Promoting equity in maternal, newborn and child health - how does gender factor in? Perceptions of public servants in the Ethiopian health sector.

Background: Advancing gender equality and health equity are concurrent priorities of the Ethiopian health sector. While gender is regarded as an important determinant of health, there is a paucity of literature that considers the interface between how these two priorities are pursued.Objective: This article explores how government stakeholders understand gender issues (gender barriers and roles) in the promotion of maternal, newborn and child health equity in Ethiopia.Methods: Adopting an exploratory qualitative case study design, we conducted semi-structured interviews with 17 purposively-selected stakeholders working in leadership positions with the Federal Ministry of Health and Federal Ministry of Women and Children Affairs as part of a larger study regarding the promotion of health equity in maternal, newborn and child health. A post hoc content and thematic sub-analysis was done to explore how participants raised gender issues in conversations about health equity.Results: Efforts to address gender inequalities were synonymous with the promotion of a women's health agenda, which was largely oriented towards promoting health service use. Men were predominant decision makers with regards to women's health and health care seeking in both public and private spheres. Participants reported persisting gender-related barriers to health stemming from traditional gender roles, and noted the increased inclusion of women in the health workforce since the introduction of the Health Extension Program.Conclusions: The framing of gender as a women's health issue, advanced through patriarchal structures, does little to elevate the status of women, or promote power differentials that contribute to health inequity. Encouraging leadership roles for women as health decision makers and redressing certain gender-based norms, attitudes, practices and discrimination are possible ways forward in re-orienting gender equality efforts to align with the promotion of health equity.

The effect of psychometric variables in predicting physical activity behavior among diabetes mellitus type-2 patients.

BACKGROUND: Diabetes mellitus type-2 (DMT-2), the most common endocrine disease in the world, is a major global public health-related issue. Diabetes mellitus is one of the most common non-communicable diseases globally, and there is substantial evidence that it is epidemic in many low- and middle-income countries. It is widely recognized that physical activity is important in preventing and treating DMT-2. The aim of this study was to identify predictors of physical activity among DMT-2 patients attending Jimma University Specialized Hospital (JUSH), Southwest Ethiopia. METHODS: A facility-based cross-sectional study was conducted in 2013 at JUSH, Southwest Ethiopia. A systematic random sampling technique was employed to select 322 diabetes patients. Data were collected using a structured questionnaire on interviewer-administered basis. A summary of descriptive statistics, and binary and multiple logistic regression analysis were computed to identify potential predictors of physical activity among diabetes mellitus patients. RESULTS: Among the 319, 70 (21%) engaged in the recommended physical activity (such as running, jogging, going to the gym, or brisk walking). Two hundred seventy-nine (87.5) of the respondents had adequate general knowledge of diabetes and 31.7% of the respondents had adequate general knowledge of physical activity. The likelihood of engaging in the recommended physical activity was associated with perceived barrier (odds ratio [OR]=0.58, 95% confidence interval, CI [0.56, 0.67]; p<0.000), perceived self-efficacy (OR=1.33, 95% CI [1.12, 1.57] p<0.001) and perceived benefit (OR=1.16 (95% CI [1.03, 1.29] p<0.000). CONCLUSION: This study illustrated that practicing the recommended physical activities among DMT-2 patients was insufficient. Perceived barrier, perceived benefit and perceived self-efficacy became potential predictors of physical activity of DMT-2 patients. None of the socio-demographic factors affect the physical activity behavior of these groups. Diabetes intervention messages should focus on building individual self-efficacy to overcome those barriers with a due emphasis to suggested concrete benefit of physical activity.

Compliance with Iron-Folate Supplement and Associated Factors among Antenatal Care Attendant Mothers in Misha District, South Ethiopia: Community Based Cross-Sectional Study.

Background. In Ethiopia, higher proportions of pregnant women are anemic. Despite the efforts to reduce iron deficiency anemia during pregnancy, only few women took an iron supplement as recommended. Thus, this study aimed to assess compliance with iron-folate supplement and associated factors among antenatal care attendant mothers in Misha district, South Ethiopia. Method. Community based cross-sectional study supported with in-depth interview was conducted from March 1 to March 30, 2015. The sample size was determined using single population proportion to 303. Simple random sampling technique was used to select the study participants. Bivariate and multivariable logistic regression analyses were employed to identify factors associated with compliance to iron-folate supplement. Results. The compliance rate was found to be 39.2%. Mothers knowledge of anemia (AOR = 4.451, 95% CI = (2.027,9.777)), knowledge of iron-folate supplement (AOR = 3.509, 95% CI = (1.442,8.537)), and counseling on iron-folate supplement (AOR = 4.093, 95% CI = (2.002,8.368)) were significantly associated with compliance to iron-folate supplement. Conclusions. Compliance rate of iron-folate supplementation during pregnancy remains very low. This study showed that providing women with clear instructions about iron-folate tablet intake and educating them on the health benefits of the iron-folate tablets can increase compliance with iron-folate supplementation.