Intimate partner violence and unmet need for contraceptive use among Ethiopian women living in marital union

AbstractBackground: The nature of the association between intimate partner violence (IPV) and unmet need for family planning is likely complex. It is important to understand the relationship in low-resource settings where the rates of IPV and unmet need for contraceptives are high, even after controlling for socio-demographic and other important reproductive health factors.Methods: The study employed a cross-sectional design using data from the 2016 Ethiopian Demographic and Health Survey. A total of 2810 woman in marital union were included in the study. Interviews with the women assessed unmet need for contraceptives using the indicator of whether the last pregnancy was wanted at the time of conception, or not wanted at all. Intimate partner violence was defined as a woman having experienced either physical or sexual violence by their partner. The association was illustrated crudely and after adjusting for some socio demographic and reproductive characteristics of the women.Results: The study found that the lifetime prevalence of intimate partner violence among women in marital union was23.8%. The level of unmet need for contraceptives for the last pregnancy was 22.0%, (13.9% for spacing and 8.1% for total limiting of bearing a child). Intimate partner violence, measured by experience of physical or sexual violence, was strongly associated with unmet need for contraceptives, even after adjusting for some socio demographic, fertility, and gender related characteristics [AOR=3.03; 95% CI, (2.45, 3.75)].Conclusion: Intimate partner is strongly associated with unmet need for contraceptives among Ethiopian women living in marital union. Policy makers working in family planning should consider prevention of gender-based violence, particularly intimate partner violence. [Ethiop. J. Health Dev. 2018;32(3):00-000]Key words: IPV, Unmet need, contraception, Ethiopia, EDH

Substance use and birth weight among mothers attending public hospitals: A case control study

Background: Substance use during pregnancy is greatly underestimated in many parts of the world. Specifically, there are limited up-to-date researches addressing the relationship between substance use and birth outcomes among women in Ethiopia. Therefore, having a study to close the gap and generate firsthand information on the issue is important. The aim of this study is to determine the effect of maternal substance use during pregnancy on the birth weight of a newborn.Methods: The study used analytic facility based case control study, using a face to face interview with a structured and pre-tested questionnaire. The total sample size was allocated to each health facility based on their patient load through proportion to population size, and a total of 112 cases of neonates with low birth weight (weight < 2500gms) were compared with 235 controls of neonates, born with a birth weight above 2500 grams or more. The data were analyzed using both bivariate and multivariable analysis.Results: - Maternal khat chewing, tobacco smoking and narghile (shisha) smoking during pregnancy and paternal smoking were statistically associated with lower birth weight. However, maternal history of alcohol drinking during pregnancy was not associated with lower birth weight. Mothers who did not attend primary school and having history of previous low birth weight child were statistically associated with low birth weight. Moreover, lesser weight gains during pregnancy and short intra pregnancy interval were associated with low birth weight.Conclusion: - The association of low birth weight with substance use was strong, particularly, with maternal khat chewing, cigarette and narghile (shisha) smoking including passive smoking during pregnancy. Therefore, we recommend health professionals working in antenatal care service, be aware, on counseling of mothers for banning or lowering use of substance during pregnancy. Key word: Substance use, Pregnancy, Birth weight, Smoking, Khat chewing, Ethiopi

A descriptive analysis of depression and pain complaints among patients with cancer in a low income country

This study highlights the clinical significance of both depression and pain complaints in patients with cancer in a low income country. Exploration of the impact of depressive disorders on quality of life and outcome of cancer is an important area for further research in low income countries

Intimate partner violence during pregnancy and preterm birth among mothers who gave birth in public hospitals, Amhara Region, Ethiopia: A case-control study

Background: Preterm birth (PTB) is an important and under-reported public health problem in developing nations such as Ethiopia. Limited research has been conducted to date to address the effect of intimate partner violence (IPV) during pregnancy on PTB. This study was conducted to assess the association between IPV during pregnancy and PTB. Methods: A case control study was conducted on 138 cases and 276 controls in four randomly selected public hospitals from February to April 2018. Mothers who gave birth before 37 completed weeks of gestation were included as cases, and mothers who gave birth at 37 and above completed weeks of gestation were deemed as controls. A simple random sampling technique was employed to select the two consecutive controls. Bivariate and multivariate logistic regression analyses were done. Results: In this study, the prevalence of any IPV during pregnancy was 44.8% among cases and 25% among controls. Any IPV during pregnancy was significantly associated with PTB [AOR = 2.85; 95% CI: 1.42-6.22]. In addition, women who were exposed to emotional violence during the recent pregnancy were three times more likely to have a PTB compared to those who were not violated [AOR = 3.05; 95% CI: 1.35-6.91]. Similarly, women who experienced physical IPV during pregnancy were 2.6 times [AOR = 2.56; 95% CI: 1.27-6.78] more at risk of PTB compared to those who had no physical IPV. Conclusion: This study found that IPV during pregnancy is significantly associated with PTB. Hence, IPV screening needs to be integrated into routine antenatal care (ANC) services. [Ethiop. J. Health Dev. 2020; 34(1):44-53] Key words: Intimate partner violence, pregnancy, preterm birth, Ethiopi

Quality of Tuberculosis Care in Private Health Facilities of Addis Ababa, Ethiopia

Ensuring provision of good quality tuberculosis (TB) care, especially in private for profit health facilities, is an important component of TB control strategy to reduce poor medical practice which results in multidrug resistant TB (MDR-TB). The aim of this study was to investigate quality of TB care in private health facilities of Addis Ababa. A facility based cross-sectional study was conducted based on Donabedian's structure-process-outcome model of health care quality. Quality of care was determined by adherence to National TB Program guidelines, treatment success rate, and client satisfaction. Exit interview was conducted on 292 patients on the intensive phase of treatment and 384 patient records were reviewed in eight private health facilities. Initial diagnostic AFB test was done for 95.4% of pulmonary TB patients. Most important components of TB care recommended by national guidelines were delivered for a significant proportion of patients. Majority (75%) of the clients were found to be satisfied with each component of TB care. The treatment success rate was 90.9%. The quality of TB care was fairly good. However, only 77.7% of the patients were counseled for HIV testing. Strengthening HIV counseling and testing, tackling shortage of streptomycin and laboratory reagent at private TB clinic is crucial

'I should not feed such a weak woman'. Intimate partner violence among women living with podoconiosis: A qualitative study in northern Ethiopia

Background Intimate Partner Violence (IPV) is a serious, preventable public health problem that affects millions of people worldwide. Research indicates that adults suffering from long term, disabling conditions are more likely to be victims of IPV due to the intersection of disease-associated stigma and discrimination. IPV in turn is known to worsen the overall health and wellbeing of those affected by it. Little research however explores the relationship between neglected tropical diseases such as podoconiosis and IPV. This study explores the relationship between IPV and podoconiosis in northern Ethiopia with the aim of identifying new avenues for limiting disability and promoting the wellbeing of people affected by this neglected tropical disease. Methods The study was conducted in East and West Gojjam zones, located in the Amhara Regional State of Ethiopia. Research participants were first screened using the domestic violence screening tool Hurt-Insult-Threaten-Scream (HITS). Data were collected by native speakers of the local language (Amharic) in the form of semi-structured interviews during January and February 2016. Thematic and content data analysis was carried out, using the Open Code 3.4 qualitative data analysis software for coding. Results A total of 15 women living with podoconiosis and experiencing IPV were interviewed (aged 31 to 75). Women experienced different forms of IPV, including beatings (with or without an object), insults, name calling, undermining, denial of equal rights over common assets, movement monitoring, cheating, abandonment, forced divorce, obstruction of health care access, inhibition of decision-making and sexual coercion. Podoconiosis increases the frequency and severity of IPV and in occasions shapes a change from physical to psychological and financial violence. In turn, frequent episodes of IPV worsen disease outcomes and contribute to disease persistence in the region, in that these impede women’s ability to manage the disease and help perpetuate the conditions of poverty that influence disease onset. Conclusions Women living with podoconiosis are victims of various, overlapping forms of IPV that negatively impact their health and wellbeing. Poverty, scarce IPV prevention services in the area together with a social acceptance of IPV and these women’s decreased ability to work due to the debilitating effects of podoconiosis and childcare responsibilities frequently prompt these women to tolerate IPV and remain in abusive relationships. Tackling disease-associated taboo and stigma, developing accessible IPV interventions, working towards greater gender equality at the household and societal levels and developing sustainable strategies for improving the socio-economic assets of women affected by podoconiosis are all necessary to both prevent IPV and to improve disease outcome

Intimate partner violence and depression among women in rural Ethiopia: a cross-sectional study

Background: Studies from high-income countries have shown intimate partner violence to be associated with depression among women. The present paper examines whether this finding can be confirmed in a very different cultural setting in rural Ethiopia. Method: A community-based cross-sectional study was undertaken in Ethiopia among 1994 currently married women. Using the Composite International Diagnostic Interview (CIDI), cases of depressive episode were identified according to the ICD-10 diagnosis. Using a standardized questionnaire, women who experienced violence by an intimate partner were identified. A multivariate analysis was conducted between the explanatory variables and depressive status of the women, after adjusting for possible confounders. Results: The 12-month prevalence of depressive episode among the women was 4.8% (95% CI, 3.9% and 5.8%), while the lifetime prevalence of any form of intimate partner violence was 72.0% (95% CI, 70.0% and 73.9%). Physical violence (OR = 2.56, 95% CI, 1.61, 4.06), childhood sexual abuse (OR = 2.00, 95% CI, 1.13, 3.56), mild emotional violence (OR = 3.19, 95% CI, 1.98, 5.14), severe emotional violence (OR = 3.90, 95% CI, 2.20, 6.93) and high spousal control of women (OR = 3.30, 95% CI, 1.58, 6.90) by their partners were independently associated with depressive episode, even after adjusting for socioeconomic factors. Conclusion: The high prevalence of intimate partner violence, a factor often obscured within general life event categories, requires attention to consider it as an independent factor for depression, and thus to find new possibilities of prevention and treatment in terms of public health strategies, interventions and service provision. © 2009 Deyessa et al; licensee BioMed Central Ltd

Community-Based Assessment of People with Chronic Diseases and Conditions Worsening the Severity of COVID-19 in Addis Ababa City Administration

AbstractBackground: the COVID-19 pandemic stayed in a sporadic form for a long time after introducing the coronavirus in the country, later appearing in clusters within communities. During such sporadic and clustered spread of the disease, the government of Ethiopia started identifying suspects through active surveillance for COVID-19. This study aimed to describe people who have chronic illnesses that could be underlying conditions for increased severity of COVID-19.Methods: A survey was conducted in May 2020 using active community-based case surveillance in 30 randomlyselected woredas in Addis Ababa City. Data were collected from each household member by assessing for general conditions and diseases expected to increase their risk of suffering higher severity from COVID-19. Data were stored in M.S. Excel and analyzed using SPSS-version 26 for windows. Descriptive analysis was conducted to know the proportion of persons with chronic diseases, and thus the population with a higher risk of suffering more severity from COVID-19 by place, person, and time. The results are presented using tables and graphs as appropriate.Results: The point prevalence of flu-like syndrome was 51.9 per 100,000 persons, and the prevalence was higher among older people. The study showed that 11,600 per 100,000 households have at least a member with chronic diseases that worsen the severity of COVID-19 morbidity. The survey also found 6,939 and 5,140 households per 100,000 households have diabetes mellitus and hypertension, respectively, and about 1950 per 100,000 households were with bronchial asthma. Nearly a quarter of the households have people with two or more chronic diseases that worsen their risk of facing a more severe course of COVID-19 than it would be for people without those underlying conditions.Discussion: High proportion of households have people with chronic diseases that worsen their risk of suffering a more severe course of COVID-19 than it would be for people without those underlying conditions. The Ministry of Health should devise and implement mechanisms to safeguard people with chronic diseases from contracting the diseases. [Ethiop. J. Health Dev. 2021; 35(2):133-140]Keywords: COVID-19, chronic diseases, severe course of COVID-19, Addis Abab