Determinants of exclusive breastfeeding practices in Ethiopia

Background: Despite the demonstrated benefits of breast milk, the prevalence of breastfeeding, in-particular exclusive breastfeeding (EBF), in many developing countries including Ethiopia is lower than the international recommendation of EBF for the first six months of lifeObjective: To assess the practice of EBF and explore its determinants in Ethiopia and provide policy makers and NGOs with relevant information for future planning and interventions.Methods: Raw data collected from nine regions and two city administrations using stratified cluster sampling method by the Ethiopian Demographic Health Survey (EDHS) 2005 were used to study the practice and determinants of EBF countrywide. Analysis was based on children whose age was less than six months and alive at the time of interviewthat was extracted from the women’s database.Results: The overall rates of exclusive and full breastfeeding were 49.0% and 68.2% respectively. Maternal education, marital status, wealth index and age of the child were closely associated with EBF practices, nonetheless, in the hierarchical analysis; being not married, middle/ richer/ richest wealth index, and child age 0-1and 2-3 month wereretained as the predictors of EBF (

Utilization of antenatal care services among teenagers in Ethiopia: A cross sectional study

Background: Teenaged women suffer from a disproportionate share of reproductive health problem. The purpose of this study was to estimate the utilization of antenatal care (ANC) services among teenagers (13-19 years) during delivery in Ethiopia.Methodology: Raw data collected from all part of the country on child bearing aged women using stratified cluster sampling method by the Ethiopian Demographic Health Survey 2005 was used. From the large dataset of women, a total of 994 teenage women at the time of their most recent childbirth five years prior to the survey was selected andanalyzed. Both bivariate and multivariate analyses were performed to determine the differentials of ANC by explanatory variables.Result: Most (60%) of the subjects were in the age group between 18 and 19 years. The vast majority (90%) was from the rural settings and most (87%) were in marital union. Almost three out of four (72.4%) of those who had given birth has no any form of formal education. Over a quarter (27.3%) of most recent childbirths had at least one ANC service, of this, 21% had started their first antenatal visit in the first trimester of pregnancy. The majority (80.4%) of the women who attended ANC delivered at home without being assisted. The major deriving factors forthe utilization of ANC service were education level of women and their male partners, better wealth index and urban residence.Conclusion: Education of partners, rich wealth index and urban residence seemed to encourage teenagers to utilize ANC. Appropriate interventions targeting teenaged women with poor socioeconomic status is recommended with more emphasis on the rural underserved segment of population

HIV positive status disclosure to sexual partner among women attending ART clinic at Hawassa University Referral Hospital, SNNPR, Ethiopia

Background: Disclosure of HIV positive status has key role in the prevention and control of HIV/AIDS. Reports of non-disclosure and negative outcome of disclosure are common. Thus, disclosure of HIV positive status is a theme that demands investigation.Objective: The objective of this study was to determine the magnitude and outcome of HIV positive status disclosure to sexual partner among women living with HIV/AIDS and attending Hawassa University Referral Hospital, South Nations and Nationalities Peoples Region (SNNPR) during a period of March to April 2008.Methods: A cross sectional survey was conducted at Hawassa University  Referral Hospital. Single population proportion formula was used to determine sample size. Using a structured and pre-tested questionnaire, data on disclosure were collected through interview. After explaining purpose of the survey, data collection was continued until the required sample was obtained. Then, data were entered using EPI info version 2002 statistical package and cross checked for reliability. Using SPSS 12.1 for windows statistical package, analysis was done. Results: Overall 85.7% of the women had disclosed their HIV positive status to sexual partner. Main barriers of disclosure reported by non-disclosed subjects were; fear of abandonment, fear of break-up in relationship and fear of stigma. More than 59% of the women with regular sexual partner faced negative partner reaction after disclosure. Compared with married women, those women who were in a cohabiting relationship were less likely to disclose their HIV status to sexual partners (AOR 0.16; 95% CI 0.04, 0.60); women who did not know HIV status of their sexualpartners were less likely to disclose their HIV positive status than their counter parts (AOR 0.02; 95% CI 0.00, 0.08) and women who had been on ART for more than one year were more likely to disclose their HIV positive status than the reference groups (AOR 8.62; 95% CI 1.35, 55.22).Conclusion: HIV positive status disclosure to sexual partner in this study was higher than what was reported in other studies in Ethiopia, for Mettu and Gore (69%) but slightly lower than the report from Jimma (94.5%) and Addis Ababa (92%). Negative partner reaction following disclosure was higher. Effectively addressing issues of disclosure was recommended to encourage disclosure and cope with negative reactions after disclosure in People Living with HIV/AIDS (PLWHA). Besides, currently existing Information Education Communication (IEC) interventions on HIV/AIDS should be strengthened, to reduce negative partner reaction following disclosure. [Ethiop. J. Health Dev. 2010;24(1):9-14

Determinants of adolescent fertility in Ethiopia

Background: Worldwide, adolescents suffer from a disproportionate share of reproductive health problem. Throughout the world, over 14 million adolescents aged 15-19 years give birth annually. The purpose of this study was to assess the level and identify proximate and other determinants of adolescent fertility in Ethiopia.Methods: Raw data collected from all part of the country using stratified cluster sampling method by the Ethiopian Demographic Health Survey 2005 (EDHS-2005) was used. After the data for adolescents aged from 15 to 19 years were extracted from the large data set, Multivariate logistic regression model was applied to identify sociodemographic and economic determinants whereas Bongaarts model was used to determine proximate determinants fertility.Results: Of the 3,266 adolescent women, 443 (13.6%) had given birth at least once prior to the survey and 133 (4.1%) were pregnant. Of the 443 adolescents who had at least given birth, the majority (72.7%) had one child while about a quarter (23.2%) had 2 live births and the rest 1.0% gave four live births with a mean number of child ever born of 1.33±0.6. The major factors associated with adolescent fertility were age, educational status, place of residence, employment, marriage, contraceptive use and postpartum infecundability. The odds for increased adolescent fertility was significantly higher in early adolescents (AOR=7.6; 95% CI=6.0 to 9.9), had lower education (AOR=6.7; 95%CI=4.1 to10.9), among rural teens (AOR=3.6; 95%CI=1.9 to 6.9) and currently not working (AOR=1.7; 95%CI= 1.3 to 2.2) than their counterparts. The observed fertility rate of 0.52 children per woman obtained from Bongaarts model of fertility indicated about 1.98 births per woman were averted due to non-marriage, delayed marriage, contraceptive use and postpartum infecundability.Conclusion: Since adolescent fertility is felt to be a problem, concerted efforts are needed to empower adolescents to fight early marriage, promote education and encourage the utilization of family planning targeting the rural teenagers. [Ethiop. J. Health Dev. 2010;24(1):30-38

Page number not for citation purposes 1 Assessment of the household availability of oral rehydration salt in rural Botswana

Introduction: Diarrhea contributed for 17.6% of under-five deaths in Botswana. Oral rehydration salt (ORS) therapy has been the cornerstone in the control of morbidity and mortality secondary to diarrheal diseases. The study was aimed at assessing the household availability of ORS following the nationwide campaign of availing ORS at household level. Methods: A cross sectional community based study was conducted in August 2012. EPI random walk method was used to identify households. Data was collected using interviewers' administered structured questionnaire. SPSS software was used in data entry and analysis. Results: Oral Rehydration Salt (ORS) was available in 50.8% of the households with under-five children. Information on ORS is well disseminated whereas only three-fourth of informed participants had adequate knowledge of ORS preparation. The sources of information were predominantly the Child Welfare Clinic (88.8%). Being grandmother as a care taker was a negative predictor of household availability of ORS (AOR 0.25, 95% CI 0.09-0.69) while respondents who are knowledgeable about ORS preparation were more likely to have ORS available at home (AOR 1.92, 95% CI 1.10-3.34). Conclusion: The campaign has brought a significant coverage in terms of availability of ORS. The health education and community sensitization efforts need to go beyond health facilities via other means like the media  and community based approaches. Approaches aimed at improving the knowledge of care takers on the importance of ORS, its preparation, correct use and restocking are of paramount importance. Availing community based outlet for ORS is an alternative to enhance accessibility.Key words: Oral, Rehydration, Salt, ORS, availability, Botswan

Illness and Treatment Perceptions of Patients with Epilepsy Attending Treatment at a Tertiary Hospital in Addis Ababa – A Qualitative Exploration

BACKGROUND: Epilepsy can be a large economic burden in countries where appropriate treatment is not taken due to religious and psychosocial beliefs. The objective of this study was to explore the perceptions and experiences of patients with epilepsy attending their treatment at Tikur Anbessa SpecializedHospital about their illness and treatment.METHODS: A qualitative exploratory design with an in-depth interview was followed. Fourteen purposively selected patients were used until saturation of key emerging themes was achieved.RESULTS: The finding showed that study participants expressed perceptions towards their illness including about its cause, timeline, severity and psychosocial consequences which at times may be considered different from the biomedical version. They also expressed concerns about their treatment, reported aboutsocial and psychological issues and in certain cases dissatisfaction with their healthcare providers. Such issues may have led to delays in treatment-seeking and non-adherence to recommended treatment regimens and as well use of traditional medicine and spiritual healing. On the other hand, reasons that were reported to positively influence their treatment experiences include necessity perceptions about their medications, family support and use of spiritual healing alongside their biomedical treatment.CONCLUSION: The healthcare provision should improve to cater to these groups of patients including instituting chronic care management and appropriate health education provision

Guide to chicken health and management in Ethiopia: For farmers and development agents

Biotechnology and Biological Sciences Research Council, United KingdomDepartment for International Development, United Kingdo

Genetic Diversity among and within Accessions of a Lablab (\u3ci\u3eLablab purpureus\u3c/i\u3e) Collection Maintained in the ILRI Forage Genebank

Lablab (Lablab purpureus L.) is an important annual multi-purpose legume used as a vegetable for human consumption, as forage for livestock, and as green manure and a cover crop to improve soil fertility. It has a high feed value with good digestibility and high crude protein content. The International Livestock Research Institute (ILRI) forage genebank holds a diverse set of 340 lablab accessions collected from different regions of the world. A total of 1,843 plants from 142 lablab accessions (1 to 29 plants per accession genotyped individually) were genotyped by the genotyping-by-sequencing (GBS) method of the DArTseq platform. The genotyping produced a total of 38,824 and 64,793 genome-wide single nucleotide polymorphism (SNP) and SilicoDArT high-density markers, respectively. The short sequence reads corresponding to the markers were mapped on the mungbean (Vigna radiata) reference genome, with approximately 37% of the SNPs and 26 % of the SilicoDArTs able to be mapped. A subset of 1,000 robust markers was filtered by different criteria and used for the diversity analysis. Clustering analysis using the discriminant analysis of principal components (DAPC) detected five major groups, each with further subgroups. Analysis of molecular variance (AMOVA) showed a highly significant (P \u3c 0.00001) variation, explaining more than 73 % of the variance among the accessions. A significant variation (P \u3c 0.005) was also observed among plants within accessions, which explained about 27 % of the variation. The results of this study provide a useful guide for the management and rationalization of activities of the lablab germplasm collection at the ILRI genebank. The substantial genetic diversity observed in the collection reveals the potential of the population for further genetic studies