Determinants of under-five mortality in Gilgel Gibe Field Research Center, Southwest Ethiopia

Background: In developing countries like Ethiopia where there is no vital events registration system and laboratory diagnosis is lacking, causes of death in under-five children and its determinants could not be well known. The objective of this study was to investigate causes of death and its determinants in under-five children in Gilgel Gibe Field Research Center. Methods: A case-control study was conducted from December 12 to 27, 2005. Cases of under-five children who died between August 27, 2004 and September 22, 2005 and controls of alive children with the same age (+/-2 months) as cases were identified by a survey as the study population. Data were collected by trained enumerators using structured questionnaire adopted from World Health Organization (WHO). Causes of death were determined using the expert algorithm based on verbal autopsy data. Results: Neonatal and infant mortality rates were respectively 38 and 76.4 per 1000 live births. The two most common causes of death during neonatal period were prematurity (26.4%) and pneumonia (22.6%). Whereas the top causes of death in post-neonatal period were pneumonia (42%), malaria (37%) and acute diarrheal diseases (30%). Maternal education, practice and perception of mothers on the severity of illness and benefits of modern treatment were found to be independent predictor of child survival. Conclusion: Neonatal causes, pneumonia, malaria and diarrheal diseases were the major killers of under-five children in Ethiopia. In this study, practice of mothers and perceived benefits on the modern treatment are identified as the key predictors of child survival which are amenable to future intervention.The Ethiopian Journal of Health Development Vol. 21 (2) 2007: pp. 117-12

Health service utilization and reported satisfaction among adolescents in Dejen district, Ethiopia: A cross-sectional study

Background: There is no adequate health service or counseling specifically suitable for adolescents in Ethiopia. Adolescents’ satisfaction on the health service provided is important to increase utilization and quality of care. The objective of this study was to assess health service utilization, reported satisfaction and predictors of satisfaction among adolescents of 15-19 years in Dejen District.Methods: A community based cross-sectional study was done from February 05 to 17, 2012. Interview method was used to collect data from 690 adolescents. Following stratification into urban and rural, six kebeles were selected by lottery method. Study participants allocated proportionally to households’ size of kebele. Households were selected randomly, and one from each household was used. Descriptive measures and binary logistic regression were used to identify independent predictors for health service satisfaction.Results: Among 690 adolescents, 313(45%) used health service. Of these, 190 (60.7%) were satisfied. Physical proximity (AOR=3.6, 95% CI: 1.8, 7.3), drug availability (AOR=2.7, 95% CI: 1.3, 5.8), health services availability (AOR=2.5, 95% CI: 1.1, 6.0), treatment in separate room (AOR=2.9, 95% CI: 1.4, 5.6), checked all adolescents problem (AOR=4.0, 95% CI: 2.0, 8.5), treated with respect (AOR=3.0, 95% CI: 1.4, 5.7) and opportunity to explain feeling (AOR=3.3, 95% CI: 1.7, 6.6) were predictors of satisfaction.Conclusion: Adolescents’ health service utilization and satisfaction were low. Adolescents’ perception of accessibility, acceptability and interaction with health workers’ had significant influence on health services satisfaction. Therefore, health professionals and administrators should work on availing services with close proximity and acceptable behavior in order to increase adolescents’ satisfaction.Keywords: Adolescent, Health service, Utilization, Satisfaction. Ethiopi

Biomass yield and nutritive value of sweet lupine in mid altitudes of Lemo District, Hadiya Zone, southern Ethiopia

The study was conducted to determine the biomass yield and nutritive value of sweet lupine varieties in mid altitudes of lemo district, hadiya zone, southern Ethiopia. The study involved a factorial experiment arranged in a randomized complete block design with three replications. The treatments for the study were two sweet lupine varieties (Vitabore (V1) and Sanabore (V2), six levels of Planting spacing (30cmx7cm (S1), 40cmx7cm (S2), 30cmx15cm (S3), 40cmx15cm (S4) 30cmx20cm (S5) and 40cmx20cm (S6) and two locations (Upper gana and Jewe kebeles). Agronomic attributes, yield, chemical composition, and in vitro digestibility values were studied. The data were subjected to analysis of variance and correlation analysis. Sweet lupine varieties in Upper gana kebele gave the highest green forage yield (39.58 t/ha) and forage dry matter (4.84 t/ha) at 30 cm x 7cm planting spacing. Grain yield (GYD) was significantly (P<0.001) affected by location, being 2.98 t/ha at Upper gana, and 2.15 t/ha at Jewe. Vitabor in Jewe kebele gave higher forage DM content (15.63%) while sanabor had higher forage ADF content (38.86 %) in Upper gana kebele. Sweet lupine forage in Jewe kebele gave the highest organic matter (87.01%) and acid detergent fiber (37.50 %) content at stage of 100 % flowering respectively. The effect of location (L), stage of flowering (SF) and planting spacing(S) on sweet lupine forage crude protein (CP) content was highly significant (P < 0.01). Metabolizable energy content of sweet lupine forage was significantly (P < 0.01) affected by both location and stage of flowering. Sweet lupine forage in Upper gana kebele gave the highest CP content (23.11%) while sweet lupine varieties at 50% flowering had the highest forage CP content (23.03%). The highest forage CP content was recorded in sweet lupine which was planted at 40 cm × 20 cm (23.67 %). The highest metabolizable energy content was obtained in Jewe kebele (9.31MJ/kg) and at stage of 100% flowering (9.44MJ/kg). In vitro organic matter digestibility (IVOMD) of sweet lupine forage was highly affected (P < 0.01) by both location (L) and planting spacing (S). Sweet lupine forage gave the maximum in vitro OM digestibility (68.15%) in Upper gana kebele while planting at a spacing of 40x20 cm gave the highest in vitro OM digestibility (69.10%). Sweet lupine grain crude protein (CP) content and in vitro organic matter digestibility (IVOMD) was highly (P<0.01) affected by location. The highest CP (29.11%) content and IVOMD (80.49%) sweet lupine grain recorded in Upper gana kebele

Risk Factors Associated with Invasive Cervical Carcinoma among Women Attending Jimma University Specialized Hospital, Southwest Ethiopia: A Case Control Study

BACKGROUND: Cervical cancer is a more serious public health problem than other cancers in women in Sub-Saharan Africa in general and in Ethiopia in particular. Thus, this study assessed risk factors related to invasive cervical carcinomas in southwestern Ethiopia.METHODS: Unmatched case control study was conducted in Jimma University Specialized Hospital from April 1 to September 30, 2010. The study consisted of 60 cases (women who had cervical cancers based on histopathologic examination) and 120 controls (women with no cervical cancers). Semi-structured questionnaire was utilized for data collection. Vaginal examinations often visualized with speculum insertions were done for both cases and controls. Punch cervical biopsies were then performed for the suspected cases at Jimma University Hospital that serves about 15 million people in a catchment radius of 250 kms. Data were analyzed using SPSS version 13.0 software. Univariate and multivariate analyes were done to describe and identify independent predictors of cervical cancer.RESULTS: The mean ages of cases and controls were 47.7 (SD=10.8) and 35.5 (SD =10.5) years respectively. Older women (40-59 years), (OR= 4.7; 95%CI= 2.3-9.6), more than one husband (OR= 2.0; 95%CI=1.0-3.9), as well as more than one wife in lifetime, (OR= 3.0; 95% CI= 1.5-5.9), women who had more than 4 children, (OR =10.3, 95% CI= 3.6-29.0), and age greater than 25 years at first full term delivery, (OR= 8.8; 95% CI= 3.5-22.0) were statistically significant and the latter two were  independently associated with invasive cervical cancer. Only 7(11.7 %) of cases and 58(48.3%) of  controls ever heard of cervical cancers; however, 2(3.3%) of cases and 7(5.8%) of controls had ever had history of papaneocolous (pap) smear tests done.CONCLUSION: Poor knowledge on cervical cancer was observed that required more work to be done to increase knowledge of mothers on cervical cancer and on associated risk factors. Behavioral  communication activities and establishment of cervical cancer screening programs for the young could help reduce the advancement of cervical cancer particularly among the less knowledgeable, older and grand multiparous women in our parts of the world.KEYWORDS: invasive cervical carcinoma, risk factors, Jimma, south west Ethiopi

Africa RISING Ethiopian Highlands Integrated Landscape Management Exchange Visit, 4-7 May 2016

United States Agency for International Developmen

Inequalities in utilization of maternal and child health services in Ethiopia: the role of primary health care

Background: Health systems aim to narrow inequality in access to health care across socioeconomic groups and area of residency. However, in low-income countries, studies are lacking that systematically monitor and evaluate health programs with regard to their effect on specific inequalities. We aimed to measure changes in inequality in access to maternal and child health (MCH) interventions and the effect of Primary Health Care (PHC) facilities expansion on the inequality in access to care in Ethiopia. Methods: The Demographic and Health Survey datasets from Ethiopia (2005 and 2011) were used. We calculated changes in utilization of MCH interventions and child morbidity. Concentration and horizontal inequity indices were estimated. Decomposition analysis was used to calculate the contribution of each determinant to the concentration index. Results: Between 2005 and 2011, improvements in aggregate coverage have been observed for MCH interventions in Ethiopia. Wealth-related inequality has remained persistently high in all surveys. Socioeconomic factors were the main predictors of differences in maternal and child health services utilization and child health outcome. Utilization of primary care facilities for selected maternal and child health interventions have shown marked pro-poor improvement over the period 2005–2011. Conclusions: Our findings suggest that expansion of PHC facilities in Ethiopia might have an important role in narrowing the urban-rural and rich-poor gaps in health service utilization for selected MCH interventions.publishedVersio