Prevalence of trachoma in Somali region, Ethiopia: results from trachoma impact surveys in 50 woredas.

BACKGROUND: Following interventions to eliminate trachoma in Somali region, Ethiopia, we aimed to re-estimate the prevalence of trachomatous trichiasis (TT) and trachomatous inflammation-follicular (TF) at woreda level and identify the factors associated with the disease. METHODS: We implemented cross-sectional community-based surveys in 50 trachoma-endemic woredas, using a standardized survey. Households were the secondary sampling unit. Surveys were undertaken through a combination of interviews of household heads and direct inspection of water, sanitation and hygiene (WASH) access, plus clinical evaluation of eligible household members for TT and TF. RESULTS: Overall, 41 (82%) of the 50 woredas had met the WHO-recommended active trachoma elimination threshold (prevalence of TF <5% in 1-9-y-olds) and 42 (84%) had met the TT threshold (prevalence of TT unknown to the health system <0.2% in ≥15-y-olds). Only 18% of households had access to an improved drinking water source within a 30-min trip and only 25% had an improved latrine. CONCLUSIONS: Additional rounds of antibiotic mass drug administration, plus interventions to enhance facial cleanliness and improve the environment, are required in nine woredas. TT surgical campaigns are needed in eight woredas. Greater access to WASH is required across all the woredas that were surveyed.

Does Voluntary Family Planning Contribute to Food Security? Evidence from Ethiopia.

This study aims to explore the effects of voluntary family planning (FP) utilization on food security in selected districts of Ethiopia. Quantitative research methods were used to conduct a community-based study among a sample of 737 women of reproductive age. The data were analyzed using a hierarchical logistic regression constructed in three models. The findings showed 579 (78.2%) were using FP at the time of the survey. According to the household-level food insecurity access scale, 55.2% of households experienced food insecurity. The likelihood of food security was lower by 64% for women who used FP for less than 21 months (AOR = 0.64: 95%CI: 0.42-0.99) in comparison to mothers who used FP for more than 21 months. Households having positive adaptive behaviors were three times more likely (AOR = 3.60: 95%CI 2.07-6.26) to have food security in comparison to those not having positive adaptive behaviors. This study also revealed that almost half of the mothers (AOR: 0.51: 95%CI: 0.33-0.80) who reported being influenced by other family members to use FP had food security, in comparison to their counterparts. Age, duration of FP use, positive adaptive behaviors, and influence by significant others were found to be independent predictors of food security in the study areas. Culturally sensitive strategies need to be considered to expand awareness and dispel misconceptions that lead to hesitancy around FP utilization. Design strategies should take into account households' resilience in adaptive skills during shocks, natural disasters, or pandemics which will be invaluable for food security.

Midwives' job satisfaction and intention to leave their current position in developing regions of Ethiopia.

BACKGROUND: The aim of this research was to analyze midwives' job satisfaction and intention to leave in developing regions of Ethiopia. METHODS: A facility-based cross-sectional study was conducted amongst 107 midwives in four developing regions of Ethiopia. All midwives who were working in 26 health facilities participated in the study. A structured self-administered questionnaire, and in depth key informant interview guides, were used to collect data. Job satisfaction was measured by nine dimensions and intention to leave their current position was measured using three questions. RESULTS: More than two-thirds (67%) of the midwives were female, with a mean age of 26.1 (sd±4.2) years old. Less than half (45%) of the midwives were satisfied with their job, less than half (42%) were satisfied with 'work environment' and less than half (45%) were satisfied with 'relationship with management' and 'job requirements'. Relatively better satisfaction rates were reported regarding 'professional status', of which more than half (56%) of midwives were satisfied, followed by more than half (54%) of midwives being satisfied with 'staff interaction'. Almost two-fifths (39%) of midwives intended to leave their current position. CONCLUSION: Job dissatisfaction and intention to leave rates amongst midwives in developing regions in Ethiopia are a source of concern. The majority of midwives were most dissatisfied with their working environment and issues related to payment. Their intention to leave their current position was inversely influenced by job satisfaction. The introduction of both financial and nonfinancial mechanisms could improve midwives' job satisfaction, and improve retention rates within the profession.

The Effect of Women's Empowerment in the Utilisation of Family Planning in Western Ethiopia: A Structural Equation Modelling Approach.

This study examines the associations between women's empowerment and family planning use in Jimma Zone, Western Ethiopia. A total of 746 randomly selected married women of reproductive age were interviewed. The data were employed by structural equation modelling (SEM) to investigate the complex and multidimensional pathways to show women's empowerment domains in family planning utilisation. Results of the study revealed that 72% of married women had used family planning. Younger women, having access to information, having access to health facilities and being aware about family planning methods, living in a rural area, having an older partner and increased household decision-making power were associated with using family planning methods. Women's empowerment is an important determinant of contraceptive use. Women's empowerment dimensions included increased household decision-making power, socio-demographic variables and having access to information about family planning and accessible health facilities. These were found to be important determinants of contraceptive use. Future interventions should focus on integrating women's empowerment into family planning programming, particularly in enhancing women's autonomy in decision making. Further research is warranted on the socio-cultural context of women that influences women's empowerment and family planning use to establish an in-depth understanding and equity of women in society.

Prevalence and Barriers to Ending Female Genital Cutting: The Case of Afar and Amhara Regions of Ethiopia.

Female genital cutting (FGC) remains highly prevalent in Ethiopia, in spite of a slowly decreasing trend over the last decade. In an effort to inform and strengthen FGC interventions in Ethiopia, this study aimed to assess FGC prevalence in cross-administrative border* districts and to explore barriers to ending FGC. A mixed methods, cross-sectional study was employed in three districts in the Afar and Amhara regions in Ethiopia. A sample of 408 women with female children under the age of 15 were included in the study. Additionally, 21 key informant interviews and three focus group discussions were held with local government officials and community stakeholders. The study found that the prevalence of FGC among mothers interviewed was 98%. Seventy-four percent of the female children of participants had undergone FGC. Of the youngest (last born) female children, 64.7% had experienced FGC. The participation of respondents in cross-administrative FGC practices ranged from 4% to 17%. Quantitative analysis found that knowledge and attitude towards FGC, level of literacy, place of residence, and religious denomination were associated with FGC practice. The study also found that the lack of participatory involvement of local women in programs that aim to end FGC and the lack of suitable legal penalties for those who practice FGC exacerbate the problem. A significant proportion of participants support the continuation of FGC practices in their communities. This finding indicates that FGC practice is likely to persist unless new approaches to intervention are implemented. It is recommended that a comprehensive response that couples community empowerment with strong enforcement of legislation is administered in order to effectively end FGC in Ethiopia by 2025, in alignment with the national plan against Harmful Traditional Practices. * Cross-administrative border means a border between two regional states in Ethiopia. In this document, it refers to the movement of people between Amhara and Afar regional states.

Determinant and outcome of early diagnosis of HIV infection among HIV-exposed infants in southwest Ethiopia.

BACKGROUND: Preventing mother-to-child transmission (PMTCT) of human immunodeficiency virus infection (HIV) has been a fundamental advancement in the acquired immunodeficiency syndrome (AIDS) response for the past decade. Several countries have made great strides in the efforts to prevent HIV through mother-to-child transmission. The objective of this study is to assess the determinant and outcome of early diagnosis of HIV infection among HIV-exposed infants in southwest Ethiopia. METHODS: An institutional based retrospective cohort study was conducted in a hospital. Medical records of HIV-exposed infants and their mothers enrolled into the program were reviewed. Data entry and analysis was carried out using SPSS version 20 for Windows. RESULTS: A total of 426 HIV exposed infant-mother pairs where both mother and infants received a minimum ARV intervention for PMTCT were included in the study. Two hundred fifty-four (59.6%) of mothers had attended antenatal care (ANC). Of all participants, 234(54.9%) mothers did not receive any PMTCT prophylaxis during ANC, while only 104(24.4) received antiretroviral (ART) as PMTCT prophylaxis and 163(38.3%) claimed that did not observe any infant PMTCT interventions while 135(31.7%) of the infants received single-dose NVP + AZT. About 385(90.4%) infants were not infected at their final infection status. Those mothers who did not attended ANC follow-up, infants on mixed and complementary feeding and infants weaned off and mothers who were in WHO clinical stage III and IV were more likely to have HIV sero positive infant. CONCLUSION: This study showed that 385(90.4%) of the infants were not infected at their final infection status. Therefore, encouraging pregnant women to visit health facilities during their course of pregnancy, focusing on exclusive breast feeding counseling and promotion, and early initiation of antiretroviral treatment to HIV infected pregnant women are recommend.