Factors associated with utilization of long acting and permanent contraceptive methods among married women of reproductive age in Mekelle town, Tigray region, north Ethiopia

Background: Ethiopia is the second most populous country in Sub-Saharan Africa. Total Fertility Rate of Ethiopia is 5.4 children per women, population growth rate is estimated to be 2.7% per year and contraceptive prevalence rate is only 15% while the unmet need for family planning is 34%. Overall awareness of Family Planning methods is high, at 87%. The prevalence of long acting and permanent contraceptive methods (LAPMs) in Tigray region was very low which accounts for 0.1% for implants and no users for intra-uterine contraceptive device (IUCD) and female sterilization. Moreover almost all modern contraceptive use in Ethiopia is dependent on short acting contraceptive methods. The objective of this study was to assess factors associated with utilization of long acting and permanent contraceptive methods (LAPM) among married women of reproductive age group in Mekelle town. Methods: A cross sectional community based survey was conducted from March 9-20, 2011. Multistage sample technique was used to select the participants for the quantitative methods whereas purposive sampling was used for the qualitative part of the study. Binary descriptive statistics and multiple variable regressions were done. Results: The study consisted of quantitative and qualitative data. From the quantitative part of the study the response rate of the study was 95.6%. Of the qualitative part two FGDs were conducted for each married women and married men. 64% of the married women heard about LAPMs. More than half (53.6%) of the married women had negative attitude towards practicing of LAPMs. The overall prevalence of LAPMs use was 12.3% however; there were no users for female or male sterilization. The main reason cited by the majority of the married women for not using LAPMs was using another method of contraception 360 (93.3%). Mothers who had high knowledge were 8 times more likely to use LAPMs as compared with those who had low knowledge (AOR = 7.9, 95% CI of (3.1, 18.3). Mothers who had two or more pregnancies were 3 times more likely to use LAPM as compared with those who had one pregnancy (AOR = 2.7, 95% CI of (1.4, 5.1). Conclusion: A significant amount of the participants had low knowledge on permanent contraceptive particularly vasectomy. More than half (53.6%) of married women had negative attitude towards practicing of LAMPs. Few of married women use female sterilization and none use of female sterilization and or vasectomy. Positive knowledge of LAMPs, women who had two and above pregnancies and women who do not want to have additional child were significantly associated. Information education communication should focus on alleviating factors hinder from practicing of LAPMs

Food insecurity and associated factors among HIV-infected individuals receiving highly active antiretroviral therapy in Jimma zone Southwest Ethiopia

Background: In resource limited settings, many People Living with HIV/AIDS (PLWHA) lack access to sufficient quantities of nutritious foods, which poses additional challenges to the success of antiretroviral therapy (ART). Maintaining adequate food consumption and nutrient intake levels and meeting the special nutritional needs to cope up with the disease and the ART are critical for PLWHA to achieve the full benefit of such a treatment. Objective: To determine the prevalence and correlates of food insecurity among HIV-infected individuals receiving highly active antiretroviral therapy in resource-limited settings. Methods: A cross sectional study was carried out from January 1, 2009 to March 3, 2009 at ART clinic at Jimma University specialized hospital (JUSH) in Ethiopia. We used multivariable logistic regression model to compare independent risk factors by food insecurity status among 319 adult PLWHA (>= 18 years) attending ART Clinic. Results: A total of 319 adult PLWHA participated in the study giving a response rate of 100%. Out of 319 PLWHA the largest numbers of participants, 46.4% were in the age group of 25-34 years. The overall 201(63.0%) PLWHA were food insecure. Educational status of elementary or lower [OR = 3.10 (95%CI; (1.68-5.71)], average family monthly income < 100 USD [OR = 13.1 (95%CI; (4.29-40.0)] and lower food diversity [OR = 2.18 (95%CI; (1.21-3.99)] were significantly and independently associated with food insecurity. Conclusion: Food insecurity is a significant problem among PLWHA on HAART. Lower educational status and low family income were the predictors of food insecurity. Food security interventions should be an integral component of HIV/AIDS care and support programs. Special attention need to be given to patients who have lower educational status and are members of households with low income

Concordance of poor child feeding and preventive behavior and its predictors in southwest rural Ethiopia

Background: Inappropriate child feeding and caring practices are a major cause of malnutrition. To date, no studies have examined concordance and discordance of child feeding and preventive behavior and their predictors in developing countries. Methods: We used baseline data generated from A 2-year-longitudinal agriculture-nutrition panel survey conducted from February 9 to April 9, 2014, in nine districts encompassing 20 randomly selected counties in Oromiya Region and Southern Nation, Nationality and Peoples Region in Ethiopia. Households were recruited using the Expanded Program on Immunization sampling method. A total of 623 children under the age of 5 years and their respective caregivers were included in the analyses. Generalized estimating equations were used to account for clustered observations. Results: Concordance of poor child feeding and preventive behavior was observed in 45.1% of the children, while 45.5% of the children were suffering from discordance of poor child feeding and preventive behavior. Concordance and discordance of poor child feeding and preventive behavior had almost different predictors. Concordance of poor child feeding and preventive behavior was significantly associated with the age of the caretaker of >= 40 years (odds ratio (OR) = 2.14; 95% confidence interval (CI): 1.04, 4.41), low household dietary diversity (OR = 3.69; 95% CI: 1.93, 7.04), medium household dietary diversity (OR = 2.17; 95% CI: 1.17, 4.00), severe household food insecurity (OR = 1.72; 95% CI: 1.01, 2.93), and increase with increasing child age. Conclusion: A substantial number of children in the southwest of rural Ethiopia are exposed to both poor child feeding and preventive behavior. Low household dietary diversity and extreme food insecurity household were predictors of concordance of poor child feeding and poor preventive behavior and provide useful entry points for comprehensive interventions to address child feeding and caring in the area

Food insecurity and linear growth of adolescents in Jimma Zone, Southwest Ethiopia

Background: Although many studies showed that adolescent food insecurity is a pervasive phenomenon in Southwest Ethiopia, its effect on the linear growth of adolescents has not been documented so far. This study therefore aimed to longitudinally examine the association between food insecurity and linear growth among adolescents. Methods: Data for this study were obtained from a longitudinal survey of adolescents conducted in Jimma Zone, which followed an initial sample of 2084 randomly selected adolescents aged 13-17 years. We used linear mixed effects model for 1431 adolescents who were interviewed in three survey rounds one year apart to compare the effect of food insecurity on linear growth of adolescents. Results: Overall, 15.9% of the girls and 12.2% of the boys (P=0.018) were food insecure both at baseline and on the year 1 survey, while 5.5% of the girls and 4.4% of the boys (P=0.331) were food insecure in all the three rounds of the survey. In general, a significantly higher proportion of girls (40%) experienced food insecurity at least in one of the survey rounds compared with boys (36.6%) (P=0.045). The trend of food insecurity showed a very sharp increase over the follow period from the baseline 20.5% to 48.4% on the year 1 survey, which again came down to 27.1% during the year 2 survey. In the linear mixed effects model, after adjusting for other covariates, the mean height of food insecure girls was shorter by 0.87 cm (P<0.001) compared with food secure girls at baseline. However, during the follow up period on average, the heights of food insecure girls increased by 0.38 cm more per year compared with food secure girls (P<0.066). However, the mean height of food insecure boys was not significantly different from food secure boys both at baseline and over the follow up period. Over the follow-up period, adolescents who live in rural and semi-urban areas grew significantly more per year than those who live in the urban areas both for girls (P<0.01) and for boys (P<0.01). Conclusions: Food insecurity is negatively associated with the linear growth of adolescents, especially on girls. High rate of childhood stunting in Ethiopia compounded with lower height of food insecure adolescents compared with their food secure peers calls for the development of direct nutrition interventions targeting adolescents to promote catch-up growth and break the intergenerational cycle of malnutrition

Food insecurity, food based coping strategies and suboptimal dietary practices of adolescents in Jimma Zone Southwest Ethiopia

Despite the high prevalence of adolescent food insecurity in Ethiopia, there is no study which documented its association with suboptimal dietary practices. The objective of this study is to determine the association between adolescent food insecurity and dietary practices. We used data on 2084 adolescents in the age group of 13–17 years involved in the first round survey of the five year longitudinal family study in Southwest Ethiopia. Adolescents were selected using residence stratified random sampling methods. Food insecurity was measured using scales validated in developing countries. Dietary practices were measured using dietary diversity score, food variety score and frequency of consuming animal source food. Multivariable regression models were used to compare dietary behaviors by food security status after controlling for socio-demographic and economic covariates. Food insecure adolescents had low dietary diversity score (P<0.001), low mean food variety score (P<0.001) and low frequency of consuming animal source foods (P<0.001). After adjusting for other variables in a multivariable logistic regression model, adolescent food insecurity (P<0.001) and rural residence (P<0.001) were negatively associated with the likelihood of having a diversified diet (P<0.001) and frequency of consuming animal source foods, while a high household income tertile was positively associated. Similarly, multivariable linear regression model showed that adolescent food insecurity was negatively associated with food variety score, while residence in semi-urban areas (P<0.001), in urban areas (P<0.001) and high household income tertile (P = 0.013) were positively associated. Girls were less likely to have diversified diet (P = 0.001) compared with boys. Our findings suggest that food insecurity has negative consequence on optimal dietary intake of adolescents. Food security interventions should look into ways of targeting adolescents to mitigate these dietary consequences and provide alternative strategies to improve dietary quality of adolescents in Southwest Ethiopia

Food insecurity and its implications on nutrition, health and education of Ethiopian adolescents

Adolescence is one of the four critical phases of human growth and development when negative effects of food insecurity and malnutrition are pronounced. However, most nutrition policies and programs and research agendas in many low and middle income countries give very little attention to the impact of food insecurity on health and wellbeing of adolescents. As a result, global evidence on adolescent nutrition and health is patchy. In Ethiopia, there is little evidence on the effect of food insecurity on nutritional status and wellbeing of adolescents. Although the Ethiopian government has a National Nutrition Strategy and National Nutrition program guiding all nutrition related actions in the country, adolescents are not identified as a vulnerable group leading to a complete absence of interventions on adolescent nutrition. This study investigated the effect of food insecurity on adolescents’ nutrition, health, and education and identifies policy advocacy issues to support adolescent nutrition programming in Ethiopia. The results show that food insecurity is profoundly affecting dietary quality, health, growth and education of adolescents and that gender plays a critical role in this process. This calls for urgent attention of policy makers

Blood/Body Fluid Exposure and Needle Stick/Sharp Injury among Nurses Working in Public Hospitals; Southwest Ethiopia

BackgroundEvery health professional around the world is at risk of blood/body fluid exposure and needle stick/sharp injury as a result of exposure to blood or body fluids and needle or sharp injuries. However, the extent of these hazards and their driving forces are not well documented in Ethiopia. Thus, the aim of this study was to assess determinants of blood/body fluid exposure and needle stick/sharp injury among nurses working in Jimma zone, southwest Ethiopia.MethodsAn institution-based census was conducted among 318 nurses working in Jimma zone public hospitals from March 10 to 30, 2016. Data were collected by using pretested self-administered questionnaire. Epi info and SPSS were used for data entry and analysis, respectively. Descriptive statistics were done. Bivariate and inter multivariate logistic regression analysis was also carried out to identify predictors of occupational hazards.ResultsThe overall prevalence of blood/body fluid exposure and needle stick/sharp injury was found to be 249 (78.3%). Blood/body fluid exposure and needle stick/sharp injury incidents were reported by 62.6 and 58.8% of respondents, respectively. Majority of the hazards occurred during morning shift. Being male [AOR: 2.20, 95% confidence interval (CI): 1.09, 4.4], being single (AOR: 2.26, 95% CI: 1.09, 4.69), and having no training on infection prevention (AOR: 5.99, 95% CI: 3.14, 11.41) were positively associated with blood/body fluid exposure and needle stick/sharp injury; while working in chronic illness follow-up clinic (AOR: 0.19, 95% CI: 0.05, 0.71) showed negative association at p value of 0.05.ConclusionPrevalence of blood/body fluid exposure and needle stick/sharp injury was high among the nurses. The safety of nurses depends directly on the degree to which nurses can identify and control the varied occupational hazards specific to jobs. Thus, working unit specific safety precautions and basic infection prevention in-service training might improve nurses’ safety practice and thereby decrease the on job hazard

Dietary Diversity, Nutritional Status, and Associated Factors Among Pregnant Women in Their First Trimester of Pregnancy in Ambo District, Western Ethiopia

Background: Poor dietary diversity and undernutrition is a major public health concern for pregnant mothers. Optimal dietary diversity is essential during pregnancy since nutritional deficiencies may have a significant impact on both the mother’s and the fetus’s health. Pregnant women in Ambo district had inadequate dietary diversity and were undernourished, but their status during the first trimester of pregnancy was not known. As a result, the objective of this research was to assess the dietary diversity, nutritional status, and associated factors among pregnant women in the Ambo district. Methods: A community-based cross-sectional study design and a multi-stage sampling technique were used among 750 pregnant women. Data was gathered using a semi-structured questionnaire. The Food and Nutrition Technical Assistance questionnaire was modified to collect data on dietary diversity. The nutritional status of pregnant women was assessed by measuring the mid-upper arm circumference. First, descriptive statistics like mean, Standard deviation, frequency and percentage were used, then bivariable and, finally, multivariable logistic regression analysis was used to assess the association of the predictors with the outcome variable. Result: The study revealed that 73.6% and 23.9% of pregnant women had low dietary diversity and were undernourished, respectively. Being in food secured household (AOR = 4.44, 95% CI: 2.14-9.15), having good knowledge (AOR = 3.32, 95% CI: 2.10-5.23) and favorable attitude toward nutrition and health (AOR = 1.71, 95% CI: 1.10-2.66) were significantly associated with dietary diversity, whereas household size (having 1-3 household members AOR = 6.59, 95% CI: 2.53-17.21, having 4-5 household members AOR = 5.62, 95% CI: 3.15-9.99), being in food secured household (AOR = 5.64, 95% CI: 2.79-11.38), having high dietary diversity (AOR = 8.49, 95% CI: 2.47-29.23), and having optimal practice on nutrition and health (AOR = 6.85, 95% CI: 3.23-14.55) were significantly associated with undernutrition ( P  < .05). Conclusions: The current study revealed that pregnant women in the study area had inadequate dietary diversity practices and a high prevalence of undernutrition. Knowledge and attitude, and households’ food security status were the predictors of dietary diversity, while household size, household food security status, dietary diversity and nutrition and health practice were predictors of undernutrition. Hence, behavior change communication needs to be designed to improve the dietary diversity and nutritional status of pregnant women

What knowledge and expectations are Ethiopian girls bringing with them into parenthood?

Background : Because of rapid population growth, many countries now have very large cohorts of young people Despite the population health importance of early child feeding practices, little work has explored the knowledge and expectations about infant feeding that youth bring with them as they transition into parenthood Objective : To examine adolescent girls' perceptions of infant and young child feeding practices in their communities, and to assess their knowledge and expectations regarding infant and young child feeding practices and explore their overlap with current feeding recommendations Methods : Cross-sectional data were obtained from a random sample of 1,018 girls 13 to 17 years of age living in rural, semiurban, and urban sites in southwestern Ethiopia Surveys were used to collect information on respondents' attitudes, expectations, and perceptions within the domain of infant and young child feeding practices Descriptive and bivariate statistics were used to describe the data Results : A total of 1 018 girls aged 13 to 17 years were interviewed The girls were able to report the age at which infants in their communities were provided liquids, semisolids, and solids as well as the perceived duration of breastfeeding in their communities The girls were generally able to report when they themselves planned to provide liquids and solids to their infants and their expected duration of breastfeedmg The girls attitudes and expectations were not consistent with exclusive breastfeeding to 6 months, and planned durations of breastfeeding were shorter than they currently perceived in their communities Conclusions : Young nulliparous Ethiopian women have well-formed attitudes and expectations about infant and young child feeding These are unlikely to promote currently accepted best practices Our results suggest both the potential that suboptimal feeding practices will be reproduced and novel intervention point