Development Projects to Improve Maternal and Child Health: Assessing the Impact

Berhane discusses a new study in PLoS Medicine that evaluated the effect of improved water access in rural Ethiopia upon birth rate and child malnutrition

Adolescents' health service utilization pattern and preferences: Consultation for reproductive health problems and mental stress are less likely

No Abstract Available Ethiop.J.Health Dev. Vol.19 (1) 2005: 29-3

The use of simplified verbal autopsy in identifying causes of adult death in a predominantly rural population in Ethiopia

BACKGROUND: Information on adult mortality is essentially non-existent in Ethiopia particularly from rural areas where access to health services is limited and most deaths occur at home. This study was conducted with the aim of identifying causes of adult death in a rural population of Ethiopia using a simplified verbal autopsy instrument. METHODS: All deaths in the age-group 15–49 years during the period of 1995–99 were taken from computerized demographic surveillance database maintained by the Butajira Rural Health Program. Data on the causes of death were collected from close relatives of the deceased persons by lay interviewers. Causes of death were diagnosed using "expert algorithm" programmed onto a computer. RESULTS: The major causes of death were acute febrile illnesses (25.2%), liver diseases (11.3%), diarrheal diseases (11.1%), tuberculosis (9.7%) and HIV/AIDS (7.4%). Overall communicable diseases accounted for 60.8% of the deaths. The high levels of mortality from communicable diseases reflect the poor socioeconomic development of the country, and the general poor coverage of health and education services in rural Ethiopia. The tools used in this study can easily be added-on to the numerous health surveys conducted in the country. CONCLUSION: The simplified approach to verbal autopsy diagnosis can produce useful data that can effectively guide priority health interventions in rural areas where routine information system is either very weak or non-existent

EditorialAvian flu pandemic threat: why is Ethiopia considered at risk

No Abstract.Ethiopian Journal of Health Development Vol. 19(3) 2005: 165-16

Noise-induced hearing loss among textile workers

Abstract: A cross-sectional study was conducted in Dire-Dawa Textile Factory in October-December 1994, to assess the prevalence of, and risk factors for, noise-induced hearing loss (NIHL). A sample of 630 workers was selected from the factory rosters by means of systematic sampling technique. Data were collected through interview, otologic examination, and pure tone audiogram measurement. Environmental noise survey and personal dosemeter data were also collected to determine noise exposure levels at every section of the mill. The highest noise level in area samples was observed in the weaving section, with mean + SD of 99.5±3.2 dB. Audiometric tests, measured at a frequency of 4,000 Hz, revealed a 34% overall prevalence of NIHL, (hearing threshold level exceeding 25 dB), with the highest prevalence of 71.1% observed among the weavers. Preventive interventions were generally absent, with no employee reporting use of personal protective devices (PPDs). In view of the documented risk of NIHL among these workers, implementation of a hearing conservation programme is recommended. [Ethiop. J. Health Dev. 1999;13(2):69-75

Cross-generational sexual relationship in Addis Ababa: A qualitative study

Background: Cross-generational sexual practices are considered unsafe sexual behaviors. The risk of acquiring sexually transmitted infections including HIV is believed to be high among those involved in cross-generational sexual relationship. However, studies addressing why and how people are engaged in such practices are limited. This study attempted to fill this gap. This study therefore explored cross generational sexual relationships and their perceived effects in Addis Ababa, Ethiopia.Methods: Qualitative research with a phenomenological study design was carried out in Addis Ababa, Ethiopia in 2014. Individuals who had personal experience of cross-generational sexual relationship (CGSR), and/or who were familiar with the practice were selected using snow balling technique. Six focus group discussions, three key informants and five in-depth interviews and non-participatory observations were conducted to obtain data for the study. All the FGDs and in-depth interviews were audio-recorded. The recorded data were transcribed and analyzed using a thematic approach in which motives, customs, perceived risks were separately identified for young girls and older men.Results: The motives for engaging in CGSR were found to be not the same for young girls and older men. The motives for young girls to get engaged in CGSR were often related with acquiring money and material while older men reported sexual pleasure as their driving force. The findings also revealed that cross-generational sexual relationship between a young girl and an older man did not last long. The economic background of young girls involved in such a practice was found to be mixed. This means that there were girls from poor economic background while also there were girls in the group whose economic background was fairly better off. Similarly, the educational background of the girls involved in CGSR was not found to be uniform. This means that many had either high school or college level educational background. Some in the group claimed to have completed university education. There were also illiterate young girls in the group that participated in the study. In connection with marriage, regardless of their economic background, both married and unmarried older men had this relationship. The young girls may have control on whether or not to engage themselves in CGSR. It should however be stated they either have no or little control on what would happen within relationships including the use of condom during sex. Similarly, asking for proof of HIV test before sex was also found to be a point beyond the relationship.Conclusion: Cross generational sexual relationships in Addis Ababa are likely to be unsafe due to the absence of condom use, absence of proof of HIV test before sex, and presence of multiple sexual partners. Further studies are necessary to measure the extent and effects of CGSRs. [Ethiop. J. Health Dev. 2017;31(4):228-235]Keywords: cross-generational sex, HIV, risky sexual behavior, transactional se

Timing of first antenatal care visit and its associated factors among pregnant women attending public health facilities in Addis Ababa, Ethiopia

Background: Early initiation of antenatal care visits is an essential component of services to improving maternal and new born health. The Ethiopian Demographic and Health Survey conducted in 2011 indicated that only 11% of pregnant women start antenatal care in the first trimester. However, detailed study to identify factors associated with late initiation of care has not been conducted in Addis Ababa where access to health services is almost universal. The aim of this study was to assess the level of late first antenatal care visit and the associated factors.Methods: Facility based cross sectional study was conducted in public health centers in Addis Ababa. The health centers with experience of at least more than two years were selected randomly, one form each sub-city. The study subjects were pregnant women visiting the facilities for the first time during the index pregnancy. The study health centers were selected randomly from each sub-city, and the study women were recruited consecutively until the required sample size was achieved. Data were collected using pre-tested questionnaire. Logistic regression analysis was done to identify factors associated with late ANC initiation.Result: A total of 979 women participated in the study; 411(42.0%; 95% CI of 38.9%, 45.1%) of them came for their first ANC visit late, after 16 weeks of gestation. Wrongly perceived ANC initiation schedule was the strongest predictor of late initiation. After controlling for basic demographic and obstetric factors, the odds of starting the first antenatal care visit late was higher for women who did not know the antennal care initiation schedule correctly compared to women who knew the schedule correctly (AOR6.6; 95% CI 3.03, 14.03).Conclusion: Over 40% of pregnant women do not initiate ANC visit in the first trimester largely due to lack of correct knowledge of the recommended ANC schedule.Keywords: Antenatal, Ethiopia, Initiation tim

Community awareness and practice of family planning in an urban community in Addis Ababa, Ethiopia

Abstract: To assess community awareness and practices concerning family planning in an urban community in Addis Ababa, Ethiopia, a survey was carried out in June and July 1993. Of the 536 people interviewed 332 (61.9%) had heard about family planning. The contraceptive prevalence rate in the community was 29.5%, with oral contraceptive pills being the most popular method. Contraceptive methods usage rate was observed to be significantly higher among people with permanent job (OR=1.98), among highly educated (OR=3.82) and among people with larger family size (OR=1.92) compared to the others. Health workers and radio were the main sources of family planning information, by 70% and 20% of the study population, respectively. The major barriers to contraceptive use were fear of side-effects and religious taboos. Only 4% of the study population obtained their contraceptives from hospitals and private clinics, and over 90% of the respondents suggested that contraceptives be distributed free of charge. The study demonstrated that there still exists a wide gap between the knowledge about contraception and actual use. Expansion of family planning services through inexpensive and more accessible means and strengthening of individual counselling are recommended as ways to reduce this gap. [Ethiop. J. Health Dev. 1995;9(3):133-139

Accuracy of physicians in diagnosing HIV and AIDS-related death in the adult population of Addis Ababa, Ethiopia

Background: The lack of cause of death information is the main challenge in monitoring the effectiveness of interventions aimed at reducing HIV and AIDS-related deaths in countries where the majority of deaths occur at home. Objective: To evaluate the accuracy of physician reviewers of verbal autopsies in diagnosing HIV and AIDS-related deaths in the adult population of Addis Ababa, the capital of Ethiopia. Methods: This study was done within the context of a burial surveillance system in Addis Ababa. Trained interviewers completed a standard verbal autopsy questionnaire and an independent panel of physicians reviewed the completed form to assign cause of death. Physicians’ review was compared to a reference standard constructed based on prospectively collected HIV-serostatus and patients’ hospital record. Sensitivity and specificity were calculated to validate the physicians’ verbal autopsy diagnoses against reference standards. Results: Physicians accurately identified AIDS-related deaths with sensitivity and specificity of 0.88 (95% CI: 0.80 - 0.93) and 0.77 (95% CI: 0.64 - 0.87), respectively. Generally, there was high level of agreement (Cohen’s Kappa Statistic (K > 0.6) between the first two physicians with some yearly variations. In 2008 and 2009 there was an almost perfect agreement (K > 0.80). Conclusion: This study demonstrated the agreement level between two independent physicians in diagnosing AIDS-related death is very high and thus using a single verbal autopsy coder is practical for programmatic purposes in countries where there is critical shortage of doctors

Neonatal mortality among hospital delivered babies in Addis Ababa, Ethiopia

Abstract: A follow up study to determine the magnitude of neonatal mortality and identify its determinants was done on a cohort of babies born at the health institutions in Addis Ababa. Baseline information on risk behaviour of the mother and child characteristics were recorded just after delivery. Then, follow up interviews were done on the 7th and 28th day by visiting each neonate/mother at home. A total of 1334 singleton newborns were included in the study. The neonatal mortality rate was found to be 71.9 per 1000 live birth with early and late neonatal mortality rates of 50.9 and 20.9 per 1000 live berth, respectively. Low birth weight and prematurity were associated with a higher risk of neonatal death. Establishing essential neonatal care facilities at all levels and further study among home deliveries are recommended. [Ethiop. J. Health Dev. 1997;11(3):275-281