Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia

Background: As the burden of cardiovascular disease increases in sub-Saharan Africa, there is a growing need for low-cost interventions to mitigate its impact. Providing self-care health education to patients with chronic heart failure (CHF) is recommended as an intervention to prevent complications, improve quality of life, and reduce financial burdens on fragile health systems. However, little is known about health education’s effectiveness at improving CHF self-management adherence in sub-Saharan Africa. Therefore the present study aimed to assess the effectiveness of an educational intervention to improve self-care adherence among patients with CHF at Debre Markos and Felege Hiwot Referral Hospitals in Northwest Ethiopia. Methods: To address this gap, we adapted a health education intervention based on social cognitive theory comprising of intensive four-day training and, one-day follow-up sessions offered every four months. Patients also received illustrated educational leaflets. We then conducted a clustered randomized control trial of the intervention with 186 randomly-selected patients at Debre Markos and Felege Hiwot referral hospitals. We collected self-reported data on self-care behavior before each educational session. We analyzed these data using a generalized estimating equations model to identify health education's effect on a validated 8-item self-care adherence scale. Results: Self-care adherence scores were balanced at baseline. After the intervention, patients in the intervention group (n = 88) had higher adherence scores than those in the control group (n = 98). This difference was statistically significant (β = 4.15, p < 0.05) and increased with each round of education. Other factors significantly associated with adherence scores were being single (β = − 0.25, p < 0.05), taking aspirin (β = 0.76, p < 0.05), and having a history of hospitalization (β = 0.91, p < 0.05). Conclusions: We find that self-care education significantly improved self-care adherence scores among CHF patients. This suggests that policymakers should consider incorporating self-care education into CHF management

Determinants of prelacteal feeding practice among postpartum mothers in Debre Markos town, Amhara regional state, Ethiopia, 2016

Tenaw Gualu,&nbsp;Abebe Dilie,&nbsp;Dessalegn Haile,&nbsp;Abebe Abate Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia Background: Prelacteal feeding (PLF) is giving liquids or food other than breast milk prior to the establishment of regular breast-feeding (colostrum). The practice of PLF is common in Ethiopia. PLF deprives the child of the valuable nutrients and the protection of colostrum and exposes the newborn to the risk of infection. There are limited studies conducted so far on this topic, and even then, findings are inconsistent. Objective: The objective of this study was to assess determinants of PLF practice and associated factors among postpartum mothers in Debre Markos town, Amhara Regional State, Ethiopia, 2016. Methods: A community-based cross-sectional study was conducted among 262 mothers (postpartum) with infants. Census data was used to include all the postpartum mothers and infant pairs. Structured interviewer-administered questionnaires were used to collect data. The data were cleaned, coded, and entered in Epi data version 3.1 and transferred to SPSS version 20.0 for analysis. Frequency and percentage were used to summarize the sociodemographic characteristics. Variables with a P-value of &lt;0.05 in multivariate analysis were declared statistically significant at a 95% confidence interval.Result: Approximately 50 (19.1%) of the mothers had given one prelacteal feed before initiating colostrum. Cow milk, butter, clean water, sugar, honey, salt, and tea were the most common prelacteal feeds used. Inability to read and write 3.5 (1.14&ndash;10.75), giving birth to a male 2.8 (1.23&ndash;6.37), home delivery 4.4 (1.78&ndash;10.85), breast-feeding initiation after 24 hours 6.4 (2.38&ndash;17.18), and previous experience with PLF 3.7 (1.48&ndash;9.22) were factors positively associated with PLF.Conclusion and recommendation: It was observed that the prevalence of PLF was relatively high in the study area (19.1%). Education status of the mother, infant&rsquo;s sex, timing of breast-feeding initiation, site of delivery, and previous experience with PLF were factors associated with PLF. Education should be provided to promote institutional delivery and increase awareness about the importance of exclusive breast-feeding. Keywords: prelacteal feeding, practice, factors, Debre Markos, Ethiopia&nbsp