Implementation fidelity and challenges of optimal cold chain management in Assossa district health system, Benshangul-Gumuz region, Western Ethiopia

AbstractIntroduction: Preventive programs which have proven to be effective in clinical trials may not necessarily impact the health and wellbeing of the community unless they are implemented with fidelity. While cold chain is the backbone of immunization programs, limited studies exist to explain fidelity implementation which likely contributes to a lack of evidence-based instructional practices of cold chain management.Aim: This study aimed to explore the fidelity implementation and challenges of optimal cold chain management in the Benshangul-gumuz region.Methods: A qualitative approach was utilized to explore the underlying challenges to optimum implementation of cold chain management in Benshangul-gumuz region. Observational techniques and key informant interviews with 12 key-informants were conducted. Data was collected at all levels of the health system including, the regional health bureau, Ethiopian Pharmaceuticals Supply Agency hub, district health offices, Health centers, and health posts. Data analysis and interpretation was performed using the framework analysis approach. Open Code 4.02 software was used for analysis.Findings: This study identified three main themes including adherence to intervention, human resource development, and availability and use of resources. The findings also revealed that a significant number of the employees were not adhering to the optimal cold chain management guidelines. Staff development, availability and utilization of equipment and related finances were major fidelity implementation challenges of cold chain management.Conclusions: Across the health facilities under study, implementation fidelity of cold chain management was considered poor. Human resource development, proper allocation and effective management of logistics and related finance could facilitate optimal cold chain management practices, and efforts to save lives through delivery of safe and quality vaccines. [Ethiop. J. Health Dev. 2021; 35(SI-3):03-08]Keywords: Cold chain management, Implementation fidelity, Challenges, Ethiopi

HIV counseling and testing uptake among adults in Amhara region; North West Ethiopia

The future course of effective HIV/AIDS prevention and control depends on a number of factors. HIV Counseling and Testing (HCT) has been considered an essential service and a vital entry point in the management of HIV/AIDS; providing a continuum for HIV prevention and provision of care, treatment and support services. According to Ethiopian Demographic and Health Survey 2011, the national HIV counseling and testing uptake coverage was quite lower, only four in every ten Ethiopians know their HIV status. This study focused on uptake of HIV counseling and testing and its determinants in adults. A secondary data analysis was carried out on Ethiopian Demographic and Health Survey 2005 and 2011 records. In the study 6564 (age 15-49 years) study subjects were included. Spatial data of Amhara region was integrated and analyzed with data mining techniques. HIV testing uptake coverage was much lower (2%) in 2005 and raised to 37% in 2011. The coverage of HIV testing uptake in the region demonstrates significant increase; however, it is still reasonably lower. Lack of information about where to get HIV testing, low mass media exposure, discriminating attitude, rural residence and living far away from Health Centers and Hospitals were found to be major reasons. Concerned bodies need to focus more on information, education and communication interventions and universal accessibility of HIV counseling and testing service.Keywords: Amhara, Ethiopia, HIV Testing Uptake, Spatial distanc

Information‑seeking behavior on sexually transmitted infections and its associated factors among university students in Ethiopia: a cross‑sectional study

Background: Sexually Transmitted Infections (STIs) are infections commonly spread through sexual contact and transmitted by bacteria, viruses, or parasites. In today’s world, STI-related information-seeking behavior is often vital for the advancement of knowledge, behavioral changes, health decisions, and the sharing of sexual health information among youths. However, paucity of evidence on information-seeking behavior among students in higher education institutions. This study aimed to assess STI-related information-seeking behavior and its associated factors among students at the University of Gondar. Methods: An institution-based cross-sectional quantitative study was conducted among students at the University of Gondar from January 15 to February 15, 2021. A total of 832 participants were selected using a stratified two-stage sampling method. A structured self-administered questionnaire was used to collect the required data. STI information-seeking behavior questionnaire was adapted from health information national survey tool (HINTS). Descriptive statistics, bi-variable, and multivariable logistic regression analyses were applied using SPSS version 26. Result: The proportion of STI related information-seeking among university students was 462 (55.5%) with 95% CI (52.3, 58.9). About 263 (56.9%) of students preferred internet as a primary source for STI related information. Year of study being 4th (AOR = 4.77, 95% CI = 2.75, 8.29) and 5th year (AOR = 5.45, 95% CI = 2.48, 12.01), field of study being health (AOR = 2.19, 95% CI = 1.16, 4.11), sexual experiences (AOR = 2.33, 95% CI = 1.56, 3.48), ever had STI symptoms (AOR = 4.19, 95% CI = 2.14, 8.18), perceived susceptibility (AOR = 5.05, 95% CI = 3.29, 7.75), and perceived severity (AOR = 2.16,95% CI = 1.45, 3.22) were significant factors for good STI information-seeking. Conclusion: The proportion of STI information-seeking among university students was low. Students' STI information-seeking behavior could be improved by increasing digital literacy and enhancing computer and internet access across the campus

Willingness to Use Mobile based e-Partograph and Associated Factors among Care Providers in North Gondar Zone, Northwest Ethiopia

AbstractBackground: The proper use of Partograph supports to capture key maternal and fetal data. Paper-based Partograph are prone to error, incompleteness, delayed decisions and loss of clients’ information. Electronic (e-Partograph) enables to easily retain and retrieve client data to ensure quality of care. Mobile technologies found an opportunity for resource-limited countries to improve access and quality of health care. Evidences were lacking on end users’ acceptance to e-Partograph.Objective: This study aimed to assess obstetric care providers’ willingness to use mobile based e-Partograph and its associated factors.Methods: Institutional based cross-sectional study was conducted from December 30, 2016 to January 21, 2017. A total 466 obstetric care providers were selected using multistage sampling technique in North Gondar Zone, Northwest Ethiopia.  A structured self-administered questionnaire was used to collect the data. The data were entered in to Epi info version 7 and analyzed by using SPSS version 20. Cronbach’s Alpha test was calculated to evaluate the reliability of data. A multivariable logistic regression analysis were used to identify factors associated with dependent variable. Adjusted odds ratio with 95%CI was used to determine the presence of association.Results:  The study found that 460(99.6%) of care providers owned mobile phone. Smartphone owners accounted only 102(22%). Of them, 205(46%) were willing to use mobile-phone for e-Partograph. Care providers aged >30 years (AOR=2.85, 95% C.I: 1.34-6.05), medical doctors and higher level clinicians (AOR=8.35, 95% C.I: 2.07-33.63), Health Center (AOR=4.41, 95% C.I:.10-9.26), favorable attitude towards Partograph (AOR=2.76, 95% C.I: 1.49-5.09) and related in-service trainings (AOR=7.63, 95% C.I: 3.96-14.69) were enabling factors for willingness to use mobile phone.Conclusions: Almost all obstetric care providers had access to mobile phone, however; smartphone ownership is still low. Willingness to use mobile-phone for e-Partograph was low. Younger aged, lower level clinicians, Hospital based workers, unfavorable attitude on Partograph and lack of in-service trainings were main factors for non-willingness. Hence awareness creation on partograph use and digital capacity building are crucial for effective e-partograph management.         Key words: e-Partograph, Ethiopia, Obstetric care provider, Willingnes

Intention to use wearable health devices and its predictors among diabetes mellitus patients in Amhara region referral hospitals, Ethiopia: Using modified UTAUT-2 model

Introduction: The burden of diabetes mellitus is increasing in Africa. Wearables have a proven track record of combating chronic diseases. However, little is known about patients’ intentions to use such technologies in resource-limited settings. Therefore, this study aimed to assess DM patients' intentions to use wearable health devices and its predictors in Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 924 diabetes mellitus patients from May 19 to June 23, 2022, at referral hospitals in the Amhara regional state of Ethiopia. An interviewer-administered questionnaire was used to collect the data using the Kobo Collect app. A systematic random sampling technique was used to select the study participants. Descriptive statistics were done using SPSS version 25 software and presented using tables and pie charts. Structural equation modeling analysis with SPSS AMOS version 26 software was employed to identify predictors associated with the intention to use wearable health devices in Ethiopia. Results: A total of 883 diabetes mellitus patients, with a 95.56% response rate, participated in the study. The proportion of intention to use wearable health devices was 47.1%, 95% CI (43.7–50.5). Effort expectancy (β = 0.543, P < 0.01), performance expectancy (β = 0.306, P < 0.01), facilitating condition (β = 0.131, P < 0.05), and habit (β = 0.093, P < 0.05) had a positive direct relationship with intention to use wearable health devices. Age (β = 0.439, p < 0.001) was moderate performance expectancy, while gender (β = 0.780, p < 0.001) had moderate effort expectancy to the intention to use wearable health devices. Conclusions: Overall, diabetes mellitus patients’ intentions to use wearable health devices were promising. The intention to use wearables was positively related to effort expectancy, performance expectancy, facilitating conditions, and habit. Thus, increasing patient intention to utilize it could be achieved through capacity building, access to technology, and technical support. In addition, implementers should prioritize improving the availability of devices, patients' abilities, encouraging customers, to utilize the product on a regular basis by actively fostering their relationship with them, and create awareness about usefulness of wearable health devices