Effectiveness of curriculum-based sexual and reproductive health education on healthy sexual behaviors among year one students at Arba Minch University: A quasi-experimental study.

INTRODUCTION: Curriculum-based sexual and reproductive health education (CBSRHE) is one of the preventive strategies targeting youth in higher institutions to protect them from sexual and reproductive health problems, despite never assessing the effect in Ethiopia. Therefore, this study aimed to assess the effect of CBSRHE on knowledge and attitude about SRH services to have safer sexual behaviors among first-year students of Arba Minch University. METHOD: We conducted a quasi-experimental study among purposively selected campuses. The campuses were allocated to (i) an intervention arm consisting of curriculum-based sexual and reproductive health, or (ii) a control arm for those who were free from intervention. Data was collected, at baseline and immediately after the intervention ended by using a structured self-administered questionnaire. To compare differences in the change from baseline to post-intervention between the two arms we use the chi-square test and independent-samples t-test. To see the effect of the CBSRHE by controlling the effect confounding inverse probability-weighted analysis was conducted. RESULT: A total of 832 and 820 students participated in a baseline and post-test respectively. The proportion of youth who practice receptive penetrative sex decreases from 40.9% to 28.3% in the intervention arm compared to 37.6% to 37.3% in the non-intervention arm between baseline and end line, with statistically significant differences between groups. However, there are statistically significant differences between the intervention and control groups in terms of changes in contraception utilization (X2 = 1.21; P>0.05). Furthermore, there were significant improvements in knowledge and attitude among the intervention arm a comprehensive knowledge of HIV/AIDS (ATE = 0.22,95% CI, 0.14 to 0.29; p < 0.01), an average change of attitude toward HIV/AIDS(ATE = 1.32, 95% CI, 1.18 to 1.47; p < 0.01), comprehensive condom knowledge score (ATE = 0.23, 95% CI, 0.13 to 0.33; p < 0.01) and the average change of attitude toward condom score (ATE = 1.83, 95% CI, 1.19 to 2.77; p < 0.01). CONCLUSION AND RECOMMENDATION: It was found that there was a significant difference in knowledge and attitude toward a disk sexual behaviors among r one student. This implies that the educational authority o the country can gain through the adoption of courses to all universities across the country, besides doing further comparative studies to determine the long-term effect of the course supported with models and/or theories like the theory of change.

Magnitude and risks of overweight/obesity among adults in Welkite town, Southern Ethiopia: A community based cross-sectional study.

BACKGROUND: Currently, adult overweight/obesity affects a high proportion of the population in low and middle-income countries, mostly in urban areas. Although some studies have been conducted on overweight/obesity in Ethiopia, most of them have focused on school children and adolescents, and there is limited evidence of overweight/obesity among adults at the community level. Therefore, the present study aimed to assess the magnitude of overweight/obesity and risk factors among adults in Welkite town, Southern Ethiopia. METHODS: A Community-based cross-sectional study was done among 524 adults aged 18 and more years in Welkite town, Southern Ethiopia, from February through March 2020. A multistage sampling technique was undertaken to recruit study participants. An interviewer-guided structured questionnaire was used for data collection. Overweight or obesity was identified using body mass index. The bivariate and multivariate analyses were employed to see an association using binary logistic regression. RESULTS: The magnitude of overweight and obesity was 22.2% (95% CI: 0.19, 0.26). Being female (AOR = 2.40, 95% CI: 1.34, 4.27), age group 30-47 years (AOR = 3.26, 95% CI: 1.52, 6.97) and 48-66 years (AOR = 2.56, 95% CI: 1.07, 6.08), average monthly income (AOR = 2.64, 95% CI: 1.51, 4.60), had own transport (AOR = 2.48, 95% CI: 1.03, 5.93), eating meat ≥ four times per week (AOR = 3.33, 95% CI: 1.03, 10.74), not involve vigorous-intensity activity (AOR = 2.96, 95% CI: 1.55, 5.64), spent sitting or reclining ≥181 minutes per day (AOR = 1.88, 95% CI: 1.08, 3.26), and consuming alcohol (AOR = 2.23, 95% CI: 1.29, 3.82) were risks for overweight and obesity. CONCLUSIONS: The magnitude of overweight and obesity among adults was high. Factors such as being female, increasing age, physical inactivity, having own transportation, high average monthly income, eating meat, sitting or reclining more and equal to 181+ minutes per day, and consumption of alcohol increased the risk of overweight and obesity significantly. Hence, preventive interventions focusing on females, age groups of 30-66yrs, encouraging Physical activity, reducing meat frequency, and reducing alcohol consumption are essential to prevent the emergence of adulthood overweight/obesity.

Exploring Barriers to Effective Implementation of Public Health Measures for Prevention and Control of COVID-19 Pandemic in Gamo Zone of Southern Ethiopia: Using a Modified Tanahashi Model.

BACKGROUND: Since the occurrence of the COVID-19 pandemic, different public health measures have been implemented to prevent and control the further spread of the disease. However, barriers that influence the effective implementation of public health measures were not explore in Ethiopia especially in study Area. Therefore, this study tried to fill this gap by exploring the barriers to effective implementation of public health measures for prevention and control of the COVID-19 pandemic in the Gamo Zone of southern Ethiopia. METHODS: The study employed a qualitative study with a phenomenology approach among purposely selected 30 individuals in the community and selected institutions. Key informant interview was used to collect the data. The data were transcribed verbatim and translated into the English language. The transcribed data were read several times to clearly understand the content for further analysis. The analysis of the data was conducted based on the modified Tanahashi framework. RESULTS: The study identified different barriers under five main themes: accessibility, acceptability, availability, contact and use, and effective implementation of public health measures related to barriers. The main barriers to effective implementation of public health measures were resistance to change, negligence, lack of community engagement, insufficient training for front line workers, poor supportive supervision, poor law enforcement, and lack of continuous community awareness creation. Beside, acceptability related barriers like cultural and religious norms and availability related barriers like shortage of personal protective equipment and shortage of skilled health professional have also lion share barriers for implementation of the public health measures. CONCLUSION: The study identified different personal, institutional, and societal level barriers for effective implementation of public health measures for the COVID-19 pandemic. Therefore, proper and targeted continuous community awareness creation with further mandatory law enforcement activities should be implemented by the concerned bodies to mitigate individual and societal level barriers. In addition, the government with relevant stakeholders should give due attention to equip and protect the frontline professionals by availing the necessary logistic and provision of continuous capacity-building activities.

Magnitude and Factors Associated with Hygiene Practice Among Primary School Children in Mareko District, Southern Ethiopia: A Cross-Sectional Study.

BACKGROUND: Poor school hygiene practice is a major health problem in developing countries, including Ethiopia, and is a leading factor for children's school absenteeism due to hygiene-related illnesses. To our knowledge, little is known about hygiene practice conducted in southern Ethiopia including our study area. Therefore, the objective of this study was to assess magnitude and associated factors of hygiene practice among primary school children in Mareko District. METHODS: A school-based cross-sectional study design with multi-stage sampling was conducted from January 15-30, 2018 in Mareko district. Out of 25 second cycle primary schools in the district, eight schools (30%) were recruited with a simple random method. Then, a sample size of 829 students was selected by a simple random method. A self-administered questionnaire was used to collect data. Data were entered into Epi Info V. 7 and then analyzed in SPSS V. 20. Multivariate logistic regression analysis was used to identify independent factors of hygiene practice. RESULTS: The magnitude of overall good hygiene practice was 252 (30.4%) with 95% CI (27.3-33.5%). Practices of hand washing, latrine utilization, and water handling were found to be 191 (23%), 387 (46.7%), and 238 (28.7%), respectively. In multivariate analysis, factors associated with hygiene practice were found to be knowledge on hand washing (AOR = 5.1, 95% CI 2.86-9.1) and latrine use (AOR = 1.99, 95% CI 1.06- 3.75); ever visited model school (AOR = 2.44, 95% CI 1.28-4.64); being 14-18 years old (AOR = 1.42; 95% CI 1.3-1.88); and cleanliness of toilets (AOR = 3.4; 95% CI 1.77-6.55). CONCLUSION: Overall, good hygiene practice among primary school children in Mareko District was low. Therefore, there should be continuous awareness of good hygiene practice and its impact on health through health education, strengthening and motivation of water, sanitation, and hygiene clubs, and also visits to model primary schools in the district.

Community Perception and Attitude towards people with Depression among Adults Residing in Arba Minch Health and Demographic Surveillance Site (AM-HDSS), Southern Ethiopia.

BACKGROUND: Negative perception and attitude of community prevents many people with depression and their caregivers from seeking help and receiving adequate treatment due to fear of social reaction and may try to hide the illness. The reasons for negative attitudes are not consistent across communities or cultures. Therefore, understanding the level of community perception and attitude towards people with depression is important to develop an intervention to reduce the impact of mental illness. METHODS: A community-based cross-sectional study was conducted among 617 randomly selected adults. The data was collected using structured, pre-tested, and interviewer-administered questionnaires. Descriptive statistics like frequency, mean, and median were performed. Bi-variable and multivariable logistic regression analyses were performed to identify the factors that affect the community attitude towards people with depression. RESULTS: Of the study population, 325(52.7%) had a good perception and 246(39.9%) had a positive attitude towards people with depression. The majority of study participants frequently identified as the perceived cause of depression was substance misuse, loss of loved one, and conflict within a family. In addition, psychosocial treatment was the most preferred treatment for people with depression in the study area. Marital status and educational status were significantly associated with the community attitude towards people with depression. CONCLUSION: Giving special attention to people with substance misuse, loss of loved one, and conflict within a family is very vital for the prevention of depression. In addition, future mental health promotion activities should focus on cause and common manifestation of depression to improve the attitude toward people with depression.

Prevalence Of Undernutrition And Associated Factors Among Adults Receiving First-Line Antiretroviral Treatment In Public Health Facilities Of Arba Minch Town, Southern Ethiopia.

INTRODUCTION: Access to antiretroviral drugs for all infected persons in need is a global health priority. The primary goals of initiating antiretroviral drugs are to suppress human immunodeficiency virus viral replication and to restore immune function. However, adequate nutrition is necessary to manage opportunistic infections and to maintain the immune system. Therefore, this study aimed to determine the recent prevalence of undernutrition and associated factors among HIV patients receiving first-line antiretroviral therapy in public health facilities of Arba Minch town, Gamo zone, Southern Ethiopia. METHODS: Institution-based cross-sectional study was used among 333 adult patients receiving first-line antiretroviral therapy at public health facilities of Arba Minch town. A simple random sampling technique was used to select the study subjects. Data were collected through interviewer-administered questionnaires. Binary and multivariable logistic regression analyses were used to identify factors associated with undernutrition. A p-value <0.05 with a 95% confidence level was used to declare statistical significance. RESULTS: The overall prevalence of undernutrition among adult patients receiving first-line antiretroviral therapy is 23.72% (95% CI: 19.13-28.27%). Current substance use (AOR=1.83, 95% CI:1.09-3.08), duration on antiretroviral therapy (AOR=1.87, 95% CI:1.06-3.30), not taking cotrimoxazole preventive therapy (AOR=2.09, 95% CI:1.15-3.82), advanced WHO clinical stages (AOR=5.1, 95% CI: 2.9-7.7), CD4 count less than 350 cell/mm3 (AOR=1.83, 95% CI: 1.09-3.05) and active tuberculosis (AOR=1.89, 95% CI: 1.02-3.53) were factors significantly associated with undernutrition among respondents who were enrolled on first-line antiretroviral therapy. CONCLUSION: This study shows that the prevalence of undernutrition was high among adult patients on first-line antiretroviral therapy. Therefore, this finding shows the need to implement nutrition programs to improve the nutritional status of adults living with HIV in the study area. The interventions should emphasise those patients who use the substance, who are in advanced WHO clinical stage and have active tuberculosis. Besides, emphasis should be given for patients to undertake cotrimoxazole preventive therapy and to regularly follow their CD4 count.

Adherence to Iron-Folate Supplementation and Associated Factors among Pastoralist's Pregnant Women in Burji Districts, Segen Area People's Zone, Southern Ethiopia: Community-Based Cross-Sectional Study.

BACKGROUND: Iron deficiency anemia among pregnant women is one of the most common public health problems in developing country particularly in Ethiopia. Iron/folic acid supplementation with optimal adherence is the main cost-effective strategy for prevention and control of iron deficiency anemia in pregnant women. However, level of adherence to iron/folic acid supplementation and its associated factors were not well identified in study area. Therefore, the aim of this study was to determine the level of adherence to iron/folic acid supplementation and associated factors among pregnant women in Burji Districts, southern Ethiopia. METHODS: A community-based cross-sectional study was conducted among 317 pregnant women in Burji Districts from March to April 2017 using interviewer administered questionnaires. Data were entered into Epi Info 3.5.1 and exported to SPSS version 20.0 for analysis. Binary and multivariable logistic regression was used to identify factors associated with iron/folic acid supplementation. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value <0.05 were used to declare statistical significance. RESULTS: Among women participating in the study, 163(51.4%) were adherent to iron/folate acid supplementation. Factors significantly associated with adherence to iron and folic acid supplementation were maternal educational status (AOR: 2.47, 95% CI: 1.13-4.97), early registration for ANC (AOR: 2.49, 95% CI: 1.45 - 4.27), history of anemia during current pregnancy (AOR: 2.02, 95% CI: 1.09-3.72), and knowledge about iron and folic acid supplementation (AOR: 1.96, 95% CI: 1.02-3.76). Forgetfulness and fear of side effects were among the leading reasons of pregnant women for nonadherence to iron and folic acid supplementation. CONCLUSIONS: This study revealed that adherence to iron /folic acid supplementation was found to be 51.4%. Maternal educational status, early registration for ANC, history of anemia during current pregnancy, and knowledge about iron and folic acid supplementation were significant factors associated with adherence to iron/folic acid supplementation among pastoralist's pregnant women. Therefore, anemia prevention strategy should include strengthening giving awareness, counseling, strengthening community health education, and participation in health programs which are necessary to improve the uptake of iron/folic acid supplements.

Determinant of Implanon Discontinuation among Women Who Ever Used Implanon in Diguna Fango District, Wolayita Zone, Southern Ethiopia: A Community Based Case Control Study.

BACKGROUND: A significant number of women make Implanon their first choice of contraception. However, they discontinue their Implanon before its expiry date was high, but factors that contribute to discontinuing their Implanon were poorly described in Ethiopia. METHODS: A community based unmatched case control study was conducted. Then simple random sampling technique was used to select 340 women. Data was collected by nurses using face to face interview. Epi-Info version 7 and SPSS 20 software were used. Bivariate and multiple logistic regressions were performed with COR and AOR with 95% CI. FINDINGS: Having preinsertion counseling (AOR: 0.36, 95% CI: 0.20-0.64), having follow-up appointment (AOR: 0.35, 95% CI: 0.2-0.62), age at insertion <20 years (AOR: 3, 95% CI: 1.16-7.8), women who had no formal education (AOR: 2.8, 95% CI: 1.31-6.11), women who had ≤4 children (AOR: 1.8, 95% CI: 1.01-3.21), and women who had previous abortion history (AOR: 2.3, 95% CI: 1.10-4.63) were determinants of Implanon discontinuation. CONCLUSIONS: Policy makers and concerned bodies should take into account future intervention and also great emphasis should be given to follow-up appointment and counseling services, especially counseling on side effects, and informed choice for clients after Implanon insertion.