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1.
Inj Prev ; 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33579673

RESUMO

BACKGROUND: Road traffic injuries, which are responsible for premature deaths and functional losses, are the leading causes of unintentional injuries in Ethiopia. As most studies on road traffic injuries, so far, have been either local or regional, it is believed that combining the regional or local data to get nationally representative information could help programme implementers in setting priorities. OBJECTIVE: The aim of this review was to estimate the proportion of road traffic injuries, mortality and risk factors for the problem among all age groups in Ethiopia. DATA SOURCES: A systematic review of articles using MEDLINE/PubMed SCOPUS Web of Science and science direct was conducted. Additional studies were identified via manual search. STUDY SELECTION: Only studies that reported road traffic injuries and/or mortalities for all age groups were included in this review. DATA SYNTHESIS: All pooled analyses were based on random-effect models. Twenty-six studies for the prevalence of RTIs (n=37 424), 24 studies for road traffic injuries (RTI) mortality, (n=38 888), 9 studies for prevalence of fracture among RTIs (n=2817) and 5 studies for the prevalence of post-traumatic stress disorder (n=1733) met our inclusion criteria. Driving in the dark increased severity of injury by 1.77, 95% CI 1.60 to 1.95). The certainty of the evidence was assessed using GRADEpro Guideline Development Tool. CONCLUSION: In this review, the burden of road traffic injuries and mortalities remains high in Ethiopia. Human factors are the most common causes of the problem in Ethiopia. The existing safety regulations should be re-evaluated and supported by continuous behavioural interventions. PROSPERO REGISTRATION NUMBER: CRD42019124406.

2.
Popul Health Metr ; 19(Suppl 1): 17, 2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33557859

RESUMO

BACKGROUND: Low birthweight (< 2500 g) is an important marker of maternal health and is associated with neonatal mortality, long-term development and chronic diseases. Household surveys remain an important source of population-based birthweight information, notably Demographic and Health Surveys (DHS) and UNICEF's Multiple Indicator Cluster Surveys (MICS); however, data quality concerns remain. Few studies have addressed how to close these gaps in surveys. METHODS: The EN-INDEPTH population-based survey of 69,176 women was undertaken in five Health and Demographic Surveillance System sites (Matlab-Bangladesh, Dabat-Ethiopia, Kintampo-Ghana, Bandim-Guinea-Bissau, IgangaMayuge-Uganda). Responses to existing DHS/MICS birthweight questions on 14,411 livebirths were analysed and estimated adjusted odds ratios (aORs) associated with reporting weighing, birthweight and heaping reported. Twenty-eight focus group discussions with women and interviewers explored barriers and enablers to reporting birthweight. RESULTS: Almost all women provided responses to birthweight survey questions, taking on average 0.2 min to answer. Of all babies, 62.4% were weighed at birth, 53.8% reported birthweight and 21.1% provided health cards with recorded birthweight. High levels of heterogeneity were observed between sites. Home births and neonatal deaths were less likely to be weighed at birth (home births aOR 0.03(95%CI 0.02-0.03), neonatal deaths (aOR 0.19(95%CI 0.16-0.24)), and when weighed, actual birthweight was less likely to be known (aOR 0.44(95%CI 0.33-0.58), aOR 0.30(95%CI 0.22-0.41)) compared to facility births and post-neonatal survivors. Increased levels of maternal education were associated with increases in reporting weighing and knowing birthweight. Half of recorded birthweights were heaped on multiples of 500 g. Heaping was more common in IgangaMayuge (aOR 14.91(95%CI 11.37-19.55) and Dabat (aOR 14.25(95%CI 10.13-20.3) compared to Bandim. Recalled birthweights were more heaped than those recorded by card (aOR 2.59(95%CI 2.11-3.19)). A gap analysis showed large missed opportunity between facility birth and known birthweight, especially for neonatal deaths. Qualitative data suggested that knowing their baby's weight was perceived as valuable by women in all sites, but lack of measurement and poor communication, alongside social perceptions and spiritual beliefs surrounding birthweight, impacted women's ability to report birthweight. CONCLUSIONS: Substantial data gaps remain for birthweight data in household surveys, even amongst facility births. Improving the accuracy and recording of birthweights, and better communication with women, for example using health cards, could improve survey birthweight data availability and quality.

3.
BMC Psychol ; 9(1): 1, 2021 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-33388086

RESUMO

BACKGROUND: Adapting and translating already developed tools to different cultures is a complex process, but once done, it increases the validity of the construct to be measured. This study aimed to assess the 12 items WHODAS-2 and test its psychometric properties among road traffic injury victims in Ethiopia. This study aimed to translate the 12 items WHODAS- 2 interview-based tools into Amharic and examine the psychometric properties of the new version among road traffic injury victims. METHODS: The 12 items WHODAS 2 was first translated into Amharic by two experts. Back translation was done by two English experts. A group of experts reviewed the forward and backward translation. A total of 240 patients with road traffic injury completed the questionnaires at three selected Hospitals in Amhara Regional State. Internal consistency was; assessed using Chronbach's alpha, convergent, and divergent validity, which were; tested via factor analysis. Confirmatory factor analysis (CFA); was computed, and the model fit; was examined. RESULTS: The translated Amharic version 12 -items WHODAS-2 showed that good cross-cultural adaptation and internal consistency (Chronbach's α =0.88). The six factor structure best fits data (model fitness indices; CFI = 0.962, RMSEA = 0.042, RMR = 0.072, GFI = 0.961, chi-square value/degree of freedom = 1.42, TLI = 0.935 and PCLOSE = 0.68). Our analysis showed that from the six domains, mobility is the dominant factor explaining 95% of variability in disability. CONCLUSION: The 12 items interview-based Amharic version WHODAS-2; showed good cultural adaptation at three different settings of Amhara Regional State and can be used to measure dis-ability following a road traffic injury.


Assuntos
Atividades Cotidianas/psicologia , Pessoas com Deficiência/psicologia , Programas de Rastreamento/estatística & dados numéricos , Psicometria/estatística & dados numéricos , Inquéritos e Questionários/normas , Ferimentos e Lesões/psicologia , Adolescente , Adulto , Avaliação da Deficiência , Etiópia , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Traduções , Organização Mundial da Saúde , Adulto Jovem
4.
J Diabetes Res ; 2020: 9240398, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33299894

RESUMO

Background: Ethiopia is one of the sub-Saharan African countries with a rapidly increasing burden of diabetes mellitus (DM). There is limited updated information about the community-based burden of the disease and its associated factors in Ethiopia which is very crucial to plan effective prevention and control measures against the disease. This study is aimed at determining the burden of DM and its associated factors in urban northwest Ethiopia. Methods: A community-based cross-sectional study was conducted from April to May 2019 among residents aged ≥ 18 years in Gondar town and urban kebeles (lowest administrative units of the country) of Health and Demographic Surveillance System site (HDSS) in Dabat district. A multistage sampling technique was used to select 773 participants. World Health Organization (WHO) stepwise approach for noncommunicable disease surveillance was used to collect the data. Fasting blood glucose (FBS) ≥ 126 mg/dl was used to diagnose DM. Descriptive statistics were done to describe the variables of the study. Prevalence with its 95% confidence interval (CI) was estimated. Binary logistic regression model was fitted, variables with p value < 0.05 were considered to have a significant association with the outcome, and odds ratio (OR) was used to measure the strength of association. Result: Of the total participants, 6.34% (95% CI; 4.82, 8.29) were found to be diabetic. Of these, 40 (81.6%) were newly diagnosed. Besides, the prevalence of prediabetes was 9.31% (95% CI: 7.45, 11.58). Increased age (AOR = 1.06, 95% CI; 1.04, 1.09) and eating vegetables one to three days per week (AOR =0.29, 95% CI; 0.13, 0.65) were significantly associated with diabetes. Conclusion: The overall prevalence of DM is a bit higher than the national estimate, while the proportion of undiagnosed DM which can easily progress to disabling and life-threatening complications was alarmingly high. Age and frequency of eating vegetables per week were associated with diabetes. In light of this finding, future prevention and control measures against the diseases should consider the identified factors. There should also be improved access to screening services.

5.
Risk Manag Healthc Policy ; 13: 2835-2844, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33304111

RESUMO

Background: Community-based health insurance is an emerging strategy for providing financial protection against health-related poverty. They have developed into alternative health financing mechanisms for out-of-pocket expenses in low- and middle-income countries. Hence, the aim of this study was to assess the drop-out rate of community-based health insurance membership and associated factors in Dera district, Northwest Ethiopia, 2020. Methods: Through systematic random sampling techniques, a community-based cross-sectional study was conducted on 584 participants. A structured interviewer-based administered questionnaire was used for data collection. EpI data is used for data entry, while SPSS 20 version is used for analysis. P-value <0.2 binary logistic regression was entered into multivariable logistic regression. Variables with a P-value of <0.05 and a 95% confidence level were considered to be significantly associated with the outcome variable. Results: The CBHI dropout rate in the district is calculated to be 37.3% (95% CI: 34, 41%) in the district. Length of enrollment, ≥4 years in the CBHI program (AOR=0.39, 95% CI: 0.26, 0.59), households visit the health facilities 4-6 times a year (AOR=1.92, 95% CI: 1.10, 3.32), have no access to the hospital (AOR=1.68, 95% CI: 1.02, 2.77), knowledge of CBHI (AOR=1.93, 95% CI: 1.32, 2.82) and official position holder for decision-making in the households (AOR=2.07, 95% CI: 1.33, 3.23) were factors associated with CBHI dropout rate in the scheme. Conclusion: This finding confirmed that the CBHI dropout rate in the district was high. Length of enrollment, health facility visit, hospital accessibility, knowledge of CBHI, and official position holders used for decision-making are significantly associated with the CBHI dropout rate. Therefore, emphasis should be given on improving members' understanding of the CBHI package of benefits; increasing access to hospitals and empowering women will increase the utilization of CBHI. In addition, the quality of care for CBHI patients can be improved when they had access to health services.

6.
Int J Pediatr ; 2020: 3746354, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32952575

RESUMO

Background: The magnitude of food insecurity in Ethiopia ranges from 38.7% to 82.3% among the general population. Children under the age of five years were more prone to food insecurity and its serious consequences like anemia, low bone density, frequent episodes of common cold, stomachache, poor educational performance, and dental carries in developing countries like Ethiopia. However, there is no any research finding that documented the magnitude of child food insecurity, coping strategies, and associated factors in the study area. Therefore, the aim of this study was estimating the magnitude of child food insecurity, major coping strategies, and factors associated with child food insecurity in the study area. Methods: A community-based cross-sectional survey has been conducted in Dabat demographic and health surveillance site among 7152 mothers/caretakers of children under the age of five years. Data were collected by experienced data collectors working for the demographic and health surveillance site, and the collected data were entered into EpiData template and then transported to Stata 14 software for data cleaning and analysis. The ordinal logistic regression model was fitted to identify predictors for child food insecurity. Results: About 21.42% of children under the age of five years were food insecure in Dabat district of whom 57.8%, 38.6%, and 3.6% had experienced mild, moderate, and severe levels of child food insecurity, respectively. All most all 1391 (92%) of the mothers/caretakers of food insecure children had practiced food insecurity coping strategies. More than half (57%) of mothers/caretakers reduces the size of child meal as insecurity coping strategy. Child food insecurity was associated with household wealth status, parent's education status, and maternal and child health service utilization and child feeding practices. Conclusion: A large segment of under-five children had experienced food insecurity in Dabat district, and the major coping strategy for child food insecurity was reducing meal size. Therefore, working on household wealth improvement and expansion of basic health services would improve child food security.

7.
J Pregnancy ; 2020: 4318197, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32908704

RESUMO

Background: The maternity continuum of care is the continuity of maternal healthcare services that a woman uses, which includes antenatal care (ANC 4+), skill birth attendant (SBA), and postnatal care (PNC) within 48 hours of delivery. It is one of the essential strategies for reducing maternal and newborn mortality. This study aimed to assess the factors associated with the completion of a continuum of maternal healthcare services among mothers who gave birth in the past five years. Methods: A community-based cross-sectional study was conducted from May 01 to June 29, 2019, among 565 randomly selected mothers who gave birth in five years before the study in primary healthcare project implementation districts of north Gondar zone, Amhara National Regional State, Ethiopia. Bivariable and multivariable logistic regression analysis were computed, and in the multivariable logistic regression analysis, adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p value of less than 0.05 were used to identify the associated factors with completion of the continuum of maternal healthcare services. Results: The study revealed that the overall completion of the continuum of maternal healthcare services was 21.60% (95% CI: 18.20, 24.90). Women who were able to read and write (AOR: 2.70, 95% CI: 1.22, 6.04), using car/motorcycle as a means of transportation to get the health facility (AOR: 5.59, 95% CI: 2.29, 9.50), travel time less than an hour to get the health facility (AOR: 4.98, 95% CI: 2.97, 8.38), being satisfied with the service delivery (AOR: 1.89, 95% CI: 1.15, 3.11), and getting health education on maternal healthcare services in the last 6 months (AOR: 2.77, 95% CI: 1.52, 5.05) were factors associated with the completion of the continuum of maternal healthcare services. Conclusions: The completion of the continuum of maternal healthcare services was relatively low, indicating that women were not getting the likely health benefit from the present health services. Therefore, interventions should focus on increasing women's awareness, improving the availability of services at nearby health facilities, and improving service delivery by considering women's preferences and needs to increase their satisfaction are essential to increase the completion of maternal healthcare services.


Assuntos
Assistência à Saúde , Acesso aos Serviços de Saúde , Serviços de Saúde Materna/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Atenção Primária à Saúde , Adolescente , Adulto , Conscientização , Estudos Transversais , Etiópia/epidemiologia , Feminino , Educação em Saúde , Instalações de Saúde , Humanos , Pessoa de Meia-Idade , Satisfação do Paciente , Cuidado Pós-Natal , Gravidez , Cuidado Pré-Natal , Adulto Jovem
8.
BMC Pregnancy Childbirth ; 20(1): 432, 2020 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-32727403

RESUMO

BACKGROUND: Perinatal mortality remains a problem in Ethiopia. Findings of primary studies varied on level of perinatal mortality and its predictors including inter-pregnancy interval. The aim of this review was to estimate the pooled perinatal mortality rate, its trend overtime and verify the association with inter-pregnancy interval in Ethiopian context. METHODS: Studies were accessed through the electronic web-based search strategies from PubMed, ScienceDirect, Hinari for health via Research4Life, Google and Advanced Google search, and retrieving via relevant references using a combination of medical subject headings (MeSH terms) and key words related with inter-pregnancy interval. R version 3.4.3 software was used for the meta-analysis. A forest plot and I2 test were done to assess heterogeneity. Sensitivity analysis and subgroup analysis were done to deal with heterogeneity. A weighted inverse variance random-effects model was applied to estimate pooled effect sizes. A funnel plot and Egger's regression test were done to check publication bias. RESULTS: A total of 34 studies used to answer review questions (30 for perinatal mortality rate and its trend estimation from 1997 to 2019 and 8 for its relationship with inter-pregnancy interval). The pooled perinatal mortality rate was 51.3 per 1000 total births (95% CI: 40.8-62.8). The pooled stillbirth rate was 36.9 per 1000 births (95% CI: 27.3-47.8) and early neonatal mortality rate was 29.5 per 1000 live births (95% CI: 23.9-35.6). Increasing trend was seen in stillbirth rate (23.7 to 36.9 per 1000 births) while decreasing trend in early neonatal mortality rate (51 to 29.5 per 1000 live births). Slight reduction trend was observed in overall perinatal mortality rate (66 to 51.3 per 1000 births). An inter-pregnancy interval less than 15 months was found to be statistically significantly associated with perinatal mortality; pooled OR = 2.76 (95% CI: 2.1-3.62). Spacing pregnancy for at least 15 months was related with reducing perinatal mortality by 64% (95% CI: 52.38, 72.38%). CONCLUSIONS: In Ethiopia, perinatal mortality rate remains high. Insignificant reduction trend was observed in overall perinatal mortality rate. Counseling couples about the importance of spacing pregnancy and intensifying long-acting contraceptive use will help in reducing perinatal mortality related to poor pregnancy spacing.

9.
Acta Paediatr ; 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32478446

RESUMO

AIM: Ethiopia has implemented the integrated community case management to reduce mortality in childhood diseases. We analysed prevention, care seeking and treatment of suspected pneumonia from household to health facility in Ethiopia. METHODS: Analyses were based on a survey in four regions that included modules covering 5714 households, 169 health posts with 276 health extension workers and 155 health centres with 175 staff. Caregivers of children aged 2-59 months responded to questions on awareness of services and care seeking for suspected pneumonia. Pneumonia-related knowledge of health workers was assessed. RESULTS: When a child had suspected pneumonia, 46% (95% CI: 25,68) sought care at health facilities, and 27% (95% CI: 12,51) received antibiotics. Forty-one per cent had received full immunisation. One-fifth (21%, 95%: 19,22) of the caregivers were aware of pneumonia treatment. Sixty-four per cent of the health extension workers correctly mentioned fast or difficult breathing as signs of suspected pneumonia, and 88% suggested antibiotics treatment. CONCLUSION: The caregivers' awareness of suspected pneumonia treatment and the utilisation of these services were low. Some of the health extension workers were not knowledgeable about suspected pneumonia. Strengthening primary health care, including immunisation, and enhancing the utilisation of services are critical for further reduction of pneumonia mortality.

10.
BMC Womens Health ; 20(1): 67, 2020 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-32245462

RESUMO

BACKGROUND: Contraceptive utilization is a guarantee to avert unwanted pregnancies. In Ethiopia however, more than half of the rural women have shorter birth intervals. Consequently, 17 and 8% of the births have been either mistimed (wanted at later date) or unwanted, respectively. Therefore, this study investigated modern contraceptive utilization and its predictors among rural lactating women. METHODS: A community based-cross-sectional study was conducted from May 01 to June 29, 2019, in Dabat and Gondar zuria districts, northwest Ethiopia. Data from 603 lactating mother were collected through face to face interviews using a structured questionnaire. Bivariate and multivariate logistic regression analyses were fitted to identify the independent predictors of modern contraceptive utilization. RESULTS: The overall prevalence of modern contraceptive (MC) utilization rate was 45.8% [95% CI: 38.01, 53.59]. The contraceptive method mix was dominated by Depo-Provera (39.8%) followed by implants (4.8%). The odds of utilization of contraceptive were 5.58 times higher among mothers of children with fully immunized [AOR = 5.58, 95% CI: 3.45, 9.01] compared to mothers whose children were vaccinated partially or not at all. Mothers who received antenatal [AOR = 1.74, 95% CI: 1.13, 4.43] and postnatal care [AOR = 2.02, 95%CI: 1.24, 2.91) were 1.74 and 2.02 folds more likely to utilize modern contraceptives than mothers who did not receive such care, respectively. CONCLUSION: The prevalence of modern contraceptive utilization in this study area was lower than the planed national target. In the region, child immunization service is one of the promising platforms for reaching lactating mothers with modern contraceptive utilization. Our findings suggest that antenatal and postnatal care visits are the other key determinants of modern contraceptive utilization. Thus, in low-resource settings like ours, the health system approaches to improved antenatal and, postnatal care and child immunization services should be intensified with more effective advice on modern contraceptive utilization to reduce unwanted pregnancies.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepcionais/administração & dosagem , Serviços de Planejamento Familiar/estatística & dados numéricos , Lactação/fisiologia , Mães/psicologia , Adulto , Comportamento Contraceptivo/etnologia , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Gravidez , Prevalência , Atenção Primária à Saúde , População Rural
11.
Am J Trop Med Hyg ; 102(2): 458-467, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31837131

RESUMO

Household water treatment including solar disinfection (SODIS) is recognized worldwide as an important intervention for prevention and control of diarrheal and other waterborne diseases. However, in Ethiopia's countryside, SODIS is not being practiced. Therefore, the objective of this qualitative study conducted in villages of Dabat district in northwest Ethiopia was to explore barriers to and enabling factors for consistent and wider implementation of SODIS. This phenomenological study design included four focus group discussions with 25 parents of children younger than 5 years and interviews with four key informants to elicit their experiences and opinions. ATLAS.ti 8.0 software (GmbH, Berlin, Germany) was used for data organization, and the content was analyzed thematically. Enabling factors were categorized into four themes, such as supportive values for SODIS (positive attitude, advantage of SODIS, and cultural acceptance of SODIS), consistent use of SODIS (community's interest, health education, availability of bright sunlight, and simplicity of the method), participation of family and community in daily implementation of the SODIS process (controlling theft of bottles and recognizing the importance of SODIS technology), and willingness to pay for new polyethylene terephthalate (PET) bottles. On the other hand, barriers were grouped into three themes such as sociocultural (poor knowledge, hesitation to leave SODIS bottles unguarded outdoor, less attention, and unplanned social events), environmental (cloud, shadow over SODIS bottles, turbidity and leeches in source water, and geographical settings), and behavioral (mishandling of SODIS bottles and drinking water). The analysis of the data revealed that all the participants had positive attitude toward the implementation of SODIS, and it was culturally accepted. They identified the barriers to and enabling factors for the implementation of SODIS. Promoting enabling factors and mitigating barriers are substantially important for consistent implementation of SODIS as a long-term interventional measure widely in rural Ethiopia for the achievement of the goal of safe drinking water for all.


Assuntos
Desinfecção/métodos , Água Potável , Características da Família , Luz Solar , Purificação da Água/métodos , Adulto , Desinfecção/economia , Desinfecção/instrumentação , Etiópia , Feminino , Humanos , Masculino , População Rural , Microbiologia da Água , Purificação da Água/economia , Purificação da Água/instrumentação , Abastecimento de Água , Doenças Transmitidas pela Água/prevenção & controle
12.
BMC Health Serv Res ; 19(1): 869, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752821

RESUMO

BACKGROUND: Knowing the factors for patient satisfaction is an important and direct indicator of quality of health care which is essential for providers to fill their gaps. Although few studies have been conducted on patient satisfaction in Ethiopia; but there is limited evidence for comparing patient satisfaction and associated factors in the public and private wing of the health services. Thus, this study aimed to investigate factors of patient satisfaction in adult outpatient departments in the private wing and regular services at public hospitals of Addis Ababa, Ethiopia. METHODS: A comparative institution based cross-sectional study was conducted from March to April 2018. A total of 955 systematically selected patients were interviewed by using an interviewer-administered structured questionnaire. Binary logistic regression analysis was performed. In the multivariable logistic regression analysis p value < 0.05 and adjusted odd ratio (AOR) with 95% confidence interval (CI) were used to identify the associated factors. RESULTS: The overall patient satisfaction was 89.3% (95% CI: 87.2-91.2). At the regular and private wings of outpatient departments it was 88.3% (95% CI: 85.4-91.2) and 90.4% (95% CI: 87.6-93), respectively. At regular service OPD, patient satisfaction was affected by female sex (AOR: 7.78; 95% CI: 2.89-20.93), long waiting time (AOR: 0.22; 95% CI: 0.07-0.73), information on the prevention of recurrent illnesses (AOR: 14.16; 95% CI: 4.58-43.83), and information on drug use and side effects (AOR: 0.22; 95% CI: 0.08-0.63). In private wing, it was affected by being in the age group of 38 to 47 years (AOR: 22.1; 95% CI: 2.39-203.6), attended elementary school (AOR: 4.69; 95% CI: 1.04-21.26), availability of drugs (AOR: 0.14; 95% CI: 0.04-0.58), and the accessibility of latrines (AOR: 6.56; 95% CI: 1.16-37.11). CONCLUSIONS: Patient satisfaction at the private wing and regular adult OPDs' of public hospitals had no statistically significant difference. Female sex and information on the prevention of recurrent illnesses were factors positively affected patient satisfaction at regular services, whereas at private wing OPDs' age, attended elementary school, and accessibility of latrines were factors that positively affected patient satisfaction.


Assuntos
Hospitais Públicos/organização & administração , Ambulatório Hospitalar/organização & administração , Satisfação do Paciente/estatística & dados numéricos , Adulto , Estudos Transversais , Etiópia , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Masculino
13.
BMC Pediatr ; 19(1): 304, 2019 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477091

RESUMO

BACKGROUND: A Shortage or excessive intake of the nutrient is malnutrition; affecting every aspect of human beings. Malnutrition at childhood has long-lasting and multiple effects. In Ethiopia significant numbers of children were suffering from malnutrition that might be associated with parents' food preference; the fact not yet investigated. Therefore the aim of this study was to assess parents' food preferences and its implication for child malnutrition. METHODS: The study was conducted among 7150 mothers/caretakers in Dabat demographic and health surveillance site. Data were collected by experienced data collectors working for the surveillance centers after extensive training. A multinomial logistic regression model was fitted to determine the effect of factors on the dependent variable and model fitness was checked using a likelihood ratio test. RESULTS: About 62.55% of mothers/caretakers prefer to feed children with a family and 16.45% of them prefer to feed children with a specific type of food. Mothers/caretakers who introduce semisolid food after 6 months 2.34(1.50-3.96) were times more likely prefer to feed with family food for their children than a balanced diet. Regarding the specific type of food preference mothers who introduce semisolid food after 6 months and those obtain food from the market were 6.53(3.80-11.24) and 4.38(3.45-5.56) times more likely to prefer to feed specific types of than balanced diet respectively. CONCLUSION: Food preference had contributed to the increased and persistent magnitude of child malnutrition as 62.55% of mothers prefer to feed children with family and only 21% of them prefer to feed a balanced diet for under-five children. Therefore we recommended integration of child dietary diversity, acceptability and safety counseling session for mothers visiting health institutions for child vaccination, ANC and PNC services.


Assuntos
Cuidadores/estatística & dados numéricos , Transtornos da Nutrição Infantil/etiologia , Preferências Alimentares , Mães/estatística & dados numéricos , Pais , Transtornos da Nutrição Infantil/epidemiologia , Pré-Escolar , Estudos Transversais , Escolaridade , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Alimentos Infantis , Modelos Logísticos , Masculino , Vigilância da População , Religião
14.
BMC Health Serv Res ; 19(1): 544, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375108

RESUMO

BACKGROUND: In most developing countries, healthcare cost is mainly paid at the time of sickness and out-of-pocket at the point of service delivery which potentially could inhibit access. The total economic cost of illness for households is also estimated to be frequently above 10% of household income which is categorized as catastrophic. The purpose of this study was to assess factors that determine decisions to join the community based health insurance in West Gojjam zone. METHODS: A community based cross sectional survey was conducted to collect data from 690 household heads using a multistage sampling technique. A binary logistic regression was used to identify the determinants of household decisions for CBHI enrollment. RESULTS: Out of the participants, 58% were CBHI members. Besides, family size (AOR = 1.17; CI = 1.02-1.35), average health status (AOR = .380; CI = .179-.805), chronic disease (AOR = 3.42; CI = 1.89-6.19); scheme benefit package adequacy (AOR = 2.17; CI = 1.20-3.93), perceived health service quality (AOR = 3.69; CI = 1.77-7.69), CBHI awareness (AOR = 4.90; CI = 1.65-14.4); community solidarity (AOR = 3.77; CI = 2.05-6.92) and wealth (AOR = 3.62; CI = 1.67-7.83) were significant determinant factors for enrolment in the community based health insurance scheme. CONCLUSION: CBHI awareness, family health status, community solidarity, quality of service of health institutions, and wealth were major factors that most determine the household decisions to enroll in the system. Therefore, in-depth and sustainable awareness creation programs on the scheme; stratified premium- based on economic status of households; incorporation of social capital factors, particularly building community solidarity in the scheme implementation are vital to enhance sustainable enrollment. As perceived family health status and the existence of chronic disease were also found significant determinants of enrollment, the Government might have to look for options to make the scheme mandatory.


Assuntos
Seguro Saúde/estatística & dados numéricos , Saúde Pública , Adulto , Comportamento do Consumidor/estatística & dados numéricos , Estudos Transversais , Assistência à Saúde/economia , Etiópia , Feminino , Humanos , Seguro Saúde/economia , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto Jovem
15.
Ecol Food Nutr ; 58(5): 481-494, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31271301

RESUMO

Under nutrition among adolescents is a major public health problem in Ethiopia and its causes are under investigated. Therefore, this study aimed to assess the prevalence of stunting and its determinants among adolescent girls in Dabat district. A total of 1556 adolescent girls were included in the study. The WHO's Anthro-plus software was used to generate the height for age z-scores. Variables having a p-value<0.2 in the simple logistic regression were entered into multiple logistic regression and a p-value < 0.05 were considered statistically significant. About 47.4%(95%CI; 45.0, 49.6%) of adolescent girls were stunted. Being in the early (AOR = 0.027, 95%CI: 0.08, 0.09) and middle age (AOR = 0.21, 95%CI: 0.06, 0.71) were less likely to be stunted compared with the late adolescent. The odds of stunting were found to be higher among adolescent of rural area (AOR = 1.45; 95%CI: 1.01, 2.10) and from household food in-secured (AOR = 1.33; 95%CI: 1.02, 1.73)families. Higher numbers of adolescent girls are stunted in Dabat district, suggesting severe public health importance of the problem. Age, residence and food security were associated with adolescent stunting. Thus, improving food security strategies targeting rural and food insecure households is recommended. Abbreviations: AOR= Adjusted Odd Ratio,CI= Confidence Interval, COR= Crude Odd Ratio, ENSSPI=Establishing Nutrition Surveillance System and Piloting Interventions HAZ=Height for Age, HDSS=Health and Demographic Surveillance System, HFSS=Household Food Security Status, INDEPTH=International Network of Demographic Evaluation of Population and Their Health, IQR=Inter Quartile Range, NNP=National Nutrition Program, NSHFP=National School Health and Feeding Program, SPSS=Statically Package for Social Science, WHO= World Health Organization.


Assuntos
Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Adolescente , Criança , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Estado Nutricional , Vigilância da População , Prevalência , Fatores de Risco , População Rural , Fatores Socioeconômicos
16.
Environ Health Prev Med ; 24(1): 43, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31189467

RESUMO

BACKGROUND: Failure to provide adequate sanitation services to all people is perhaps the greatest development failure. Globally, billions of people have no access to improved sanitation facilities. Though the link between sanitation and childhood morbidities is established globally, the evidence is limited in rural parts of Ethiopia. This survey was, therefore, designed to determine the prevalence of common childhood morbidities and to identify sanitation predictors in rural parts of northwest Ethiopia. METHODS: A re-census reconciliation, which is a cross-sectional design, was employed from October to December 2014. All households found in the research and demographic sites were included as study subjects. A questionnaire and an observational checklist were used to collect data. Households' sanitation performances, house type, illumination, household energy sources, water supply, and waste management were assessed. The occurrence of childhood morbidities was determined from the occurrence of one or more water, sanitation, and hygiene (WASH) preventable diseases. Multivariable binary logistic regression analysis was done to identify the association of sanitation factors with childhood morbidities on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05. RESULTS: About 575 (7.00%) of under-five children had hygiene- and sanitation-related diseases. Gastrointestinal and respiratory health problems accounted for 287 (49.91%) and 288 (50.09%), respectively. Childhood morbidities among under-five children were associated with poor housing condition [AOR = 1.27, 95% CI = (1.04, 1.54)], dirty cooking energy sources [AOR = 1.52, 95% CI = (1.22, 1.89)], volume of water below 20 l/p/d [AOR = 1.95, 95% CI = (1.19, 3.18)], and narrow-mouthed water storage containers [AOR = 0.73, 95% CI = (0.56, 0.96)]. CONCLUSION: A significant proportion of under-five children had childhood morbidities in the study area. Housing condition, cooking energy sources, volume of water collected, and type of water storage containers were factors associated with the occurrence of childhood morbidities. Enabling the community to have the access to a safe and continuous supply of water and proper disposal of wastes, including excreta, is necessary with particular emphasis to the rural communities and semi-urban areas to reduce the occurrence of childhood morbidities.


Assuntos
Morbidade , População Rural/estatística & dados numéricos , Saneamento/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Fatores de Risco
17.
Arch Public Health ; 76: 56, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30305899

RESUMO

Background: Food insecurity is a global problem affecting many people worldwide, including approximately 220 million people in sub-Saharan Africa. Ethiopia is among the countries severely affected by hunger. However, evidence on how populations within Ethiopia cope with hunger and food insecurity is limited. This study aimed to identify household coping mechanisms in response to food insecurity at a Dabat Health and Demographic Surveillance System site. Methods: This study used data from a re-census collected between October 2014 and December 2014.15,159 household members in thirteen kebeles of the Dabat Health and Demographic surveillance system were included. The outcome variables of the study were food insecurity and coping strategies. Household Food Insecurity Access Scale (HFIAS) was used to assess food insecurity. If food insecurity was found, families were asked about coping mechanisms used. Binary logistic regression analysis was applied to identify socio-demographic determinants of reducing amount and frequency of meal as a coping mechanism in response to food insecurity. Result: Of the 15,159 households surveyed, 6671 (44.01%) reported the presence of a food insecurity in their household. Decreasing meal frequency and portions (3733 (55.96%)), borrowing money and food (2542 (38.11%)), and receiving food and money aid (1779 (26.67%)) were among the major coping strategies used by the households. Urban dwellers (AOR 2.07: 95% CI 1.74, 2.46), mid-altitude (weyina-dega) and high-land (dega) dwellers (AOR 2.46: 95% CI 2.08, 2.92 and AOR 1.22 95% CI 1.08, 1.38 respectively), and not married persons (AOR 1.60: 95% CI 1.07, 2.39) were more likely to consume less when faced with a food insecurity (using reducing amount and frequency of meal as a coping strategy). Conclusion: Households in the study area experienced a very high rate of food insecurity. Decreasing meal frequency and portions was the primary coping mechanism used by the households. Due to the severe insecurity of food in their household, many people chose to reduce the amount and frequency of their meal in order to prolong the small amount of food in their house. This finding indicates a high risk for undernourishment which can exacerbate the burden of malnutrition and related diseases in the region.

18.
BMC Res Notes ; 11(1): 593, 2018 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-30115114

RESUMO

OBJECTIVES: Appropriate complementary feeding is vital to reduce young child morbidity and mortality. However, it continues as sub-optimal in Ethiopia, and literatures are also scarce. Therefore, this study aimed to determine timely initiation of complementary feeding and associated factors among mothers with children aged 6-24 months in the rural population of northwest Ethiopia. In the community based cross-sectional study, data on child feeding practices, individual and household characteristics were collected in Dabat Demographic Surveillance System site, Dabat District, northwest Ethiopia from 01 May to 29 June 2015. The bivariate and backward stepwise multivariable statistical methods were carried out to identify factors associated with timely initiation of complementary feeding. RESULTS: About 53.8% [95% CI 45.9, 61.7] and 4.6% [95% CI 1.3, 7.9] of children were found with timely initiation of complementary feeding and had minimum dietary diversity, respectively. The odds of timely initiation of complementary feeding was higher among mothers with medium [AOR = 2.34, 95% CI 1.54, 3.81] and high [AOR = 2.10, 95% CI 1.41, 3.87] mother's IYCF knowledge. In Dabat district, complementary feeding practice is lower. Thus, efforts should be strengthened to boost mother's IYCF knowledge.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Fenômenos Fisiológicos da Nutrição do Lactente , População Rural , Estudos Transversais , Etiópia , Feminino , Humanos , Lactente , Mães
19.
Trials ; 19(1): 412, 2018 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-30064489

RESUMO

BACKGROUND: Solar Disinfection (SODIS) of water is an economical, user-friendly, and environmentally safe household water treatment method that has been advocated as a means of decreasing the burden of diarrhea among children under 5 years of age. Laboratory studies have consistently shown the efficacy of the SODIS method to destroy waterborne pathogens. However, the evidence-based health effect of a SODIS intervention at the household level is limited. The main aim of the study was to examine the effectiveness of a SODIS intervention in reducing the incidence of diarrhea among under-five children. METHODS: A community-based, cluster randomized controlled trial was conducted, over 6 months from 10 January to 7 July 2016, in 28 rural villages of northwest Ethiopia. In the intervention group, 384 children in 279 households received polyethylene terephthalate (PET) bottles, and in the control group 394 children in 289 households who continued to use their usual drinking-water sources were included in the trial. The study compared diarrheal incidence among the intervention group children who were exposed to SODIS household water treatment and the control group children who were not exposed to such water treatment. A generalized estimating equation (GEE) model was used to compute the adjusted incidence rate ratio and the corresponding 95% confidence interval. RESULTS: In this trial, the overall SODIS compliance was 90.6%. The incidence of diarrhea was 8.3 episodes/100 person-week observations in the intervention group compared to 15.3 episodes/100 person-week observations in the control group. A statistically significant reduction was observed in the incidence of diarrhea in the intervention group compared to the control (adjusted IRR 0.60 (95% CI 0.52, 0.70) with a corresponding prevention of 40% (95% CI: 34, 48). CONCLUSION: The SODIS intervention substantially reduced the incidence of diarrhea among under-five children in a rural community of northwest Ethiopia. This indicates that a SODIS intervention is an invaluable strategy that needs to be integrated with the National Health Extension Program to be addressed to rural communities. TRIAL REGISTRATION: Clinical Trial Registry India, ID: CTRI/2017/09/009640 . Registered retrospectively on 5 September 2017.


Assuntos
Diarreia/prevenção & controle , Desinfecção/métodos , Habitação , Saúde da População Rural , Energia Solar , Microbiologia da Água , Purificação da Água/métodos , Abastecimento de Água , Distribuição por Idade , Pré-Escolar , Diarreia/diagnóstico , Diarreia/epidemiologia , Diarreia/microbiologia , Etiópia/epidemiologia , Feminino , Humanos , Incidência , Lactente , Masculino , Fatores de Proteção , Fatores de Risco , Fatores de Tempo
20.
BMC Womens Health ; 18(1): 118, 2018 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-29970089

RESUMO

BACKGROUND: Despite the enormous benefits of family planning services, the contraceptive utilization still remains low in Sub-Saharan Africa. There is regional variation in modern contraceptive utilization in Ethiopia. Therefore, this study was aimed to determine the prevalence of modern contraceptive utilization and determinants in Dabat demographic and health surveillance system site, northwest Ethiopia. METHODS: A re-census was carried out in Dabat Health and Demographic Surveillance System (HDSS) site from October to December 2014. Data of 8271 married women collected in the re-census was used. The outcome variable was current utilization of any modern contraceptive methods whereas socio demographic and economic variables were the potential determinants considered. Bi-variable and multivariable binary logistic regression along with odds ratio and 95% confidence interval were used to describe the strength of association. RESULTS: Prevalence of modern contraceptive utilization among married women in Dabat DHSS site was found to be 32.5% (95%CI: 31.5, 33.5%). After adjusting for covariates; the odds of using modern contraceptive were 2.35 times, 1.91 times, and 1.39 times higher among women of secondary and above educational level, urban residents, and women having six and above living children, respectively. CONCLUSION: Modern contraceptive utilization was found to be very low. Effort has to be applied to improve women's educational level that increases their understanding of reproductive health issues. It is also important to give special emphasis for rural residents, those aged 20-40 years, and those with six or more living children while serving for modern contraceptive methods.


Assuntos
Comportamento Contraceptivo/psicologia , Anticoncepção/psicologia , Anticoncepcionais/uso terapêutico , Características Culturais , Casamento , Adolescente , Adulto , Criança , Anticoncepção/métodos , Comportamento Contraceptivo/estatística & dados numéricos , Estudos Transversais , Etiópia/epidemiologia , Serviços de Planejamento Familiar , Feminino , Humanos , Modelos Logísticos , Razão de Chances , Prevalência , População Rural/estatística & dados numéricos , Adulto Jovem
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