Mulusew Gerbaba

Factors associated with exclusive breastfeeding practices among mothers in Goba district, south east Ethiopia: a cross-sectional study

BackgroundExclusive breastfeeding is defined as feeding infants only breast milk, be it directly from breast or expressed, with no addition of any liquid or solids apart from drops or syrups consisting of vitamins, mineral supplements or medicine, and nothing else. Several studies have shown that exclusive breastfeeding for the first six months plays a great role in preventing morbidity and mortality. However, in Ethiopia a large portion of infants are not exclusively breastfed according to the infant feeding recommendations. Understanding the factors that influence exclusive breastfeeding is crucial to promoting the practice. This study was carried out to identify factors predicting exclusive breastfeeding among mothers in Bale Goba district, south east Ethiopia.MethodsA community-based cross-sectional study was conducted from March to February 2010 involving both quantitative and qualitative data. A total of 608 mothers were selected randomly. A convenience sampling technique was used to generate the qualitative data. The qualitative data were analyzed using thematic frameworks. A multivariable logistic regression analysis was used to identify independent predictors of exclusive breastfeeding after controlling for background variables.ResultsThe prevalence of exclusive breastfeeding in the last 24 hours preceding the survey was 71.3%. The median duration of exclusive breastfeeding was three months and mean frequency of breastfeeding was six times per day. Being unemployed [AOR: 10.4 (95% CI: 1.51, 71.50)] and age of infants of less than two months [AOR: 5.6 (95% CI: 2.28, 13.60)] were independently associated with exclusive breastfeeding.ConclusionsA large proportion of infants are not exclusively breastfed during the first 6 months, despite what is recommended in the national and global infant and young child feeding (IYCF) guidelines. Employed mothers were less likely to practice exclusive breastfeeding, implying the need for promoting workplace breastfeeding practices and creating an enabling environment for exclusive breastfeeding. Extensions of maternity leave up to the first six month of child’s age to achieve optimal level of exclusive breastfeeding practices should also be looked into as an alternative solution.

Determinants of timely initiation of breastfeeding among mothers in Goba Woreda, South East Ethiopia: A cross sectional study

BackgroundAlthough breastfeeding is universal in Ethiopia, ranges of regional differences in timely initiation of breastfeeding have been documented. Initiation of breastfeeding is highly bound to cultural factors that may either enhance or inhibit the optimal practices. The government of Ethiopia developed National Infant and Young Child Feeding Guideline in 2004 and behavior change communications on breast feeding have been going on since then. However, there is a little information on the practice of timely initiation of breast feeding and factors that predict these practices after the implementation of the national guideline. The objective of this study is to determine the prevalence and determinant factors of timely initiation of breastfeeding among mothers in Bale Goba District, South East Ethiopia.MethodsA community based cross sectional study was carried out from February to March 2010 using both quantitative and qualitative methods of data collection. A total of 608 mother infant pairs were selected using simple random sampling method and key informants for the in-depth interview were selected conveniently. Descriptive statistics, bivariate analysis and multivariable logistic regression analyses were employed to identify factors associated with timely initiation of breast feeding.ResultsThe prevalence of timely initiation of breastfeeding was 52.4%. Bivariate analysis showed that attendance of formal education, being urban resident, institutional delivery and postnatal counseling on breast feeding were significantly associated with timely initiation of breastfeeding (P < 0.05). After adjust sting for other factors on the multivariable logistic model, being in the urban area [AOR: 4.1 (95%C.I: 2.31-7.30)] and getting postnatal counseling [AOR: 2.7(1.86-3.94)] were independent predictors of timely initiation of breastfeeding.ConclusionsThe practice of timely initiation of breast feeding is low as nearly half the mothers did not start breastfeeding with one hour after delivery. The results suggest that breast feeding behavior change communication especially during the post natal period is critical in promoting optimal practice in the initiation of breast feeding. Rural mothers need special attention as they are distant from various information sources.

Intimate partner physical violence among women in Shimelba refugee camp, northern Ethiopia

BackgroundDomestic violence has unwanted effects on the physical and psychological well-being of women, which have been recognized globally as an important public health problem. Violence perpetrated by intimate partner is one form of domestic violence, a serious human rights abuse and a public health issue, among refugees owing to its substantial consequences for womens physical, mental and reproductive health problems. Because the incidents are under-reported, the true scale of the problem is unknown and unexamined among refugee women in Ethiopia. Thus, this study aim to assess the magnitude of intimate partner physical violence and associated factors among women in Shimelba refugee camp, Northern Ethiopia.MethodsA community-based cross-sectional study was conducted among a sample of 422 refugee women from March to April 2011. A simple random sampling method was used to select the study subjects from seven zones of the refugee camp. Census was done to identify all households with women having an intimate partner. A pre-tested interviewer guided structured questionnaire was used for data collection. Data were entered, cleaned and analyzed using SPSS software version 16.0. Descriptive, bivariate and multivariate logistic regression analyses were done where applicable. A p-value less than 0.05 with 95% CI were set and used as a cut-off point to examine the statistical association between the explanatory and outcome variables.ResultsThe prevalence of physical violence in the last 12 months and lifetime were 107(25.5%) and 131(31.0%) respectively. The commonest forms of physical violence reported included slapping 101(61.6%) and throwing objects 32(19.5%). Significant risk factors associated with experiencing physical violence were being a farmer (AOR = 3.0[95%CI: 1.7, 5.5]), knowing women in neighborhood whose husband to beat them (AOR = 1.87[95%CI: 1.0, 3.5]), being a Muslim (AOR = 2.4 [95%C.I: 1.107, 5.5]), and having a drunkard partner (AOR = 2.1[95%C.I:1.0, 4.5]).ConclusionsIntimate partner physical violence was found to be high and a serious problem among women in Shimelba refugee camp. Multifaceted interventions such as male counseling, increasing awareness on the consequences of intimate partner violence and the effect of substance use like alcohol will help to reduce intimate partner violence.

Risky sexual practices and related factors among ART attendees in Addis Ababa Public Hospitals, Ethiopia: a cross-sectional study.

BackgroundMany HIV-positive persons avoid risky sexual practices after testing HIV sero-positive. However, a substantial number continue to engage in risky sexual practices that may further transmit the virus, put them at risk of contracting secondary sexually transmitted infections and lead to problems with drug resistance. Thus, this study was intended to assess risky sexual practices and related factors among HIV- positive ART attendees in public hospitals of Addis Ababa.MethodsA cross-sectional study was conducted among ART attendees from February to March, 2009. Questionnaire-based face-to-face interviews were used to gather data. SPSS software was used to perform descriptive and logistic regression analyses.ResultsSix hundred and one ART attendees who fulfilled the inclusion criteria was included in the study and interviewed. More than one-third (36.9%) had a history of risky sexual practices in the three months prior to the study. The major reasons given for not using condoms were: partners dislike of them, both partners being positive for HIV and the desire to have a child. Factors associated with risky sexual practices included: lack of discussion about condom use (Adjusted Odds Ratio (AOR = 7.23, 95% CI: 4.14, 12.63); lack of self-efficacy in using condoms (AOR = 3.29, 95% CI: 2.07, 5.23); lack of sexual pleasure when using a condom (AOR = 2.39, 95% CI: 1.52, 3.76); and multiple sexual partners (AOR = 2.67, 95% CI: 1.09, 6.57). Being with a negative sero-status partner (AOR = 0.33, 95% CI: 0.14, 0.80), or partners of unknown sero-status (AOR = 0.19, 95% CI: 0.09, 0.39) were associated with less risky practice.ConclusionsA considerable proportion (36.9%) of respondents engaged in unprotected sexual intercourse, potentially resulting in re-infection by a new virus strain, other sexually transmitted infections and onward transmission of the HIV virus. Health education and counseling which focuses on the identified factors has to be provided. The health education and counseling can be provided to these people at ART appointments on follow- up care. It can be provided in a one-on-one basis or through patient group educational discussions at the clinics.

Mothers’ experiences and satisfactions with health extension program in Jimma zone, Ethiopia: a cross sectional study

BackgroundAlthough mothers are the fundamental unit of interventions in Health Extension Program in Ethiopia, their experiences and satisfactions with the service remain unstudied. Therefore, this study was aimed to assess mothers’ experiences and satisfaction with health extension service.MethodsA community based cross sectional study was conducted in Jimma Zone, Oromiya, Ethiopia. Three hundred Seventy-nine mothers were participated in the study. The study was conducted in four randomly selected rural villages. Systematic sampling technique was used to identify respondents. As part of the data collection process, four focus group discussions were conducted with mothers. SPSS 17.0 and ATLASti.4.1. Softwares were used for data analysis.ResultsOne hundred Sixty nine (51.7%) of the respondents had an experience of interactions with health extension workers during one year prior to the survey, while 271 (71.5%) of them reported that they received visits from health extension workers during the same period. 298 (78.6%) of the respondents received information at least on one of the Health extension packages. In fact, they had better exposure to personal hygiene and environmental sanitation packages. Even though health extension program is being run by female workers alone, it was believed that the involvement of men is vital to the success of the program. Mothers thought that men are more courageous and professionally competent to deal with complex matters. They also tended to criticize health extension program for lacking curative services and health extension workers are less competent. The greater emphasis laid on outreach services was not supported. 286 (75.5%) of the respondents rated their relationship with health extension workers as positive. Similarly, higher satisfaction was reported though the program has problems. Age, perceived skill to diagnose community problems, perceived respect, involvement of husband and being recognized as a model family were significantly predicted satisfactions with health extension services.ConclusionsMost mothers had good relationship, were satisfied with and had positive attitude towards health extension program though the program was criticized for not including curative services and the less attention given to static services at health post. Stakeholders are required to reconsider these issues.

Determinants of inter birth interval among married women living in rural pastoral communities of southern Ethiopia: a case control study

BackgroundThough birth interval has beneficial effects on health status of the mother and their children, it is affected by range of factors some of which are rooted in social and cultural norms and the reproductive behaviors of individual women. However, there was limited data showed the determinants of birth intervals in rural pastoral communities of South Ethiopia. Therefore, the study was aimed to assess the determinants of inter birth interval among women’s of child bearing age in Yaballo Woreda, Borena zone, Oromia Regional State, Ethiopia.MethodsA community based unmatched case–control study with multi stage sampling technique was conducted from January to March 2012. Cases were women with two subsequent birth intervals of less than three years and controls were women with two subsequent birth intervals between three and above years. Simple random sampling technique was employed to select six hundred fifty two (326 cases and 326 controls) study subjects. All explanatory variables that were associated with the outcome variable (birth interval) during bivariate analysis were included in the final logistic model. Multivariable backward logistic regression when P values less than or equal to 0.05 and 95% CI were used to determine independent determinants for the outcome of interest.ResultsThe median duration of birth interval was 31 & 40 months among cases and controls respectively. Variables such as number of children (AOR 3.73 95% CI: (1.50, 9.25), use of modern contraceptives (AOR 5.91 95% CI: (4.02, 8.69), mothers’ educational status (AOR 1.89 95% CI: (1.15, 3.37), and sex of the child (AOR 1.72 95% CI: (1.17, 2.52) were significantly associated with birth intervals.ConclusionsConcerted efforts to encourage modern contraceptive use, women education, and breastfeeding should be made.

Sexual and reproductive health services utilization and associated factors among secondary school students in Nekemte town, Ethiopia

BackgroundDespite policy actions and strategic efforts made to promote sexual and reproductive health service uptake of youths in Ethiopia, its utilization remains very low and little information was found on the extent to which school youths utilize available reproductive health services in Nekempt town. This study was aimed to assess utilization of Sexual and Reproduactive Health (SRH) services and its associated factors among secondary school students in Nekemte town, Ethiopia.MethodA school based cross-sectional study design was conducted from April 18 to 22, 2016. Multistage cluster sampling technique was used to select a total of 768 students who attended secondary schools. Sexual and reproductive health services utilization was measured using one item asking whether they had used either of sexual and reproductive health services components during the last one year or not. The data was entered using EpiData Manager with Entry Client and further analysis was done using SPSS version 21 software. Descriptive statistics, cross tabulations, biviarate and multivariate logistic regression analyses were used. All variables were set by p-values less than 0.05 and reported by Adjusted Odds Ratio with its 95%CI.ResultOut of the 768 study subjects, 739 participants underwent all the study components giving response rate of 96%. About 157 (21.2%) school youths reported that they utilized SRH services. On multivariable logistic regression analysis after adjusting for other variable, discussion with health workers (AOR 3.0, 95%CI [1.7–5.2]), previous history of perceived Sexually transmitted infections (STIs) symptoms (AOR 2.6, 95%CI [1.2–5.5]), being ever sexually experienced (AOR 5.9, 95%CI [3.4–10.2]) and exposure to information from school teachers (AOR 0.36, 95%CI [0.2–0.6]) were found to be independent determinants of sexual and reproductive services utilization among secondary school youths. Inconvenient times, lack of privacy, religion, culture, and parent prohibition were barriers to SRH service uptake cited by the school youths.ConclusionsThe overall utilization of sexual and reproductive services was low among school youths in the town. Discussion with health workers, history of perceived STIs symptoms, sexual experience and information were the association factors of sexual and reproductive service utilization among secondary school youths.

Integrating nutrition into health systems at community level: Impact evaluation of the community-based maternal and neonatal health and nutrition projects in Ethiopia, Kenya, and Senegal

Maternal undernutrition and mortality remain high in several African countries. Key nutrition and health interventions improve maternal and birth outcomes. Evidence is scarce on how to strengthen health systems to ensure pregnant women and newborns are reached with these interventions. We conducted three quasi-experimental nonrandomized Community Based Maternal and Neonatal Health and Nutrition projects in regions of Ethiopia, Senegal, and Kenya to demonstrate how proven nutrition interventions could be integrated into health programs to improve knowledge and practices during pregnancy, birth, and postpartum. We evaluated impact on knowledge and practices related to maternal and neonatal care using logistic regression and repeated-measures models with districts as a fixed variable and adjusted for covariates. Combined country analyses show significant positive effects of the intervention on women receiving first antenatal care visit (ANC) during first trimester (OR = 1.44; p < .001), those consuming any iron and folic acid supplement during their latest pregnancy (OR = 1.60; p = .005), those whose <6 months infants were exclusively breastfed (OR = 2.01; p=.003), those whose delivery was facility based (OR = 1.48; p=.031), and those whose postnatal care was facility based (OR = 2.15; p<.001). There was no significant differences between intervention and control groups regarding one or more and four or more ANC visits, women consuming iron and folic acid for ≥90 days, and early initiation of breastfeeding. We conclude that integrating proven nutrition interventions into health programs at community level improved components of access to and use of ANC, delivery services, and postnatal care by women in three African countries.

Modeling the probability of giving birth at health institutions among pregnant women attending antenatal care in West Shewa Zone, Oromia, Ethiopia: A cross sectional study

BACKGROUND Although ante natal care and institutional delivery is effective means for reducing maternal morbidity and mortality, the probability of giving birth at health institutions among ante natal care attendants has not been modeled in Ethiopia. Therefore, the objective of this study was to model predictors of giving birth at health institutions among expectant mothers following antenatal care. METHODS Facility based cross sectional study design was conducted among 322 consecutively selected mothers who were following ante natal care in two districts of West Shewa Zone, Oromia Regional State, Ethiopia. Participants were proportionally recruited from six health institutions. The data were analyzed using SPSS version 17.0. Multivariable logistic regression was employed to develop the prediction model. RESULTS The final regression model had good discrimination power (89.2%), optimum sensitivity (89.0%) and specificity (80.0%) to predict the probability of giving birth at health institutions. Accordingly, self efficacy (beta=0.41), perceived barrier (beta=-0.31) and perceived susceptibility (beta=0.29) were significantly predicted the probability of giving birth at health institutions. CONCLUSION The present study showed that logistic regression model has predicted the probability of giving birth at health institutions and identified significant predictors which health care providers should take into account in promotion of institutional delivery.

Health-Related Quality of Life and Associated Factors among Women on Antiretroviral Therapy in Health Facilities of Jimma Town, Southwest Ethiopia

Background. This study examined health-related quality of life and associated factors among HIV positive women receiving antiretroviral therapy in health facilities of Jimma town. Methods. A cross-sectional study was conducted, and consecutive sampling technique was employed to select 377 HIV positive women who were on antiretroviral therapy. Quality of life was measured using WHOQOL-BREF tool. Descriptive statistics, bivariate, and multivariable logistic regression analyses were performed. P values < 0.05 and adjusted odds ratio with 95% of confidence interval were used to determine statistical significance and report associations between the quality of life and independent variables. Results. Among the sampled participants, 344 were interviewed, yielding 91% of response rate. The mean ± standard deviation age of the respondents was 34.07 ± 8.76 years and 80.5% of them were urban dwellers. The proportion of women reporting good health-related quality of life was found to be 46.5%. Specific to each domain, the mean ± standard deviation of level of independence domain was the highest (14.08 ± 3.07) followed by physical (13.46 ± 2.95), social relationships (13.27 ± 3.91), psychological (12.97 ± 2.47), environmental (12.94 ± 3.25), and spiritual (12.39 ± 2.84) domains. Good social support (AOR: 4.99; 95% CI: [2.88, 8.34]), higher wealth status (AOR: 1.85; 95% CI: [1.02, 3.39]), and being on antiretroviral therapy for shorter duration (AOR: 1.85; 95% CI [1.14, 3.03]) were independently associated with better overall health-related quality of life among the participants. Conclusions. The study demonstrated high proportion of HIV positive women on ART had poor health-related quality of life which was affected by wealth index, social support, and duration on antiretroviral therapy.