoth potential productive lands, which are most likely promised to satisfy the demand for food and raw materials. Therefore, the stakeholders should make hard-nosed efforts on sage land use and adopt exactly the optimum land suitability plans to advance the current cropland resources for maximize yield in a sensational way for the healthier development of the region.

An Interpretative Study of LARCs Discontinuation in Ethiopia: The Experiences of Women Accessing Contraceptives in Selected Public Health Facilities.

Background: Discontinuation of contraception for reasons other than wanting to become pregnant is a public health concern as it affects women's autonomy in sexual and reproductive health decision making as well as gender equality. Studies identified various factors, including community perception and users' dissatisfaction that limited the reach and impact of contraceptives, primarily LARCs, on women's wellbeing. In Ethiopia, however, the reasons for early discontinuation of LARCCs are not adequately explored. Against this backdrop, this study explores the main reasons for the early discontinuation of LARCs among Ethiopian women in selected public health facilities. Methods: This study used an institution-based qualitative study design and covered selected university hospitals and health centers in Addis Ababa, Gondar, Mekelle, and Jimma. It involved in-depth interviews with 29 women aged 15-49 to gather data and explore the decision-making processes involved in the early discontinuation of LARCs. It used description, narration and thematic interpretation as data analysis procedures. Results: Interviewees reported several reasons for early discontinuation of LARCs, including side effects (eg, weight gain/loss, heavy menses, tiredness, and reduced libido), desire to conceive, and husbands' disapproval. This study found that women were sufficiently aware of alternative contraceptives, including LARCs. Many reported experimenting before deciding on an option. Conversely, others' reports reveal the influences of gender roles and community misconceptions on women's decisions to discontinue LARCs. Discussion and Implications: The common threads in interviewees' narratives highlight the significance of traditional values, gender roles, community perception, and experience with side effects to women's early discontinuation of LARCs. This study concludes with remarks on how to improve the effectiveness of family planning programming by adopting the gender transformative approach (GTA) in their design and implementation.

Numerical study on effect of constant and variable axial loads on RC column subjected to blast load.

Explosion is an instant release of potential energy, heat, temperature and sound producing a pressure wave that travels away from the source radially on which the resulting force the blast wave is a blast load. Besides this, column especially external column as a main load bearing compressive structural component in buildings is the most critical structural element vulnerable to explosion and require an in-depth investigation on its performance against blast loads. Despite this, currently there is perceived gap and meagre of researches regarding numerical investigation on effect of presence of constant and variable axial loads on reinforced concrete column when subjected to blast load. In this study, the responses of reinforced concrete column under different scaled distance blast load scenarios accompanied by constant and axial loads were investigated. The finite element method of structural analysis was employed accompanied by nonlinear explicit time integration software LS-DYNA. The numerical analysis result revealed that RC columns subjected to large axial loads accompanied by small scaled distance blast scenario made the reinforced concrete column to suffer severe damages including crushing of concrete especially direct shear failures and breaking of reinforcing steel bars. In addition to this, comparing the nature and behaviour of variable axial loads with constant axial loads, the former loading case revealed larger nodal displacement values along height of column, and a higher displacement-time history curve was traced. On the other hand, the damage propagation nature of RC columns loaded with variable axial load was slow and progressive and different with RC columns with constant axial loads accompanied by small scaled blast scenario which was rendered to have a severely crushed concrete element without bending actions leaving the entire column inadequate for service.

Impact of health education intervention on demand of women for cervical cancer screening: a cluster-randomized controlled trial.

BACKGROUND: Cervical cancer is considered preventable disease, though it is the second largest killer of women's cancer in low and middle-income countries. Despite the government's attempts to broaden screening facilities, the screening service utilization was poor. Our study evaluated the impact of health education intervention on women's demand for cervical cancer screening. METHODS: Community-based cluster-randomized controlled trial was conducted in thirty district towns as clusters in Tigray region, Ethiopia. A total of 700 women aged 20 to 60 years were recruited for both groups using simple random sampling from April to July, 2018. After baseline data collection, health education intervention was given to the intervention group by trained health professionals using power point presentation and peer group discussion at the nearest health institution. The health education was given for three days followed by subsequent consultations for 6 months. The outcome variable was demand of women for cervical cancer screening. The intent-to-treat and per-protocol analysis were considered to evaluate the inflation of the loss to follow-up on effect size. Chi-square test was used to assess the difference of variables between control and intervention groups at baseline data. Finally, difference in difference analysis was used to see the true effect of the intervention on outcome variable. RESULTS: A total of 674 participants (340 in intervention and 334 in control groups) were able to complete the follow-up, making a response rate of 96.3%. At baseline, the differences in proportion of all outcome variables in control and intervention groups were not statistically significant. After follow-up, a statistically significant difference between control and intervention groups was observed in the proportion of willingness to screen (p value = 0.000), having plan to screen (p value = 0.000), ever screened (p value = 0.000), and the overall demand for cervical cancer screening (p value = 0.000). Finally, the impact of intervention was explained by the difference in differences in the proportion of willingness to screen (36.6%) (p value < 0.000), having plan to screen (14.6%) (p value < 0.000), ever screened (16.9%) (p value < 0.000), and overall demand for cervical cancer screening (36.9%) (p value < 0.000). CONCLUSION: This study revealed that health education intervention could increase in overall demand of women for cervical cancer screening. Thus, it would be helpful to consider health education in health planning and service provision. TRIAL REGISTRATION: The registration number is PACTR201808126223676; date registered: 23 April 2018, and the type is "retrospectively registered."

Numerical investigation of steel-concrete composite (SCC) beam subjected to combined blast-impact loading.

Existing literatures on combined effects of blast-impact loadings on steel-concrete composite beams are limited. In this study, behavior of steel-concrete composite beam subjected to combined blast-impact loading was investigated using LS-DYNA nonlinear FEA software program. The accuracy and reliability of developed FEA model was validated using experimental data reported in literature. Parametric studies were performed on impacting speed, concrete strength, various characteristics of H-structural steel, yield strength of studs and steel rebars to get insight into performance of composite beam subjected to combined blast impact loading. FEA results revealed that increase in specified cylindrical compressive strength of concrete, yield stress, flange and web thicknesses of H-type structural steel beam significantly improved dynamic response of a steel-concrete composite beam under combined impact-blast load case whereas yield stress of studs, and reinforcement steel bars showed insignificant contribution. Moreover, increasing impactor's initial velocity significantly affects dynamic response of a SCC beam under combined blast-impact loading.

Effect of Flexible Sacrum Position on Maternal and Neonatal Outcomes in Public Health Facilities, Amhara Regional State, Ethiopia: A Quasi-Experimental Study.

Restricting women giving birth in health care facilities from choosing the most comfortable position during labor and birth is a global problem. This study was aimed to examine the effect of flexible sacrum birth positions on maternal and neonatal outcomes in public health facilities in Ethiopia's Amhara Region. A non-equivalent control group post-test-only design was employed at public health facilities from August to November 2019. A total of 1048 participants were enrolled and assigned to intervention or control groups based on their choice of birth position. Participants who preferred the flexible sacrum birth position received the intervention, while participants who preferred the supine birth position were placed in the control group. Data were collected using observational follow-up from admission to immediate postpartum period. Log binomial logistic regression considering as treated analysis was used. Of the total participants, 970 women gave birth vaginally, of whom 378 were from the intervention group, and 592 were from the control group. The intervention decreased the chance of perineal tear and poor Apgar score by 43 and 39%, respectively. The flexible sacrum position reduced the duration of the second stage of labor by a mean difference of 26 min. Maternal and newborn outcomes were better in the flexible sacrum position.

Numerical investigation on CFRP strengthening and reinforcement bar detailing of RC columns to resist blast load.

The failure of column, which is a critical compressive structural member of a building, may lead to devastating progressive collapses. The present numerical study involves investigation on the performance of as-built and strengthened RC columns using 0°/90° CFRP layers under blast loading. A nonlinear FEA program, LS-DYNA was employed to study the RC columns response when subjected to blast loading. Blast field test data from recent literatures was employed for validation and further parametric studies. Variables considered were different charge masses, height of bursts, concrete compressive strengths, standoff distances, tie spacings, transverse reinforcement steel detail schemes, and 0°/90° CFRP layers. It was revealed that scaled distance parameters had a significant effect on the behaviour of RC columns under blast loading. Compared to as-built column, 0°/90° CFRP strengthened RC columns displayed excellent blast resistance. Transverse reinforcement steel details had a significant effect on lateral displacement response and failure modes of RC columns. Compared to conventionally-detailed columns, seismically-detailed columns and transverse reinforcement steel bars accompanied with square-diamond shaped ties exhibited enormous blast resistance capacity.

Factors associated with discontinuation among long-acting reversible contraceptive users: a multisite prospective cohort study in urban public health facilities in Ethiopia.

OBJECTIVE: The study aims to determine discontinuation among long-acting reversible contraceptive users at 3, 6, 9 and 12 months after initiation and its associated factors among new long-acting reversible contraceptive (LARC) users. DESIGN: A facility-based multicentre prospective cohort study was conducted with a sample size of 1766 women. SETTING: The study was conducted in five large cities of Ethiopia (Addis Ababa, Gondar, Mekelle, Jimma and Harar) between March 2017 and December 2018. Various referral hospitals and health centres that are found in those cities are included in the study. PARTICIPANTS: The study population was all women who were new users of LARCs and initiated LARCs in our selected public health facilities during the enrolment period. INTERVENTIONS: A pretested structured questionnaire was administered at enrolment and at 6 and 12 months to determine discontinuation proportion and factors associated with discontinuation. RESULT: From the total of 1766 women sampled for the study only 1596 (90.4%) participants completed all the questionnaires including the 12-month follow-up study. The overall proportion of discontinuation of LARCs at 12 months was 21.8% (95% CI 19.8 to 23.9). The overall discontinuation proportions at 3, 6, 9 and 12 months were 2.94%, 8.53%, 3.94% and 6.36%, respectively. Location of method initiation (adjusted HR (aHR)=5.77; (95% CI 1.16 to 28.69)) and dissatisfaction with the method (aHR=0.09; (95% CI 0.03 to 0.21)) were found to be the predictors of discontinuation among intrauterine contraceptive device users. Being satisfied with the method (aHR=0.21; (95% CI 0.15 to 0.27)), initiation after post abortion (aHR=0.48; (95% CI: 0.26, 0.89)) and joint decision with partner for method initiation (aHR=0.67; (95% CI: 0.50, 0.90)) were inversely associated with implant discontinuation. CONCLUSION: The majority of LARC users discontinue the method in the first 6 months after insertion and dissatisfaction with the method increased the likelihood of removal during the first year of LARC use.

Prevalence of violence and associated factors among youth in Northwest Ethiopia: Community-based cross-sectional study.

BACKGROUND: Violence as a known serious public health problem affects people in all stages of life, from childhood to the elderly. In society, one of the most visible forms of violence is young people violence, whereas they, adolescents and young adults, are the main victims of such violence. There was limited information on the burden of violence and factors among this age group. Therefore, this study aimed to determine the prevalence of violence and its associated factors among youth in Northwest, Ethiopia. METHODS: A community-based cross-sectional study design was conducted to estimate the magnitude of violence among youth in Northwest, Ethiopia. Data were taken from the mega project entitled assessment of common health problem and risky health behavior among youth. Youth violence was the dependent variable whereas the socio-demographic variables and substance use were the independent-variables. The bivariate logistic regression model was employed to identify associated factors. An adjusted odds ratio with a 95% confidence interval was used to determine factors associated with violence. RESULTS: From the total 1765 representatives of the youth population,1597 (90.5%) youth participated in the study. Overall, the prevalence of violence among youth aged 15-24 years for the last 12 months was 21.5%. In the multivariable logistic regression model, factors significantly associated with violence were being married and divorced (AOR = 1.77, 95%CI: 1.13, 2.79) and (AOR = 5.67, 95%CI: 2.93, 10.99), respectively, living with mother's only (AOR = 1.85,95%CI: 1.28, 2.66) and father's only (AOR = 2.45, 95% CI: 1.30, 4.63), and substance use (AOR = 2.38,95% CI: 1.56, 3.66). CONCLUSIONS: The prevalence of violence among youth was high compared to other studies. Special emphasis Should be given for youth violence in order to manage the victims as well as for preventing and controlling the identified factors through strengthening policies and strategies.

Psilocybin: Characterization of the Metastable Zone Width (MSZW), Control of Anhydrous Polymorphs, and Particle Size Distribution (PSD).

Psilocybin, a serotonergic agonist, was granted a "breakthrough therapy" status by the Food and Drug Administration for clinical trials involving major depressive disorder and treatment-resistant depression. The direct phosphorylation of psilocin to psilocybin that uses a fast crystallization associated with a kinetically controlled process resulted in a smaller particle size distribution. Herein, the measurement of the metastable zone width (MSZW) and nucleation induction enabled a thermodynamically controlled crystallization process, which leads to the formation of a crystal structure with stronger interactions, controlled particle size distribution (PSD), and improved impurity profile. Employing a high-resolution inline microscopy viewer allowed the real-time monitoring of the crystallization process and the measurement of the particle size. We also present a comprehensive study of the formation of polymorph B (trihydrate), polymorph A (anhydrate), and polymorph H (anhydrate) using water recrystallization, which indicates that the formation of polymorph B (trihydrate) is independent of the crystallization method. However, polymorphs A and H are dependent on the mode of drying: drying at room temperature under vacuum gives rise to mainly polymorph A, and when heated even at relatively low temperatures, a mixture of polymorphs A and H beings to form.

Youth Risky Sexual Behavior: Prevalence and Socio-Demographic Factors in North-West Ethiopia: A Community-Based Cross-Sectional Study.

INTRODUCTION: Despite, risky sexual behavior behaviors adversely affect the health of youth people, youth has been start sexual lives during teenager is increasing, thus youth has been engaged in risky sexual behaviors. However, almost all the previous studies are institutional based and did not considered out school youth. Therefore, this community based study among youth was implemented to identify sociodemographic determinants of risky sexual behaviors among youth. METHODS: The community based cross-sectional study design was conducted from March 15 to April 15, 2019, among youths. Data were extracted from data collected for project on assessments of common health problem and risky behaviors in central, north and west Gondar zone, Northwest Ethiopia. A bivariable and multivariable logistic regression model was fitted. Adjusted odds ratio with 95% confidence interval were used to determine the presence of an association between independent variables and risky sexual behavior. RESULTS: The overall prevalence of risky sexual behavior was 27.5%, 95%CI: (25-29). Age 20-24 years (AOR = 1.8,95% CI:1.3-2.5), female (AOR = 1.6,95%CI: 1.2-2.1), had no formal education (AOR = 1.9,95% CI:1.1-3.4), not schooling during data collection year (AOR = 1.8,95%CI:1.3-2.6), family wealth index status; lowest (AOR = 2.3,95%CI:1.3-3.9), low (AOR = 2.1,95%CI:1.2-3.5), medium (AOR = 1.9,95%CI:1.2-3.0) and high (AOR = 1.8, 95%CI:1.1-3.0), having common mental disorder (AOR = 2.0,95% CI: 1.4-2.7), and watching pornography materials (AOR = 1.6, 95%CI: 1.2-2.1) were factors associated with risky sexual behaviors. CONCLUSIONS: Findings of this study revealed that one every four youths aged 15-24 years old had risky sexual behaviors. Hence, working on economic development of the family and prevention of violence can contribute to reducing risky sexual behavior among youths.

Suicide attempt and its determinants among youth in central, north, and west Gondar zones, northwest Ethiopia: Findings from the youth health project.

Introduction: Suicide is a deliberate attempt to take one's own life. Suicidal behavior among adolescents and young people, a significant global public health issue, is under-researched, particularly in developing nations like Ethiopia. Therefore, this study aimed to assess the prevalence of suicide attempts and their determinants among school-aged and out-of-school youth in the central, north, and west Gondar zones of Ethiopia. Methods: A community-based cross-sectional study was conducted from 15 March to 15 April 2019, among youth in the central, north, and west Gondar zones. The data for this study were extracted from information collected for the assessment of common health problems and risky behaviors among youth. A multistage cluster sampling technique was used to collect the data using face-to-face interviewer-administered questionnaires. Bivariable and multivariable logistic regression analyses were done to identify the independent determinants of suicide attempts. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to identify the presence and direction of the association between the dependent and independent variables. Results: A total of 1,597 youth participated in this study, and the mean age of the participants was 19.1 ± 2.8 standard deviations (SDs). The lifetime prevalence of suicide attempts in the study participants was 5.5% (95% CI: 4.4, 6.8%). Risky sexual practices (AOR = 1.89, 95%CI: 1.19-2.99), the presence of common mental health problems (AOR = 6.31, 95% CI: 3.78-10.88), having a personal income (AOR = 1.68, 95% CI: 1.05-2.71), and a history of violence (AOR = 2.81, 95% CI 1.76-4.49) were significantly associated with a suicide attempt. Conclusion: In this study, the prevalence of lifetime suicide attempts among youth is high. The presence of common mental health problems, having a personal income, risky sexual practices, and a history of violence increase the likelihood of suicide attempts. Working on the reduction of risky sexual practices, ensuring the integration of psychological treatment into medical treatment programs for victims of violence, psychosocial support for young people, and integrating youth-friendly health services to promote mental health would help to reduce suicide attempts among youth.

Magnitude of metabolic syndrome in Gondar town, Northwest Ethiopia: A community-based cross-sectional study.

BACKGROUND: Metabolic syndrome (MetS) is becoming a major public health problem globally; it is clear that the burden of MetS is rapidly increasing the rates of non-communicable diseases (NCD). In Ethiopia studies done so far have shown a large disparity in magnitude of the prevalence of MetS and were mainly institution-based studies. Therefore, this study assess the prevalence of MetS among adults who are residing in Gondar city using Adult Treatment Panel III (ATP III) and the International Diabetes Federation (IDF) assessment tool. The findings are imperative to developing and strengthening national NCD prevention and control programs. METHODS: This study was conducted in Gondar city Northwest Ethiopia in 2018. It employs a community-based cross-sectional study design among 3,227 individuals 18 years of age or older. Data was collected using the WHO stepwise tool, lipid profile, blood pressure (BP), waist circumference (WC) body mass index (BMI), fasting blood glucose levels (FG), and anthropometric measurements. The prevalence estimation was made along with a 95% confidence interval (CI). The Kappa statistic was used to analyze the statistical agreement between ATP III and IDF definitions of the MetS. Stratified analysis was also performed for description and analysis components using ATP III and IDF as an outcome. RESULT: Of the total study participants (3227), 3059 (94.8%) were included in the final analysis and 52.5% were female. The mean (±SD) age of the study participant was 40.8 years (16.2 ±SD). The overall prevalence of MetS using ATP III was 11.2% [95%CI: 10.1, 12.3] and using IDF was 11.9% [95%CI: 10.8, 13.2]. The sex-specific proportion was high in females rather than males irrespective of the criteria. The overall level of agreement between ATP III and IDF prevalence was 91.7% and the Kappa statistics was 0.594. Older age, low-density lipoprotein cholesterol, body mass index, being female, born in an urban area, consumption of an alcoholic drink in the preceding 30 days, and non-fasting practice was significantly associated with MetS. CONCLUSION AND RECOMMENDATION: There was a higher prevalence of metabolic syndrome among females than males irrespective of metabolic syndrome diagnostic criteria. This also shows good agreement between ATP III and IDF. Being female, urban birthplace, frequent alcohol consumption in the last 30 days, and non-fasting practice are factors associated with higher rates of metabolic syndrome. Hence, awareness campaigns, physical exercise, and nutrition education intervention should be undertaken to promote health behavioral practice.

Perceived quality of essential newborn care implementation among health facility deliveries in North Gondar Zone, Northwest Ethiopia: a cross-sectional study.

BACKGROUND: Quality of essential newborn care is defined as the extent of health care services to improve the health of newborns. However, studies are scarce regarding the quality of newborn care implementation. Therefore, this study aimed to measure the magnitude and factors associated with essential newborn care implementation perceived quality among health facility deliveries in Northwest Ethiopia. METHODS: A facility-based cross-sectional study design was employed to collect data from 370 randomly selected deliveries in 11 health facilities from November 2018 to March 2019. Essential newborn care implementation perceived quality was assessed in two domains (delivery and process) from clients' perspectives. A pre-tested interviewer-administered structured questionnaire was adopted from different kinds of literature and guidelines. The research data were collected by trained midwives and nurses. A binary logistic regression model was used to identify associated factors with newborn care implementation perceived quality. Odds ratio with 95% CI was computed to assess the strength and significant level of the association at p-value < 0.05. RESULTS: About 338 mothers completed the interview with a response rate of 97.1%. The mean age of the study participants was 26.4 (SD = 5.7) with a range of 12 and 45 years. Most mothers, 84.3%, have attended antenatal care. The overall implementation perceived quality of essential newborn care was found to be 66.3%. The implementation perceived quality of cord care, breast-feeding and thermal care was 75.4, 72.2 and 66.3% respectively. Newborn immunization and vitamin K administration had the lowest implementation perceived quality i.e. 22.4 and 24.3% respectively. Friendly care during delivery (AOR = 5.1, 95% CI: 2.4, 11.0), partograph use (AOR = 3.0, 95% CI: 1.1, 8.6), child immunization service readiness (AOR = 2.9, 95% CI: 1.5, 5.7), BEmEONC service readiness (AOR = 2.1, 95% CI: 1.2, 3.9) and facing no neonatal illness at all (AOR = 4.2, 95% CI: 1.6, 10.9) were significantly associated with good essential newborn care implementation qualities. CONCLUSIONS: The perceived quality of essential newborn care implementation was low in the study area. This is associated with poor readiness on BEmEONC and child immunization services, unfriendly care and not using partograph during delivery. Hence, availing the BEmEONC and the child immunization service inputs, continuous training and motivation of healthcare workers for friendly care are vital for improving essential newborn care implementation perceived quality.

Essential newborn care is a set of practices provided by healthcare workers and mothers to every newborn during delivery. Studies are scarce regarding the quality of newborn care implementation. Therefore, this study aimed to measure the magnitude and factors associated with essential newborn care implementation perceived quality among health facility deliveries in Northwest Ethiopia.A facility-based cross-sectional study design was employed to collect data from 370 randomly selected deliveries in 11 health facilities. A pre-tested interviewer-administered structured questionnaire was adopted from different kinds of literature and guidelines. A binary logistic regression model was fitted to assess the strength and significant level of the association at p-value < 0.05.The overall implementation perceived quality of essential newborn care was found to be 66.3%. The implementation perceived quality of cord care, breast-feeding and thermal care was 75.4, 72.2 and 66.3% respectively. Newborn immunization and vitamin K administration had the lowest implementation perceived quality i.e. 22.4 and 24.3% respectively. Friendly care during delivery (AOR = 5.1, 95% CI: 2.4, 11.0), partograph uses (AOR = 3.0, 95% CI: 1.1, 8.6), child immunization service readiness (AOR = 2.9, 95% CI: 1.5, 5.7), BEmEONC service readiness (AOR = 2.1, 95% CI: 1.2, 3.9) and facing no neonatal illness at all (AOR = 4.2, 95% CI: 1.6, 10.9) were significantly associated with good essential newborn care implementation qualities.The perceived quality of essential newborn care implementation was low in the study area. This is associated with poor readiness on BEmEONC and child immunization services, unfriendly care and not using partograph during delivery. Hence, availing the BEmEONC and child immunization service inputs, continuous training and motivation of healthcare workers for friendly care are vital for improving essential newborn care implementation perceived quality.

Health extension workers' perceived health system context and health post preparedness to provide services: a cross-sectional study in four Ethiopian regions.

OBJECTIVE: The health system context influences the implementation of evidence-based practices and quality of healthcare services. Ethiopia aims at reaching universal health coverage but faces low primary care utilisation and substandard quality of care. We assessed the health extension workers' perceived context and the preparedness of health posts to provide services. SETTING: This study was part of evaluating a complex intervention in 52 districts of four regions of Ethiopia. This paper used the endline data collected from December 2018 to February 2019. PARTICIPANTS: A total of 152 health posts and health extension workers serving selected enumeration areas were included. OUTCOME MEASURES: We used the Context Assessment for Community Health (COACH) tool and the Service Availability and Readiness Assessment tool. RESULTS: Internal reliability of COACH was satisfactory. The dimensions community engagement, work culture, commitment to work and leadership all scored high (mean 3.75-4.01 on a 1-5 scale), while organisational resources, sources of knowledge and informal payments scored low (1.78-2.71). The general service readiness index was 59%. On average, 67% of the health posts had basic amenities to provide services, 81% had basic equipment, 42% had standard precautions for infection prevention, 47% had test capacity for malaria and 58% had essential medicines. CONCLUSION: The health extension workers had a good relationship with the local community, used data for planning, were highly committed to their work with positive perceptions of their work culture, a relatively positive attitude regarding their leaders, and reported no corruption or informal payments. In contrast, they had insufficient sources of information and a severe lack of resources. The health post preparedness confirmed the low level of resources and preparedness for services. These findings suggest a significant potential contribution by health extension workers to Ethiopia's primary healthcare, provided that they receive improved support, including new information and essential resources.

Recommended dietary practice and associated factors among patients with diabetes at Debre Tabor General Hospital, northwest Ethiopia: institutional-based cross-sectional study design.

OBJECTIVE: This study aimed to assess dietary practice and associated factors among patients with diabetes attending the Debre Tabor General Hospital. DESIGN: Institutional-based cross-sectional study. SETTING: Amhara regional state, Debre Tabor General Hospital. PARTICIPANTS: Patients with diabetes attending the diabetics' clinic. MEASUREMENTS: The study was conducted from February to March 2016. Simple random sampling technique was used to select the study participants and data were collected using a pretested structured interviewer administered questionnaire. Patients' dietary practice was assessed using the general advice for diabetic plan containing 11 items. The data were entered using Epi Info V.7 and analysed using SPSS V.20. Binary logistic regressions analysis was used to identify factors associated with poor dietary practice. Adjusted ORs (AORs) with corresponding 95% CI and p˂0.05 were used to identify significant factors affecting poor dietary practice. RESULTS: A total of 390 patients with diabetes were participated in the study making a response rate of 96.5%. The overall proportion of poor dietary practice was 55.4% (95% CI 50.8% to 60.5%). Respondents of rural residence (AOR 1.99, 95% CI 1.21 to 3.28), Not getting diabetic nutrition education (AOR 3.32, 95% CI 2.02 to 5.44), difficulty to determine what to eat (AOR 5.49, 95% CI 3.34 to 9.02), not having family/friends support (AOR 2.50, 95% CI 1.46 to 4.27), worried about high cost of foods (AOR 2.12, 95% CI 1.29 to 3.49) were significantly associated with poor dietary practice. CONCLUSIONS: More than half of patients with diabetes were had poor dietary practice. Rural dwellers, not getting nutrition education, difficulty of choosing foods, not getting family/friends support and worried about high cost of foods were positively and significantly associated with poor dietary practice. Hence, integration of diabetic based nutrition education with motivation particularly for rural patients is highly recommended.

Birth preparedness and complication readiness practice and associated factors among pregnant women in Northwest Ethiopia: 2018.

BACKGROUND: Birth-preparedness and complication readiness is a comprehensive strategy aimed at promoting the timely utilization of skilled maternal and neonatal health care. Pregnancy-related complications both on the mother and the newborn could be largely alleviated if there is a well-consolidated birth preparedness and complication readiness plan developed during pregnancy and implemented at the time of delivery. OBJECTIVE: To determine the prevalence of birth preparedness and complication readiness practice (BPCR) and associated factors among pregnant women in North Gondar Zone, Northwest Ethiopia, 2018. METHODS: A community based cross-sectional study was conducted among pregnant women in North Gondar Zone from March 2017 to February 2018. A multistage clustered sampling technique was used to enroll a total of 1620 participants. The data were collected by face to face interviews using pretested and semi-structured questionnaires at baseline and following delivery. The data were entered using EPI-data version 3.1 and analyzed using STATA version 14 software. Bivariate and multivariable logistic regression model was fitted to assess factors with BPCR practice. Adjusted odds ratio (AOR) with 95% confidence interval was used to determine the association between covariates and the outcome variable. RESULTS: From a total of 1620 pregnant women only 1523 (94.0%) mothers were followed at the end line. The prevalence of BPCR plan during pregnancy was 66.1% [95% CI: 63.8, 68.5] and the practice at the time of delivery was 73.5% [95% CI 71.3, 75.7]. Of the total respondents who mentioned having a BPCR plan, 76.4% practiced at the time of delivery. Frequency of ANC visits [AOR = 1.97; 95% CI: 1.67, 2.32], larger number of family in the household [AOR = 1.14; 95%CI: 1.00, 1.30], highest wealth asset [AOR = 1.87; 95%CI: 1.16, 3.01], Multigravidity [AOR = 0.30; 95% CI: 0.15, 0.62], husband involvement in decision making [AOR = 2.2; 95% CI: 1.25, 3.82], counseled on BPCR [AOR = 2.35; 95% CI: 1.51, 3.68], were found to be significantly associated with BPCR practice. CONCLUSION: BPCR practice at the time of delivery was higher than previous studies conducted in the country. However, BPCR practice was found to be lower than the standard that every woman should practice the plan at the time of delivery. Intersectoral collaborative interventions required to improve the economic status and living standard of families in the community as well as various awareness creation strategies should be implemented to support women to attend ANC follow-up visits.