Sexual and reproductive health services use, perceptions, and barriers among young people in southwest Oromia, Ethiopia

Background: Utilizations of sexual and reproductive health (SRH) services among young people is vital in reducing sexual and reproductive health problems. This study investigated young people’s perceptions and barriers towards the use of sexual and reproductive health services in Southwest Ethiopia.Methods: A cross sectional study was employed to collect data from 1,262 in-school youths. Simple random sampling technique was used to select schools and study participants. Fifteen focus group discussions and 22 key informant interviews were conducted. Multiple logistic regression analyses were conducted . P value ≤ 0.05 was set to determine statistical significance. Data were analyzed using SPSS v16. Qualitative data were triangulated with quantitative findings and also presented in themes.Results: Four hundred sixty (36.5%) of the respondents had utilized sexual and reproductive health services. Advice on sexual and reproductive health was the major (67.2%) service sought followed by seeking-treatments (23.3%). Health centers were the major (65.0%) source of SRH services. Being married, being sexually active, father-child communication, religion and place of residence were significantly associated with use of sexual and reproductive health services (p<0.05). Lack of information about SRH, poor perceptions about SRH, feeling of shame, fear of being seen by others, restrictive cultural norms, lack of privacy, confidentiality and unavailability of services were deterring use of sexual and reproductive health services.Conclusions: Only a small proportion of young people used sexual and reproductive health services. Hence, in addition to behavioral modification interventions, it is essential to consider multi-level and culturally sensitive interventions in a holistic approach.Keywords: Young People, Sexual and Reproductive Health, Youth Perceptions, Service Use, Ethiopi

Barriers and facilitators of maternal health care services use among pastoralist women in Ethiopia: Systems thinking perspective

We explored the barriers and facilitators of maternal health care service use among women in the pastoralist region of Ethiopia. We used a mixed methods design—focus group discussions, key informant interviews, review of the literature and Participatory Ethnographic Evaluation Research (PEER) methods followed by a household survey among randomly chosen pastoralist women of reproductive age (n = 1,499). We used multi-variable regression analyses, and a p value ≤ 0.05 was set to determine statistical significance. In addition, we analysed qualitative data thematically and developed a causal loop diagram using dynamic synthesis methodology to analyse non-linearity, intricate relationships of the variable of interests. In this study, 20.6% of women used modern contraceptive methods, 44.6% had four or more antenatal visits and 38.4% of sampled women received skilled delivery services. We observed multiple individual and community related factors such as education, income and women’s and their partner’s knowledge, perceptions, husband approval, social norms and value-expectations and providers’ gender preferences and health systems factors such as access to health facilities, place of living, provider's cultural competency skills, supplies, delivery positions, economic and political stability, and provider's attitude were linked to maternal health care services utilization among women in pastoralist regions. Approaches towards pastoralists’ health care delivery systems should be responsive to their cultural and political ecology and human agency

The effect of food insecurity on health status of adolescents in Ethiopia: longitudinal study

Abstract Background The effect of food insecurity on health and wellbeing of a population has been the subject of much research. Yet, limited research has investigated its effect on adolescents’ health and wellbeing in Ethiopia. Method We used data from the Jimma Longitudinal Family Survey of Youth which began tracking a cohort of adolescents in 2005 to examine the social, behavioral and economic determinants of their health and well-being. A total of 1,919 sample were included in the main analyses. All youths provided data related to their food insecurity experiences and their health status. A mixed effect logistic regression using random intercept and trend model was used to examine the relationship between food insecurity and their health status. Fixed effects estimates were also computed to check the parsimoniousness of the random intercept and trend model. Results The results indicated that the mean (±SD) age of adolescents was 18.6(±1.4). Nine hundred twenty three (48.1%) of them were female. The magnitude of self-rated health status was relatively unstable ranging from 18.9%, 34.7% to 37.3% in each round. Similarly, 20.4%, 48.4% and 20.6% of adolescents were food insecure during each consecutive round of the survey respectively. Exposure to food insecurity is strongly associated with self-rated health status (β = 0.28, P < 0.001) and poor self-rated health was also more pronounced for some time (β =2.11, P < 0.001) and decline after a turning point (β = −0.38, P < 0.001). Conclusions These findings imply that any social, nutrition and public health interventions designed to improve adolescent health should consider underlying social determinants of health such as food insecurity

Food Insecurity and Common Mental Disorders among Ethiopian Youth: Structural Equation Modeling.

BACKGROUND:Although the consequences of food insecurity on physical health and nutritional status of youth living have been reported, its effect on their mental health remains less investigated in developing countries. The aim of this study was to examine the pathways through which food insecurity is associated with poor mental health status among youth living in Ethiopia. METHODS:We used data from Jimma Longitudinal Family Survey of Youth (JLFSY) collected in 2009/10. A total of 1,521 youth were included in the analysis. We measured food insecurity using a 5-items scale and common mental disorders using the 20-item Self-Reporting Questionnaire (SRQ-20). Structural and generalized equation modeling using maximum likelihood estimation method was used to analyze the data. RESULTS:The prevalence of common mental disorders was 30.8% (95% CI: 28.6, 33.2). Food insecurity was independently associated with common mental disorders (β = 0.323, P<0.05). Most (91.8%) of the effect of food insecurity on common mental disorders was direct and only 8.2% of their relationship was partially mediated by physical health. In addition, poor self-rated health (β = 0.285, P<0.05), high socioeconomic status (β = -0.076, P<0.05), parental education (β = 0.183, P<0.05), living in urban area (β = 0.139, P<0.05), and female-headed household (β = 0.192, P<0.05) were associated with common mental disorders. CONCLUSIONS:Food insecurity is directly associated with common mental disorders among youth in Ethiopia. Interventions that aim to improve mental health status of youth should consider strategies to improve access to sufficient, safe and nutritious food