Household food insecurity and its association with school absenteeism among primary school adolescents in Jimma zone, Ethiopia

Abstract Background Household food insecurity and lack of education are two of the most remarkable deprivations which developing countries are currently experiencing. Evidences from different studies showed that health and nutrition problems are major barriers to educational access and achievement in low-income countries which poses a serious challenge on effort towards the achieving Sustainable Development Goals. Evidence on the link between food security and school attendance is very important to address this challenge. This study aimed to assess to what extent food insecurity affects school absenteeism among primary school adolescents. Methods A school based cross-sectional study was conducted among primary school adolescents in Jimma zone from October-November, 2013. Structured questionnaire was used to collect data on the household food security and socio-demographic variables. Data were analyzed using SPSS for windows version 16.0 after checking for missing values and outliers. Multivariable logistic regression analyses were used to determine the association of school absenteeism and food insecurity with independent variables using odds ratio and 95 % of confidence intervals. Variables with p ≤ 0.25 in the bivariate analyses were entered into a multivariable regression analysis to control for associations among the independent variables. Results The frequency of adolescent school absenteeism was significantly high (50.20 %) among food insecure households (P < 0.001) compared to their peers whose households were food secure (37.89 %). Findings of multivariable logistic regression analysis also showed that household food insecurity [AOR = 2.81 (1.70, 4.76)] was positively associated with poor school attendance while female-headed household [AOR = 0.23 (0.07, 0.72)], urban residence [AOR = 0.52 (0.36, 0.81)] and male-gender [AOR = 0.64 (0.54, 0.74)] were inversely associated with school absenteeism. Household food insecurity was positively associated with lack of maternal education [AOR = 2.26 (0.57, 8.93)] and poor household economic status [AOR = 1.39 (1.18, 2.83)]. However, livestock ownership [AOR = 0.17 (0.06, 0.51)] was negatively associated with household food insecurity. Conclusions Findings of this study showed that household food insecurity has strong linkage with adolescent school absenteeism. Maternal education and household economic status were significantly associated with household food security status. Therefore, national policies and programs need to stress on how to improve family income earning capacity and socioeconomic status to handle household food insecurity which is a key contributor of adolescent school absenteeism

Enhancing personal hygiene behavior and competency of elementary school adolescents through peer-led approach and school-friendly: a quasi-experimental study

Background: Recent studies showed that poor personal hygiene practices play a major role in the increment of communicable disease burden in developing countries. In Ethiopia, 60% of the disease burden is related to poor sanitation practices. This school based study was aimed to assess the effectiveness of school-friendly and peer-led approach in improving personal hygiene practices of school adolescents in Jimma Zone, Southwest of Ethiopia.Methods: A total of 1000 students from 10 to 19 years were included into the study. The intervention was done using peer-led approach, health clubs and linking the school events with parents. Data were collected at baseline, midline and end-line using structured questionnaires. Repeated measurement analysis was done and statistical significance was considered at alpha 0.05.Results: The findings of this study indicated that there was a significant difference in personal hygiene practices and knowledge between the intervention and control groups (P&lt;0.001). A significant difference was also observed with the duration of time in the intervention schools (P&lt;0.05). The proportion of adolescents who reported illness before the baseline survey was significantly high among the intervention schools (P&lt;0.01). However, at midline of the survey, the proportion of self-reported illness was significantly high among the control group(P&lt;0.001).Conclusion: The findings of this study showed that there was a significant improvement in personal hygiene knowledge and practice of students in the intervention schools. Therefore, there is a need for proper health education intervention through the framework of schools for the students to improve their personal hygiene knowledge and practices.Keywords: Hygiene, School, Knowledge, Attitude, Jimm

Prevalence of Obstetric Danger Signs during Pregnancy and Associated Factors among Mothers in Shashemene Rural District, South Ethiopia

Introduction. Obstetric danger signs are those signs that a pregnant woman will see or those symptoms that she will feel which indicate that something is going wrong with her or with the pregnancy. Evidence on the prevalence of obstetric danger signs and contributing factors were crucial in designing programs in the global target of reducing maternal morbidity and mortality. Objective. To assess the prevalence of obstetric danger signs during pregnancy and associated factors among mothers in a Shashemene rural district, South Ethiopia. Methods. A community-based cross-sectional study design was conducted among 395 randomly selected women who gave birth in the last six months. A pretested interviewer-administered questionnaire was utilized. Data were cleaned, coded, and entered into Epi data manager version 4.1 and then exported to SPSS version 20. Bivariable and multivariable logistic regression analyses were employed to assess the association between independent variables with the outcome variable. Statistical significance was declared at p<0.05. Result. One hundred sixty-three (41.3%) of women had a history of obstetric danger signs during pregnancy. The most prevalent obstetric danger signs were vaginal bleeding (15.4%) followed by swelling of the body 12.7% and severe vomiting 5.3%. Women who have less than four times antenatal care visits were 6.7 times more likely to experience obstetric danger signs (AOR 6.7 (95% CI 3.05, 14.85)) compared to those who had antenatal care visit four times and above. Women who have inadequate knowledge of obstetric danger signs were 2.5 times more likely to experience obstetric danger signs during pregnancy (AOR 2.5 (95% CI 1.34, 4.71)), and primigravida women were 6.3 times more likely to have obstetric danger signs during pregnancy (AOR 6.3 (95% CI 2.61, 15.09)) compared to multiparous women. Conclusion. About half of the pregnant mothers have experienced at least one obstetric danger signs. Public health interventions on maternal health should give priority to the prevalent causes of obstetric danger signs, strengthening completion of four antenatal care visits and health education on obstetric danger signs for pregnant mothers at community level especially for primgravid women

Factors associated with birth preparedness and complication readiness in Southern Ethiopia: a community based cross-sectional study

Abstract Background Birth preparedness and complication readiness (BP/CR) is a strategy to promote use of skilled maternal and neonatal care so that they can get timely skilled care, particularly during child birth. There is minimal evidence on the factors associated with BP/CR among pregnant women in Ethiopia. Hence, this study aimed to assess the factors influencing BP/CR among pregnant women in Southern Ethiopia for the purpose of improving utilization of skilled attendant at birth. Methods A community based cross-sectional study was conducted among 707 pregnant women in Southern Ethiopia in March 2015. Both quantitative and qualitative methods of data collection were used. For the quantitative study, the study subjects were included in the study by employing multi-stage sampling. Data was entered into Epidata version 3.1 and analyzed using IBM SPSS statistics 20. Level of statistical significance was declared at a p- value of  = 4 (AOR = 4.52, 95% CI = 2.26, 9.02), who received advice on BP &CR (AOR = 1.84, 95% CI = 1.13, 3.01),and who were knowledgeable on labor and delivery(LAD) danger signs (AOR = 1.85, 95% CI = 1.01, 3.44). However, it was lower among women with parity of 2 - 4(AOR = .0.51, 95% CI = 0.31, 0.84) and >4 (AOR = 0.51, 95% CI = 0.31, 0.84) than primiparous women. It was also lower among women from food insecure households (AOR = 0.26, 95% CI = 0.16, 0.42) than their counterparts. Lack of awareness on BP/CR, privacy and respect in health institutions were mentioned by the FGD discussants as barriers to women’s preparation for birth. Conclusions The study showed that BP/CR is inadequate among pregnant women in the study area. Improving socio-economic and food security status of women, strengthening community-based education on complete attendance of ANC, and conforming to professional ethical standards were recommended

Additional file 1: of Factors associated with birth preparedness and complication readiness in Southern Ethiopia: a community based cross-sectional study

Raw data: It is an Excel data with the file name “revised additional file 1” which contains the raw data supporting the findings of this study. (XLS 1266 kb

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

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

Improving dietary diversity of school adolescents through school based nutrition education and home gardening in Jimma Zone : Quasi-experimental design

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