Delivery Site Preferences and Associated Factors among Married Women of Child Bearing Age in Bench Maji Zone, Ethiopia

BACKGROUND: Efforts to reduce maternal mortality and morbidity must address societal and cultural factors that affect women’s health and their access to services. There was no research conducted previously on delivery site preferences and associated factors among married women of child bearing age in the study area. The aim of this study was to assess the delivery site preferences and associated factors among women of child bearing age in Bench Maji Zone, Southwest Ethiopia.METHODS: A community based cross sectional quantitative study design supplemented by qualitative data was conducted from April 20 to May 20, 2013. Simple random sampling to select kebeles and systematic random sampling to contact eligible woman were used. Data was collected using structured questionnaire. Data was analyzed by using SPSS version 16. Logistic regressions analysis was employed to identify potential predictor variables. Odds ratio with 95% confidence interval was used to assess the association of variables. P-value less than 5% was used to declare significant association.RESULTS: Three hundred five (61.9%) of the mothers gave birth at home. Three Hundred ninety six (78.7%) of them had Ante natal care. The preference of facility delivery was 412(88.3%). Age of women, mothers’ educational level, and place of delivery of the last baby, perception of mothers about pregnancy and health care workers significantly affected delivery site preference.CONCLUSION: Most of the women attended Ante natal care. However, only some had actually delivered at health facilities to their last pregnancy. Community members should get health education to reduce misconceptions on delivering in health facility.KEYWORDS: Delivery preference, Institutional delivery, Antenatal car

Predictors of regular physical activity among Type 2 diabetes mellitus patients in Wolaita Sodo University teaching hospital using the Trans-Theoretical Model

Background: Globally, 382 million people are estimated to have diabetes. To date there is paucity of evidence regarding predictor of regular physical activity among Type 2 diabetes mellitus patients with application of Trans-theoretical model. Therefore the objective of this study was to determine predictors of regular physical activity among type 2 diabetes mellitus patients in Wolaita Sodo University hospital using the Trans- theoretical model. Method: Institutional based cross-sectional study was conducted on 400 systematic random selected Type 2 diabetes mellitus patients. One-way ANOVA was used to show mean scores differences of processes of change, decisional balance and self-efficacy across stages of change. Multivariable logistic regressions were also conducted.Result: Of the participants, 34.3% were physically active. The processes of change, the pros and the self-efficacy significantly increased from precontemplation to maintenance stage while the cons decreased across the stages (p<0.05). The result of multivariable logistic regression showed that pros, cons, self-efficacy, self-liberation and counter conditioning were predictors of physical activity.Conclusion: Type 2 diabetes mellitus patients’ physical activity was very low. Stage matched intervention should be designed to increase processes of change, pros and self-efficacy from precontemplation to maintenance stages. [Ethiop. J. Health Dev. 2018;32(2):97-103]Key words: Physical activity, Type 2 diabetes mellitus, Transtheoretical mode

Intention to voluntary HIV counseling and testing (VCT) among health professionals in Jimma zone, Ethiopia: the theory of planned behavior (TPB) perspective

BACKGROUND: Voluntary HIV Counseling and Testing (VCT) forms one of the cornerstones of HIV prevention strategies. It is imperative to understand HIV testing correlates and their theoretical underpinnings in order to promote VCT uptake. The aim of this study was to predict the intention to VCT and associated factors among health professionals in Jimma zone, Ethiopia using the theory of planned behavior. METHODS: An institution based cross-sectional quantitative study among a sample of 336 health professionals in 12 selected districts of Jimma, Ethiopia was conducted in 2012. The constructs and principles of the theory of planned behavior (TPB) were measured. Data were collected using structured questionnaire on self administered basis. A multivariable linear regression model was used to predict the role of independent variables/TPB constructs on the intention to use VCT using SPSS version 16.0. RESULTS: The components of TPB independently explained the variance in intention to VCT by 30.3%. Both components of TPB and socio-demographic characteristic in the final model explained 32.7% of variance in the intention to use VCT services. Significant proportions (33.0%) of the respondents have never been tested for HIV. The respective indirect components of the TPB predicted the direct components. The strongest predictors of intention to VCT were subjective norm (β=0.39, p<0.001) and attitude (β= 0.19, p<0.001) whereas, none of the socio-demographic variables were significantly predicted the intention to use VCT. Past VCT experience did not have significant statistical association with VCT use intention. CONCLUSIONS: Behavioral intention to use VCT was a function of attitude and perceived social pressure. Demographic related social determinants were not barriers for VCT use intention. Most health workers test their blood by themselves. Strategies to empower health professionals on social pressure resistance and programs targeted at changing negative attitude on VCT use can enhance intention of health professionals to use VCT

Psychographic predictors of intention to use cervical cancer screening services among women attending maternal and child health services in Southern Ethiopia: the theory of planned behavior (TPB) perspective

Abstract Background Detection of the premalignant forms cervical cancer through screening in the target age group is one of the effective strategies in the prevention of the disease. Nevertheless, the cervical cancer screening service use remains considerably low in Ethiopia. Indeed; promoting screening behaviors requires understanding the factors influencing women’s motivation towards the service. Our study has explored the psycho-graphic factors associated to intention to use cervical cancer screening among women visiting maternal and child health services in Southern Ethiopia, 2017. Methods Institution based cross-sectional study was used employing 422 women’s age between 30 and 49 years old. A structured questionnaire was used to collect data on interviewer-administered basis. All assumptions of theory of planned behavior (TPB) were considered to measure intention, attitude, perceived social pressure and perceived ability to control circumstances against cervical cancer screening. Data were analyzed using statistical package for social sciences version 21.0. Multiple linear regression models were conducted to identify factors associated to intention to use cervical cancer screening. P-value less than 5% was considered to indicate significant association. Result Four hundred and two (95%) of the respondents completed the interview. Knowledge of the disease signs, symptoms, risk factors and prevention methods was 162(41.4%). Knowledge about the disease and past screening experience were positively associated with intention to use cervical cancer screening (β = 0.145, 95% CI = [0.047, 0.170]) and (β = 0.098, 95% CI = [0.093, 1.001]) respectively. Further; standardized regression coefficient showed that all dimensions of TPB were positively associated to intention to use the services with perceived behavioral control (β = 0.297, 95% CI = [0.172, 0.343]), perceived social pressure (β = 0.248, 95% CI = [0.131, 0.301]) and attitude towards screening (β = 0.110, CI = [0.018, 0.158]). Conclusion Overall; the intention to use cervical cancer screening was a function of attitude, perceived social pressure and perceived behavioral control confirming the hypothesis of the study. None of the socio-demographic variables were associated to intention. Health behavior change interventions should focus on increasing knowledge and empowering women that enable them to evaluate their control beliefs and develop ability against social norms and circumstances that compete with the use of cervical cancer screening services

Lactating mothers' perception towards diarrheal disease in Bench-Maji Zone, South-West Ethiopia: mixed study design

Introduction:&nbsp;acute diarrheal diseases are the leading cause of preventable death, especially among children under-five in developing countries. Worldwide and nationwide diarrheal disease is the second leading cause of death in under-five year children. Therefore, the aim of this study is to assess perception of lactating mothers' toward diarrheal disease in Mizan-Aman District, South-West Ethiopia. Methods:&nbsp;community based cross-sectional quantitative study supplemented by qualitative study was employed. A total of 383 selected households with the lactating mothers were involved in the study. Data was collected through face-to-face interview technique by trained data collectors. Data was entered and analyzed using SPSS version 16. Multiple logistic regressions analysis was used to identify the independent predictors. Odds ratio, with 95% confidence level and P &lt; 0.05 were used to determine statistically significant association. Results:&nbsp;the majority of the respondents had primary education (44.4%) and from rural area (52.2%). Multiple logistic regression analysis showed that the residence area [AOR = 4.79, CI (1.33,7.78), P&lt;0.003], educational status [AOR = 0.72, CI (0.55,1.29), P&lt;0.045], Wealth index [AOR = 8.9, CI (0.99,17.45), P&lt;0.001], knowledge [AOR = 2.34, CI (1.2-4.3) P&lt;0.023]. Perceived susceptibility [AOR = 0.44, CI (0.33,11.33), P&lt;0.001] and perceived severity of their child towards diarrheal disease [AOR= 0.24, CI (1.23,7.99), P&lt;0.033] had significant associations with the perception of the diarrheal diseases among lactating mothers'. Conclusion:&nbsp;lactating mothers' perceptions towards their children of getting diarrheal disease and danger of the disease with primary education and above were better protected than mothers with no education. Thus, implementing effective information educational communication (IEC) programs that emphasize on the benefit of complying with nationally recommended practice to prevent diarrheal disease is important to reduce the risk

Perceived sustainability of the school-based social and behavior change communication (SBCC) approach on malaria prevention in rural Ethiopia: stakeholders’ perspectives

Abstract Background Evidence on what makes the school-engaged social and behavior change communication (SBCC) interventions on malaria prevention more sustainable are limited in literature partly due to its recent emergence. Enrolling the key stakeholders, this study explored the perceived sustainability of the SBCC interventions on malaria prevention through primary school communities in rural Ethiopia. Methods The SBCC interventions were implemented from 2017 to 2019 in 75 primary schools and villages in rural Jimma to promote malaria preventive practices. As a part of program evaluation, this study employed a mixed-method to collect qualitative and quantitative data from 205 stakeholders following the end of the program. Data were collected using interview guides and structured questionnaires. The SPSS version 26 and Atlas ti7.1 software were used to analyze the data. Multivariable linear regression modeling was used to identify predictors of the perceived sustainability of the program (SOP). Results The mean score of SOP was 25.93 (SD = 4.32; range 6–30). Multivariable linear regression modeling showed that the perceived risk to malaria (β = 0.150; P = 0.029), self-efficacy (β = 0.192; P = 0.003), and perceived fidelity of implementation (β = 0.292; P = 0.000) and degree of adoption (β = 0.286; P = 0.000) were positively predicted the perceived SOP. The qualitative result identified various barriers and opportunities to sustaining the program that summarized under three themes which include perceptions about the quality of program delivery (e.g inadequate involvement of stakeholders and staffs, concerns over short project life, immature sustainability efforts), school settings (e.g schools’ malaria priority, schools’ climate and quality of coaching) and the outer settings (e.g existing structures in the health and education systems). Conclusion The study identified key predictive variables such as stakeholders’ perceived risk to malaria, self-efficacy, perceived fidelity of implementation and degree of adoption that could help to improve the sustainment of the school-based SBCC approach on malaria prevention and control. Further longitudinal study should be conducted to examine the rate of decline in program components over time and how improved sustainability would contribute to the effectiveness on malaria preventive behaviors among students

Shifting Beliefs and Practices around Family Planning in Rural Ethiopia

Background: Over the last ten years Ethiopia has substantially increased uptake of family planning methods. As a result, most regions of the country experienced a decrease in fertility. The aims of this study are to: (1) Describe the current family planning beliefs in one rural district in Ethiopia; (2) Identify which beliefs promote or hinder the uptake of family planning; (3) Acquire insights into how these beliefs may be changing through time; and, (4) Specify the social influences involved in the diffusion of information and ideas related to fertility and family planning. Methods: In July 2016, in collaboration with our Ethiopian research partners, we conducted five focus groups and twelve individual interviews (n = 59) with adolescents, men, women and key informants in Oromia, Ethiopia. We used a random sampling protocol to recruit participants. Focus group and interview questions covered childbearing, gender roles, decision-making, and modern contraceptive use. We analyzed data using thematic analysis and Nvivo v.11 qualitative software. Results: All participants knew of and accepted modern contraception to space childbirth. Adults considered it a positive change within their community and adolescents considered it a common part of the community for married women. We also found that there are two decision-making networks in regards to family planning: (1) one that pertains to basic decisions about having children, which remains patriarchal; and (2) a second network that pertains to family size and spacing decisions which includes the Government Health Extension Workers who are perceived as trusted community members who helped bring family planning methods and health education to the community. Adolescents described use of contraception among married women as commonplace but did not discuss it for themselves. Some key informants reported a need for improved adolescent sexual health services. Conclusion: While marriage and initial childbearing remain patriarchal, Government Health Workers have helped to increase contraception uptake among married women who space births after their first birth. Focusing efforts on spacing after first birth among married women could be an effective first step to increase contraception uptake within a community

Malaria Risk Perception and Preventive Behaviors Among Elementary School Students, Southwest Ethiopia. Generalized Structural Equation Model

BACKGROUND: In 2020, more than three billion of the world’s population were the risk of being infected with malaria and four out of five deaths were from the African population. However, information is scarce on the association between risk perceptions and malaria prevention behaviors in resource-limited countries, particularly Ethiopia. Therefore, this study aimed to assess malaria risk perceptions and preventive behaviors. METHODS: A cross-sectional study design was conducted among 401 elementary school students in Jimma zone, Oromia, Ethiopia, from April 2 to June 8, 2020. Data were collected through interviews using a semi-structured questionnaire. The data were entered into Epi-data 4.6 and analyzed using STATA version 14.2. The descriptive statistics were presented using frequency and percentages. A Cronbach’s α coefficient of 0.7 or higher was used to assess the reliability of each domain. The Generalized Structural Equation Model (GSEM) was employed to examine the relationships and prediction of explanatory variables with risk perception and preventive behaviors of malaria. The model with a lower information criterion was taken as a better-fitting model. Finally, the statistically significant model effects were declared at a P-value of less than 0.05 at a confidence interval of 95%. RESULTS: This study showed that having knowledge about malaria had an indirect positive effect on malaria preventive behavior (β = 1.29, 95% CI 0.11 to 2.47), and had a positive total effect on the preventive behavior (β = 2.99, 95% CI 0.08 to 2.67). Besides, an increased knowledge level had a direct positive effect on malaria risk perceptions (β = 0.08, 95% CI 0.01 to 0.14), and malaria risk perception had a direct positive effect on malaria preventive behavior (β = 1.21, 95% CI 0.10 to 2.31). CONCLUSION AND RECOMMENDATION: This study demonstrated that having knowledge about malaria had a direct and indirect association with malaria preventive behavior. An increased level of knowledge had a direct positive effect on malaria risk perceptions. Moreover, malaria risk perception had a direct positive effect on malaria preventive behavior. Therefore, malaria prevention-targeted interventions, behavior change, and knowledge enhancing communication should be enhanced or scaled up to contribute to prompt treatment and progress toward the elimination of malaria