Fully Vaccination Coverage and Associated Factors among Children Aged 12 to 23 Months in Arba Minch Zuriya Woreda, Southern Ethiopia

Despite efforts to improve Expanded Program on Immunization (EPI) services, outbreaks related to vaccine preventable diseases are still major problems in developing countries including Ethiopia. The objective of this study was to assess fully vaccination coverage and associated factors among children aged between 12 to 23 months. A community-based cross-sectional study using thirty-by-seven cluster sampling technique developed by WHO in 1978 was employed in Arba Minch zuriya district, Southern Ethiopia in March, 2014. The district was divided in to thirty clusters based on geographic boundary and a total of 210 mothers/care givers whose children aged between 12-23 months old during study period were included in the study. Interviewer administered pre-tested structured questionnaire was used to collect quantitative data from mothers/care givers and in- depth interviews with  Arba Minch Woreda health office, respective health centers EPI coordinators and  health extension workers using interview guide were conducted. Bivariate and multivariate analysis was used to assess factors associated with fully vaccination coverage. Fully vaccination coverage among children aged 12–23 months in the study area was 53.3%. Those mothers/care givers who attended formal education [AOR = 3.73, (95% CI = 1.66, 8.42)]; received antenatal care in their last pregnancy [AOR = 4.05, (95% CI = 1.7, 9.63)]; delivered their last child at health facility [AOR = 3.24, (95% CI = 1.23, 8.42)] and informed the date of subsequent vaccine during EPI session by health workers [AOR = 6.72, (95% CI = 2.83, 15.94)] were more likely to get their child fully vaccinated than their counter parts. In conclusion fully vaccination coverage among children aged 12–23 months remains low. Maternal education on the benefits of vaccination and health care utilization (especially antenatal care and institutional delivery) should be strengthened. Keywords: Fully vaccination, Vaccination coverage, Children aged 12-23 months, Arba Minc

Fetal Outcome after Vacuum Assisted Vaginal Delivery in Arba Minch General Hospital, Southern Ethiopia

Background: Vacuum assisted delivery (VAD) is one of the interventions used to reduce life-threatening complications for mothers and their babies. However, the effect of vacuum use on fetal outcomes was not well understood in low resource settings like Ethiopia. Objective: The objective of this study was to assess fetal outcome after vacuum assisted vaginal delivery in Arba Minch general hospital, southern Ethiopia.Method: A facility based cross sectional study was conducted among selected mothers who gave birth by vacuum assisted vaginal delivery from January 2013 to December 2014 at Arba Minch general hospital, southern Ethiopia.  A total of 208 mothers record were traced from labor and delivery ward log book in January 2015.  Data was collected by three intern medical doctors. Then it was entered into Epi data version 3.1 and exported to SPSS 20 statistical software for analysis. Descriptive statistics were done to display variables. Then bivariate and multivariate analysis was employed to determine independent predictors for favorable fetal outcome. Odds ratio with 95% CI were used to declare statistically significant association with outcome variables. Results: The proportion of favorable fetal outcome in the study area was 158(76%). While controlling for confounding variables during multivariate analysis, shortened duration of second stage of labor [AOR = 12.04(95% CI = 5.23, 27.74)] and non- application of episiotomy [AOR = 4.07(95% CI = 1.81, 9.13)] had shown positive association with favorable fetal outcome. Conclusion: The proportion of favorable fetal outcome in the study area was satisfactory. Early and appropriate management of second stage of labor were major predictors for favorable fetal outcome. Thus, government and organizations working on newborns health care should focus on factors enhancing shortened second stage of labor and avoid routine use of episiotomy during labor. Keywords: Vacuum assisted delivery, fetal outcome, fetal complication, Arba Minch, southern Ethiopia

Predictors of provider- initiated HIV testing and counseling refusal by outpatient department clients in Wolaita zone, Southern Ethiopia: a case control study

Abstract Background Despite different strategies designed to rapidly identify HIV infected individuals, majority of HIV-infected people are unaware of their sero-status in developing countries. The objective of this study was to assess predictors of provider-initiated HIV testing and counseling (PITC) refusal by outpatient department (OPD) clients in Wolaita zone, Southern Ethiopia. Methods Facility based unmatched case control study was conducted on outpatient department clients in randomly selected seven health facilities in Wolaita zone, Southern Ethiopia in February 2012. A total of 291 participants (97 cases and 194 controls) were included in our study. Cases were patients who refused HIV test while controls were patients who tested for HIV after provider-initiated HIV testing and counseling (PITC) recommendation by outpatient department (OPD) clinicians. We used both quantitative and qualitative methods of data collection. Pretested interviewer administered questionnaires were used to collect quantitative data by trained nurses, and in-depth interview with 14 OPD clinicians was conducted by principal investigator to supplement quantitative findings. Bivariate and multivariate analyses were done to identify independent predictors of provider-initiated HIV testing and counseling refusal by OPD clients. Result Study participants who had stigmatizing attitude [AOR = 6.09, (95 % CI: 1.70, 21.76)], who had perceived risk for HIV infection [AOR = 5.23, (95 % CI: 2.22, 12.32)], who did not perceive the benefits of provider-initiated HIV testing and counseling [AOR = 4.64, (95 % CI: 1.79, 12.01)], who did not get minimum recommended pretest information from their providers [AOR = 2.98, (95 % CI: 1.06, 8.35)], who ever not heard of provider-initiated HIV testing and counseling service [AOR = 2.41, (95 % CI: 1.14, 5.09)], and who were from urban area [AOR = 2.40, (95 % CI = 1.26, 4.57)] were more likely to refuse provider-initiated HIV testing and counseling service than their counterparts. Conclusion Knowledge on HIV/AIDS, attitude towards people living with HIV/AIDS and perceived risk for HIV infection by clients were the major barriers for provider-initiated HIV testing and counseling acceptance. Health professionals working at outpatient department should give due attention to overcome these barriers so as to enhance HIV testing acceptance by their clients