Knowledge, attitude and practice of emergency contraceptives among female college students in Arba Minch Town, Southern Ethiopia

Background: Young and unmarried women constitute a high risk group for unplanned pregnancies and unsafe abortions. It has been estimated that widespread use of emergency contraception (EC) may significantly reduce abortion-related morbidity and mortality.Objective: To assess knowledge, attitude and practice of emergency contraceptives among female college students in Arba Minch town.Method: A cross-sectional institution-based study was conducted from March 1st to 5th 2010 among 407 female students that were selected by using a stratified sampling technique.Result: One hundred seventy three (42.5%) of the respondents said that they heard about emergency contraceptive. Of those who mentioned pills as an emergency contraceptive method, 26.4% correctly identified 72 hours as the time limit for use of the method. The summary index for knowledge disclosed that 21.9% had good knowledge about EC. Though 50% of students had positive attitude towards EC, 11 (2.7%) of the total students had used emergency contraception. EC use was significantly higher among students who were married and among students who have good knowledge on EC, (P<0.027, P< 0.01 respectively).Conclusion: The study showed that knowledge of emergency contraception among female students is low and the method is still underused. Therefore, there is a need to expand IEC about RH and regular methods in general and EC in particular at college level. [Ethiop. J. Health Dev. 2011;25(3):176-183

Editorial: High quality health information system for improved health system

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Predictors of early neonatal mortality at a neonatal intensive care unit of a specialized referral teaching hospital in Ethiopia

Background: The larger fraction of infant mortality is that of neonatal; and early neonatal death is the most significant contributor of neonatal mortality as a whole. There are various factors which may be associated with early neonatal mortality and they have been the reasons for the wide variation in mortality rates among the health facilities reporting.Objective: This study was made to assess the independent predictors of early neonatal mortality.Methods: From 2001 through 2005, a total of 3789 live born neonates, who were admitted to the neonatal intensive care unit of Tikur Anbessa Hospital, were included in this study. Variables were classified into two: Socio economic/reproductive factors and maternal/newborn factors. Predictors were assessed using a multivariable binary logistic regression. Variables with a p-value of <0.05 were entered into a multivariable logistic model.Results: From the socio-economic/reproductive variables: age less than one day (AOR=2.53 95% CI= (1.66, 3.85)), having three or more siblings (AOR=2.04, 95% CI= (1.15, 3.64) ), second birth order (AOR=1.79, 95% CI= (1.28, 2.51)), absence of antenatal care (AOR=1.70, 95% CI= (1.28,2.26)), and being unmarried (AOR=1.55 95%CI= (1.20,2.00)) were independent predictors of increased mortality. On the other hand, singleton pregnancy was found to be protective by 30% against early neonatal mortality with an odds of 0.70, 95% CI of (0.54, 0.90). From the neonatal/ maternal variables: gestational age of <32 weeks (AOR= 10.46, 95% CI= (5.39, 20.31)), first minute APGAR of three or less (AOR=2.12, 95% CI= (1.39, 2.23)), presence of any congenital anomaly ( AOR=2.02, 95% CI=(1.33,2.51)), presence of peri-natal asphyxia (AOR=1.82, 95% CI=(1.32,2.51)), any oxygen treatment (AOR=2.65, 95% CI=(1.89,3.72)), birth weight less than 1500 (AOR=9.64, 95%CI=(3.32,27.97)) were independent predictors of neonatal mortality. A normal weight at admission was protective of early neonatal mortality.Conclusion: There are many factors that could have influenced neonatal mortality in the current study. Antenatal care follow up is the key point of contact for planning and managing labor and delivery; it should be improved to control most other variables. The care provided to these high risk babies should also be maximized to reduce mortality in these risk groups

Factors Affecting Diffusion and Adoption of Agricultural Innovations Among Farmers in Ethiopia Case Study of Ormia Regional State Western Shewa

The contribution of new technology to economic growth can only be realized when and if the new technology is widely diffused and used. Diffusion itself results from a series of individual decisions to begin using the new technology, decisions which are often the result of a comparison of the uncertain benefits of the new invention with the uncertain costs of adopting it. An understanding of the factors affecting this choice is essential both for economists studying the determinants of growth and for the generators and disseminators of such technologies. The study was to determine the factors affecting farmer’s adoption of improved agricultural innovation in Welmera district western part of Oromia regional state Ethiopia. Non replaceable lottery method and proportional to size sampling techniques were employed for the selection of 130 respondents; structural questionnaires and group discussion were used. Data were analyzed using Statistical tests like chi-square, t-test, one way ANOVA and econometric model Tobit was used to identify the effect of the hypothesized variables on the dependent variable . The result of the econometric model indicated that educational level of respondent, total land holding, accesses to research and access to extension were found significant to influence adoption of improved potato production packages. The mean average age of sample respondent was 45-54. The independent t-test result shows that there was no significant difference between adopter categories in terms of age to the adoption of improved potato technology (t=1.747, p 0.991). From the sample household heads 13.85% of respondent farmers are illiterate and the remaining 86.15% are educated. Majority of high adopters have been educated from grade 5 to 10 Chi-square test also shows the significant difference between adopter categories of improved potato technologies (χ2=17.25a, P=0.004). It is time to look participatory extension approach which invites different stakeholders. FRG approach contributed significant role in the diffusion and adoption of agricultural innovations. Keywords: Agricultural new technology, adoption, Farmers Research Group DOI: 10.7176/JBAH/13-13-02 Publication date:August 31st 2023

Assessment of antiretroviral treatment outcome in public hospitals, South Nations Nationalities and Peoples Region, Ethiopia

Background: The outcome of antiretroviral treatment, survival patterns and associated determining factors in public hospitals are not well known. Thus a longitudinal study is vital to understand the pattern of survival and treatment outcome.Objective: To assess the outcome of antiretroviral treatment in rural public hospitals in South Nations, Nationalities and Peoples Region, Ethiopia.Method: A historical retrospective cohort study design was used for patients visiting hospitals from January 1, 2005 to January 31, 2009. A total of 5,664 patient records were examined from eight randomly selected public hospitals. Kaplan-Meier models were used to estimate mortality and Cox proportional hazards models to identify predictors of mortality.Results: The median age was 30 years and 73.6% were in the age group 25-40 while the higher HIV risk age group 14-24 covered only 12.8%. The proportion of females was 56.3%. The cumulative proportions of survivals were 92%, 90%, 88% and 86% at months 6, 12, 24 and 36 respectively. The hazard of death was higher in male (AHR: 1.632, CI: 1.309-2.034) and those who had a baseline CD4 cell count < 50 cells /ml compared to these with a count of above 200 (AHR: 3.176, CI: 2.304- 4.434). Patients with WHO stage IV at baseline had a higher risk of death compared to these with a WHO stage I (AHR: 5.603, CI: 1.753-17.905).Conclusions: There is an indication of improvement of survival in the patient population. An advanced disease stage, Low CD4 cell count, gender and timing of ARV regimen combinations had significant contribution in determining a longer survival time. Priority should thus be given to identify HIV-infected individuals and start ART earlier in the course of their illness. [Ethiop. J. Health Dev. 2011;25(2):102-109

Estimation of the total fertility rates and proximate determinants of fertility in North and South Gondar zones, Northwest Ethiopia: An application of the Bongaarts' model

Background: Evidence shows that nearly two million people are added to the population of Ethiopia each year. It has become clear that uncontrolled fertility has adversely influenced the socio-economic, demographic and environmental situations of the country.Objectives: To estimate the total fertility rates and look into the relative contribution of the intermediate determinant variables in bringing fertility below its biological maximum in North and South Gondar zones of Northwest Ethiopia.Methods: A cross-sectional study which included a sample size of 3512 women of reproductive age was performed. Multi-stage cluster sampling was used to select the required study subjects. The Bongaarts model was employed to estimate fertility rates and quantify the contribution of each of the proximate determinants of fertility.Results: The overall total fertility rate of the two Gondar zones was computed as 5.3. Among the three major proximate determinants in reducing fertility in the two zones, postpartum infecundability (Ci=0.55) stood first followed by contraceptive use (Cc=0.75) and non- marriage (Cm=0.83). Conclusion: The fertility-inhibiting effect of postpartum infecundability resulting from prolonged breastfeeding is by far the most important proximate determinant in the entire study areas. A substantial role (particularly in urban areas) is played by contraceptive use. The promotion of breastfeeding should continue by all concerned bodies and the region should continue exerting its maximum effort to make the majority of the rural population users of modern contraceptive method

Age at sexual initiation and factors associated with it among youths in North East Ethiopia

Background: For behavioral as well as physiological reasons, early sexual debut increases young peoples' risk for infection with HIV and other STIs. Youths who begin sexual activity early are more likely to have high-risk sex or multiple sexual partners and are less likely to use condoms. It is crucial to understand the factors associated with early sexual initiation in a broader context for designing and implementing effective interventions targeting youth. Objective: The objective of the study was to determine the median age at first sexual intercourse and the associated factors of sexual initiation among rural and urban youths (age 15- 24 years). Methods: A comparative cross sectional study was conducted between, March 1 -15, 2008, in Dessie town and Dessie Zuria Woreda. To draw a total sample of size 1294 (647 urban and 647 rural), a multistage cluster sampling was used. Bivariate and multivariate analyses were employed. Moreover, Kaplan Meier survival analysis was used to estimate the probability of sexual initiation at various age stratified by residence and sex. Result: About half, 51.3% of the youths have ever had sex. Rural youths initiate sexual intercourse at lower age than their urban counterparts with mean (±SD) (16.49+2.11) for rural and (17.18+2.32) for urban youths. The median age at sexual debut was 16 years for rural and 17 years for urban. The hazard ratio for sexual imitation was significant (AHR [95% CI] =1.45 [1.19, 2.55]. Multivariate analysis showed that being female by gender (AOR [95% CI]=1.56 [1.11, 2.19]), chewing Khat (AOR [95% CI] = 2.05 [1.05, 3.96]), drinking alcohol (AOR [95% CI] = 2.16 [1.12, 4.18]), watching pornographic materials at age < 18 years (AOR [95% CI] = 24.13 [3.28, 177.80]) and being less connected with parents (AOR [95% CI] =2.30 [1.35, 3.91]) were associated with early sexual initiation. Conclusion and Recommendation: Early sexual initiation prevails more in rural than urban youths. Delaying sexual debut can be achieved through well designed sexual education programs at earlier life. Strengthening the norm of virginity should be advocated. Equally, ways to access condoms and other contraceptives especially to rural youths should be sought for those who already initiate sexual intercourse.

Levels and proximate determinants of fertility in Butajira District, South Central Ethiopia

Background: Uncontrolled population growth is evidenced mainly because of the high fertility. Improving maternal and child health services in Ethiopia were one of the main aims of the health extension program. The impediment of early marriage was revised in the national family code which claims assessment of fertility situations.Objectives: This study aimed at measuring levels and fertility inhibition effects of proximate determinants in Butajira district.Methods: A cross-sectional study was conducted on resident women of reproductive age group recruited from the Butajira Demographic Surveillance System database. A total of 9996 women with different characteristics were thus interviewed.Results: Total fertility rate was 5.3 children per woman with high urban-rural gradient. The non-marriage (Cm=0.66) had the highest fertility inhibition effect followed by postpartum infecundability (Ci=0.68), contraception (Cc=0.77) and abortion (Ca=0.96). Main differences were observed across residential environment and educational status. Abortion had a paramount significance among in school women (ca=0.76).Conclusion: Not being married followed by postpartum infecundability and contraception inhibited high fertility. Abortion significantly reduced fertility among students. Keen awareness about negative consequences of high fertility should be attained. Women ought to be advised to marry late and stay in-school for long years. Extended breast feeding should be maintained for birth spacing. There must be sustained effort to increase contraception use rate. In-school women should be educated on problems of abortions. Youth-friendly contraceptive services must also be made available. [Ethiop. J. Health Dev 2011;25(3):184-191

Determinants of mortality among under-five children admitted with severe acute malnutrition in Addis Ababa, Ethiopia.

BACKGROUND: Management of severe acute malnutrition (SAM) has been a program priority in Ethiopia, but it remains the leading cause of mortality in under-five children. Hence, this study aimed to identify the incidence density rate of mortality and determinants among under-five children with severe acute malnutrition in St. Paul's Hospital Millennium Medical College, 2012 to 2019. METHODS: A retrospective cohort study was conducted and data were collected using a structured checklist from 673 charts, of which 610 charts were included in the final analysis. The Kaplan-Meier survival curve with Log-rank test was used to estimate the survival time. Bi-variable and multi-variable Cox proportional hazard regression models were fitted to identify determinants of death. Schoenfeld residuals test was used to check a proportional hazard assumption. Goodness of fit of the final model was checked using Nelson Aalen cumulative hazard function against Cox-Snell residual. RESULTS: In this study, 61 (10%) children died making the incidence density rate of death 5.6 (95% CI: 4.4, 7.2) per 1000 child-days. Shock (Adjusted Hazard Ratio) [AHR] =3.2; 95% CI: 1.6, 6.3)), IV fluid infusion (AHR = 5.2; 95% CI: 2.4, 10.4), supplementing F100 (AHR = 0.12; 95%CI: 0.06, 0.23) and zinc (AHR = 0.45; 95% CI: 0.22, 0.93) were determinants of death. CONCLUSION: The overall proportion of deaths was within the range put forth by the Sphere standard and the national SAM management protocol. Shock and IV fluid infusion increased the hazard of death, whereas F100 & zinc were found to decrease the likelihood death. Children with SAM presented with shock should be handled carefully and IV fluids should be given with precautions

Trends of modern contraceptive use among young married women based on the 2000, 2005, and 2011 Ethiopian Demographic and Health Surveys: a multivariate decomposition analysis

Published: January 30, 2015Introduction: Accessing family planning can reduce a significant proportion of maternal, infant, and childhood deaths. In Ethiopia, use of modern contraceptive methods is low but it is increasing. This study aimed to analyze the trends and determinants of changes in modern contraceptive use over time among young married women in Ethiopia. Methods: The study used data from the three Demographic Health Surveys conducted in Ethiopia, in 2000, 2005, and 2011. Young married women age 15–24 years with sample sizes of 2,157 in 2000, 1,904 in 2005, and 2,146 in 2011 were included. Logit-based decomposition analysis technique was used for analysis of factors contributing to the recent changes. STATA 12 was employed for data management and analyses. All calculations presented in this paper were weighted for the sampling probabilities and non-response. Complex sampling procedures were also considered during testing of statistical significance. Results: Among young married women, modern contraceptive prevalence increased from 6% in 2000 to 16% in 2005 and to 36% in 2011. The decomposition analysis indicated that 34% of the overall change in modern contraceptive use was due to difference in women’s characteristics. Changes in the composition of young women’s characteristics according to age, educational status, religion, couple concordance on family size, and fertility preference were the major sources of this increase. Two-thirds of the increase in modern contraceptive use was due to difference in coefficients. Most importantly, the increase was due to change in contraceptive use behavior among the rural population (33%) and among Orthodox Christians (16%) and Protestants (4%). Conclusions: Modern contraceptive use among young married women has showed a remarkable increase over the last decade in Ethiopia. Programmatic interventions targeting poor, younger (adolescent), illiterate, and Muslim women would help to maintain the increasing trend in modern contraceptive use.Abebaw Gebeyehu Worku, Gizachew Assefa Tessema, Atinkut Alamirrew Zelek