Dessalegn Tamiru

The Emerging Nutritional Problems of School Adolescents: Overweight/Obesity and Associated Factors in Jimma Town, Ethiopia

Background: Globally, overweight is rapidly becoming one of the most important medical and public health problems. Adolescent obesity is a multisystem disease with potentially devastating consequences that persist into adulthood. However, there is a paucity of available information regarding the adolescent overweight and obesity in Ethiopia, particularly in the study area. Methods: A school‐based cross‐sectional study was conducted from March to April/2015 among 546 adolescents. Study participants were selected using a multi‐stage, stratified random sampling method. An interviewer administered questionnaire was used to collect data. Multivariable logistic regression analysis was used to identify independent predictors of overweight and obesity at 95% confidence intervals. Results: The mean dietary diversity score of school adolescents was 6.97 ± 1.15. Cereal based diets (99.6%) and vegetables (73.9%) are the two common foods of adolescents. The prevalence of overweight/obesity was 13.3%. Overweight/Obesity was significantly associated with being a female (AOR = 3.57 [95% CI:1.28–9.9]), attending private schools (AOR = 7.53 [2.51–22.3]), lack of paternal education (AOR = 5.57 [95% CI:1.53–20.26]), wealthy households (AOR = 3 [95% CI:1.09–8.26]) and not being a vegetarian (AOR = 9.23 [95% CI:1.68–50.8]). Adolescents who are physically inactive (AOR = 3.7 [95% CI:1.06–13.02]) and those with sedentary lifestyles (AOR = 3.64 [95% CI:1.39–9.5]) were more obese compared to their counter peers. Conclusions: The proportion of overweight/obesity among school adolescent was considerably high. Being a female, learning in private school, high household economic status, not being a vegetarian and having a sedentary life were significantly associated with overweight/obesity. Practice implications: Findings of this study can be used to guide the development of programs aimed at preventing overweight/obesity in Ethiopia by informing policymakers and other stakeholders about this emerging nutrition‐related problem among school adolescents.

Constraints to the optimal breastfeeding practices of breastfeeding mothers in the rural communities of Arba Minch Zuria Woreda, Ethiopia: a community-based, cross-sectional study

Abstract Objective: The aim of this study was to identify the constraints and factors associated with breastfeeding practices. Design: This was a community-based, cross-sectional study. Subjects and setting: Three hundred and eighty-four breastfeeding mothers of infants aged two years and younger were randomly selected from rural communities in Arba Minch Zuria Woreda. Outcome measures: Data were collected using structured questionnaires, and from using an observation checklist and in-depth interviews. Quantitative data from binary logistic regression were used to determine the strength of association between the independent and dependent variables using odds ratios and 95% confidence intervals. Multivariate logistic regression analysis was employed to identify predictors of the delayed initiation of breastfeeding and non-exclusive breastfeeding practices. Results: Breastfeeding is considered to be a natural gift from God in Arba Minch Zuria Woreda. The delayed initiation therefof was common in this study. Only 57% of the mothers initiated breastfeeding within an hour of delivery. Some women rejected their colostrum as they considered it to be an expired substance capable of causing abdominal pain to their infants. The delayed initiation of breasfeeding was positively associated with a lack of education and failure to attend health education sessions. Thirty-one per cent of the mothers did not exclusively breastfeed their infant up to six months of age months. Non-exclusive breastfeeding was significantly associated with having a radio, attending antenatal care and attending health education. Conclusion: The promotion of strong community-based networks tp ensure optimal infant and young child feeding is recommended through both governmental and non-governmental organisations.

Optimal dietary practices and nutritional knowledge of school adolescent girls in Jimma Town, South West Ethiopia

Abstract Addressing the nutritional problems of adolescent girls is important as their nutritional status has a negative effect on the future generation. This study aimed to assess the optimal dietary practices and nutritional knowledge of school adolescent girls in Jimma Zone, South-west Ethiopia. School-based cross-sectional study was conducted among 455 school adolescent girls. Multivariable logistic regression was used to identify independent variables. Majority (61.3%) of students had dietary diversity score less than five and their mean (±SD) dietary diversity score was 4.34 ± 1.41. The majority (55.8%) of adolescent girls had a good knowledge score about nutrition related information which they earned from the school (86.6%). Low dietary diversity of school adolescent girls was positively associated with attending government schools, lack of maternal education and low-economic status. Therefore, both government and non-government organizations need to focus on school and community based nutrition intervention to address the low dietary diversity of school girl adolescents.

Effect of integrated school-based nutrition education on optimal dietary practices and nutritional status of school adolescents in Southwest of Ethiopia: a quasi-experimental study

Abstract Background: Malnutrition and infection are major barriers to educational access and achievement in low-income countries and also work in conjunction with each other in deteriorating wellness and productivity of school adolescents. Methods: A quasi-experimental design was used to evaluate the effectiveness of school-based nutrition education using a peer-led approach, health promotion through school media and health clubs. Data were collected at baseline, midline and end line from sampled participants. To account for the effect of time trend, the difference was measured using a repeated measure analysis. Variables that have p≤0.25 in the bivariate analyses were entered into multivariables to determine the independent effect of interventions. Results: There is a significant difference in food variety between food secure and insecure households (p<0.01). A significant improvement of animal source dietary intake was observed among intervention schools (p<0.001) that was significantly associated with an intervention [adjusted odds ratio (AOR)=0.26, confidence interval (CI): 0.16, 0.42], male gender (AOR=0.48, CI: 0.31, 0.73) and household economic status (AOR=1.69, CI: 1.01, 2.84). The control group had high body mass index (BMI) at baseline, but a significant improvement was observed among the intervention schools, which positively associated with male gender (AOR=4.13, CI: 2.38, 7.15) and having a middle-income family (AOR=2.93, CI: 1.92, 6.15). Conclusion: This study showed that by integrating a dietary intervention into school-based activities, there might be significant improvements in dietary intake of primary school adolescents. Therefore, school-based nutrition education programs should be a part of comprehensive school health programs to reach the students and potentially their families.

Food Insecurity and Its Association With School Absenteeism Among Rural School Adolescents in Jimma Zone, Ethiopia

Studies showed that poor health and nutrition among school adolescents are major barriers to educational access and achievements in low-income countries. This school-based study was aimed to assess the association of school absenteeism and food insecurity among rural school adolescents from grades 5 to 8 in Jimma zone, Ethiopia. Regression analyses were used to see the strength of association between dependent and independent variables using odds ratio and 95% confidence intervals. Multivariable logistic regression analysis was used to identify the predictor of school absenteeism. Validated tools are used to collect household food insecurity data. Results showed that school absenteeism is significantly high among adolescents from food insecure households when compared to adolescents from food secure households (P <.001). School absenteeism was negatively associated with male sex (adjusted odds ratio [AOR] = −0.91, 95% CI −1.85 to −0.03), household food security (adjusted odds ratio = −1.85, 95% CI −3.11 to −0.59), being an elder sibling (AOR = −0.37, 95% CI, −0.62 to −0.12), and mother involvement in decision making (AOR = −0.68, 95% CI, −1.33 to −0.03) while male-headed household was positively associated (AOR = 2.46, 95% CI, 1.37 to 4.56). Generally, this study showed that household food insecurity has significant contribution to school absenteeism among rural adolescents. Therefore, efforts should be made to improve household income earning capacity to reduce the prevalence of school absenteeism among rural school adolescents.

Validation of Health Extension Workers Job Motivation Scale in Gamo-Gofa Zone, Southern Ethiopia: A Cross-Sectional Study

Introduction. Well-trained and highly motivated community health workers are critical for delivery of community-based health care services. Understanding what motivates especially community health care providers for better community health requires the use of psychometrically reliable and valid scale. This study was conducted to validate job motivation scale in Gamo Gofa Zone, Southern Ethiopia. Methods. A cross-sectional study was conducted in 150 health care posts in Gamo Gofa Zone, from February 01, 2013, to March 01, 2013. A total of 301 participants responded to questionnaires asking about sociodemographic characteristics and job motivation. Exploratory factor analysis with principal component extraction and varimax with Kaiser Normalization rotation were employed to develop scales for job motivation. Eigenvalues greater than 1 were used as criterion of extraction. Items with item factor loadings less than 0.4 and double loaded items were dropped. Alpha and exploratory factor analyses were examined to test reliability and validity of the scale. Results. During exploratory factor analysis eight factors emerged from the three dimensions of job motivation scale, namely, educational career, workload, financial incentive, supervisor encouragement, community recognition, access to infrastructure, living condition, and better achievement in work. The factor loadings of the items in each dimension ranged from 0.58 to 0.83. Crobachs alpha of the scales ranged from 0.79 to 0.90. To check validities of the scales developed in this study, the previous studies conducted to develop job motivation scale were used. Conclusion. Although the present scale has the potential to measure the job motivation of health extension workers and it is low in cost and easy to administer and analyze, it should be field-tested at different settings.

Dietary Patterns and Anthropometric Status of Under-Five Children in Arba Minch Zuria, Gamo Gofa Zone: Community-Based Cross-Sectional Study

Background: Malnutrition continues to be a major public health problem in developing countries. The problem is very significant among infant and young children. Although malnutrition is remarkably responsible for childhood death, the contributing factors are not well studied in the study area. Therefore, this study aimed to assess dietary patterns and anthropometric status of under-five children in Arba Minch Zuria, Gamo Goffa Zone, Southern Ethiopia. Methods: This cross-sectional study was conducted on child-mother-pairs in Arba Minch Zuria from February- July, 2012. Quantitative data were obtained from sample of 762 respondents by using pretested questionnaires and observational checklists. Qualitative data were collected by using in-depth interviews with tape recorder. Sociodemographic status, maternal and child characteristics, child feeding practices, anthropometry and dietary diversity were assessed. Results: Breastfeeding is considered as natural gift in this community. About 95.8% of mothers had ever breastfed their children. More than half of mothers (57.3%) initiated breastfeeding within first hour of delivery and small number 78(10.2%) of mothers discarded colostrum. About 60.4% of mothers exclusively breastfed their children to 5-6 months. Majority of (74.5%) children had diets in the lowest dietary diversity group (<3 food groups), 16% of the children had diets in the medium dietary diversity group (4-5 food groups). Thirteen percent of the children are wasted and 45.9% of them are stunted. Stunting was significantly associated with number of under-five children, lack of paternal education, not exclusive breastfeeding and lack of dietary diversity. More than one-fourth (25.7%) of children are underweight which significantly associated with lack of dietary diversity, lack of maternal and paternal education. Conclusions: Behavioral change communications on key optimal child feeding behaviors need to be given in this community to maximize the effect of global and national infant and young child feeding recommendations. In addition, consumption of different types of food and nutrition education interventions that address the dietary diversity issues of the study area are urgently required in the study participants.