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Assessment of knowledge, attitude, practice, and associated Factors towards pediatric pain management among nurses Workingat jimma university medical center, jimma, Ethiopia
No full textBackground: Pain is an unpleasant sensory and emotional experience associated with actual or
potential tissue damage or described in terms of such damage. This highlights that pain is not just
a physical sensation but an emotional experience too. In simple words, pain is what the patient
says, and hurts, which emphasizes the patient's experience.
Objective: To assess knowledge, attitude, practice, and associated factors toward pediatric pain
management among nurses at the pediatrics wards of Jimma University Medical Center (JUMC),
Jimma, Ethiopia.
Methods: An institutional-based cross-sectional study was conducted among nurses working at
the pediatric wards of JUMC. Data was collected using a structured questionnaire. The collected
data was entered into Epi-Data version 4.6 and exported to statistical package for social sciences
(SPSS) version 27 for further analysis. Descriptive statistics was used to summarize the data and
a multivariate logistic regression model was computed to see the association between
independent and dependent variables. The results are presented using narratives and tables.
Result: A total of 85 nurses were included in the study; morethan half of them (57, 67.1%) were
females. Over half of the participants had poor knowledge (44, 51.8%) and practice (47, 55.3%)
about pediatrics pain management. Male nurses had poor knowledge than female nurses
[p=0.001, AOR=0.241, 95% CI (0.070, 0.837)], and those nurse with age group from 31-40 had
poor knowledge than those with age group 20-30[p=0.001, AOR=0.214, 95% CI (0.075, 0.611)]
regarding pediatric pain management. Diploma holders have negative attitude toward pediatric
pain management than Master’s nurses [p=0.002, AOR=0.229 and 95% CI (0.054, 0.971),] and
nurses with 2-5 year experience had negative attitudes than those with experience >5 years’
[p=0.042, AOR=0.282 and 95% CI (0.102, 0.783)] regarding pediatric pain management. Nurses
in the age range of 31-40 years had poor practice when we compare with nurses who were on the
age range of 20-30 years old [p=0.001, AOR=0.214 and 95% CI (0.075, 0.611)], and nurses with
a diploma had poor practice compared to those with a master’s degree (p = 0.034, AOR = 0.179,
95% CI: 0.033, 0.969)
Conclusion and recommendation: Nurses working at pediatric ward of JUMC have poor
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knowledge and practice about pediatrics pain management but they have positive attitude. Thus,
the situation demands various educational and quality improvement initiatives that could
enhance the nurse‘s knowledge and practice in the area of pain management
Practice and Challenges of Instructional Leadership in Government Secondary Schools in Jimma Zone Oromia National Regional State, Ethiopia.
No full textThe purpose of this study was to identify the level of Practices and Challenges of
Instructional Leadership in Government Secondary Schools in Jimma Zone Oromia's
national regional state. To conduct this study mixed method was employed with triangulation
purposes. For data collection 70 teachers were selected by using systematic sampling
techniques, and 24 school leaders were selected by using availability sampling techniques.
There were 94 participants in respondents out of 408 populations. The data-gathering tools
were principal instructional management rating scales questionnaires, and interviews. Both
primary and secondary sources of data were used for the research. Quantitative data was
analyzed by SPSS version 26 through descriptive statistics such as mean, standard deviation,
and inferential statistics. Qualitative data was analyzed through narration. The findings of
the study indicated that defining school goals, communicating school goals, coordinating
curriculum, supervising& evaluating classrooms, monitoring student progress, promoting
professional development, protecting instructional time, maintaining high visibility,
providing incentives for teachers, and providing incentive for learning were moderately
practiced.The study also identify the major challenges of instructional leadership .Such as,
Lack of human resource ,absenteeism of students, Lack of financial resources, Lack of skill
and training, Inconsistent monitoring and evaluation, Lack of cooperation from superiors
and community, Lack of motivation of teachers and students, sociopolitical factors were
affected instractinal leadership practice.Therefore, all stakeholders should be make effective
instructional leadership may be beter to improve the teaching and learning process in
secondary schools of Jimma Zone
Impact of Household Air Pollution on Childhood Linear Growth and Health, in Jimma Town, Oromia Region, Ethiopia
No full textBackground: Stunting, defined as impaired linear growth and development in children, remains
a significant public health challenge, particularly in low- and middle-income countries. It is
commonly attributed to factors such as chronic undernutrition, recurrent infections, and poor
overall health conditions.
While inadequate diet and illness have traditionally been identified as the primary causes of
stunting, recent evidence highlights the growing role of environmental factors especially
household air pollution in contributing to growth impairments. Exposure to indoor air pollutants
has been associated with multiple adverse health outcomes, including childhood stunting and risk
of multimorbidity.
The leading cause of household air pollution is the widespread use of biomass fuels such as wood,
charcoal, and dung for cooking. This practice is particularly prevalent in resource-constrained
settings and has emerged as a pressing global health concern. According to the World Health
Organization (WHO), more than three billion people worldwide rely on polluting fuels, with
approximately 95% of them residing in low- and middle-income countries.
The relative contribution of household air pollution to childhood linear growth impairments and
the risk of multimorbidity in Ethiopia remains underexplored. While some global studies have
highlighted the adverse health effects of indoor air pollution on young children, there is a scarcity
of context-specific evidence from Ethiopia that quantifies this relationship, particularly in urban
settings like Jimma town. Therefore, this study aims to investigate the impact of household air
pollution on linear growth and the risk of multimorbidity in children under five years of age in
Jimma town, Ethiopia.
Objectives: The main objective of this study is to investigate the impact of household air pollution
on the linear growth and health of under-five children in Jimma town, Ethiopia.
Methods: To synthesize the global and local evidence on the impact of household air pollution on
childhood linear growth, this study employed a combination of systematic review and meta
analysis, comparative cross-sectional analysis, and a prospective cohort design. A total of 280
under-five children, with 140 residing in households that use solid fuels (exposed group) and 140
in households that use clean fuels (unexposed group) were involved for the primary studies. The
children's height and height-for-age Z scores (HAZ) were measured and compared over a 12
month follow-up period to assess differences in linear growth between the two groups.
Environmental exposure was evaluated by measuring real-time concentrations of indoor air
pollutants. These included particulate matter (PM₂.₅ and PM₁₀), carbon monoxide (CO), carbon
dioxide (CO₂), and volatile organic compounds (VOCs), using Laser PM2.5 Meter-5800D/5800E
and Aeroqual’s TM Series 500 portable air quality monitors, respectively. Additionally, data on
childhood morbidity were collected using the Ethiopian Demographic and Health Survey (EDHS)
morbidity questionnaire, administered to mothers to capture information on common illnesses
experienced by their children. Analytically, difference-in-differences estimators were used to
compare changes in height and HAZ scores between baseline and endline across the two groups.
A multivariable linear regression model was applied to assess the independent effect of solid fuel
use on HAZ scores. Furthermore, multiple logistic regression was employed to explore the
association between household solid fuel use and the likelihood of childhood multimorbidity,
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while Poisson regression was used to examine whether exposure to solid fuels increased the
number of reported morbidities. Statistical significance was determined at a p-value of less than
0.05 with corresponding 95% confidence intervals
Results: The results of systematic review and meta-analysis indicate that exposure to household
air pollution was significantly associated with increased odds of child stunting [pooled estimate:
Odds Ratio = 2.42, (95% CI: 1.45, 4.03), P < 0.0010]. Likewise, children who were exposed to
household air pollution from cooking with solid fuels had significantly lower HAZ scores than
children who lived in households where cleaner fuels were used [Standardized Mean Difference =
0.41, (95% CI: 0.12, 0.71), p < 0.001] (Chapter 4).
The findings of quantitative measurements of Household Air Pollution showed that the mean (SD)
and median concentrations of pollutants in all measured households were: PM2.5; 455 (386) and
294 µg/m3, PM10; 819 (829) and 270 µg/m3, CO2; 787 (488) and 577 mg/m3, CO; 12 (13.9) and
7.9 mg/m3, and VOC; 1154 (861) and 1077 mg/m3. Households using solid fuels had significantly
higher concentration of PM2.5 (U = 53.0, Z = -14.436, p < 0.001), PM10 (U =63.0, Z = -14.502, p
< 0.001), CO2 (U = 3519.50, Z = -7.273, p < 0.001), CO (U = 3246.0, Z = -4.445, p < 0.001) and
VOC (U = 2073.0, Z = -11.40, p < 0.001) than households using clean fuel (Chapter 5).
The results of the assessment of the Impact of Indoor Air Pollution on the Linear Growth of
Children, compared with the clean fuel type, revealed that in an unadjusted model (Model 1),
the mean difference in the height-for-age Z score of children in households using solid fuel was
lower by 0.54 (-0.54, 95% CI -0.97, -0.12, P = 0.011). The beta coefficient remained negative after
adjusting for age and sex (Model 2 -0.543, 95% CI -1.373, -0.563) and sociodemographic variables
(Model 3: -0.543, 95% CI -1.362, -0.575). In the final model (Model 4), which adjusted for wealth
quantile, dietary practice, water, sanitation and hygiene status and household food insecurity
access scale, the beta coefficient held the same and significant (beta: -0.543, 95% CI -1.357,
0.579, P < 0.001) (Chapter six).
In the findings of the investigation of Exposure to Household Air Pollution and Childhood
Multimorbidity Risk, the overall prevalence of childhood multimorbidity was 34.3% [95% CI:
0.29–0.40]. Among these cases, 23.9% was among children from solid fuel user households,
whereas about 10.4% was from clean fuel user households. Adjusted for all possible covariates,
children living in solid fuel user households had more than three times the odds of childhood
multimorbidity compared to children living in clean fuel user households (AOR = 3.14, 95% CI
[1.42–6.95], p < 0.001). Moreover, household air pollution from solid fuel use was positively
associated with an increased number of individual morbidity conditions, with an adjusted β
coefficient of 0.46 (IRR = 1.58, 95%CI [1.17-2.13], p = 0.003) (Chapter 7).
In conclusion, indoor air pollution was negatively associated with childhood linear growth, and
solid fuel use independently predicted morbidity risk. Addressing this requires public education
on health risks and promoting better kitchen ventilation and improved cooking stoves to reduce
child growth impairments and multimorbidity (Chapter 8)
Effect of Dietary Supplementation and High-Intensity Motor Learning on Nutritional Status, Body Composition, Muscle Strength, and Motor Skill-Related Physical Fitness in 5-7-Year-Old Children with Moderate Thinness in Ethiopia
Full text linkBackground: Despite global efforts, child malnutrition remains a persistent challenge, exacerbating
disparities and posing ongoing threats to children and adolescents in developing nations. Malnutrition
refers to an inadequate or imbalanced intake of essential nutrients, encompassing both
undernutrition and overnutrition. Undernutrition is characterized by an inadequate intake of essential
nutrients, resulting in deficiencies. Thinness has been recognized as a more suitable indicator of
recent nutritional deprivation, such as insufficient dietary intake of energy, protein, or various
micronutrients.
Undernutrition is characterized by stunting and thinness. Stunting refers to being short relative to
one's age, while underweight is defined in terms of grades of thinness (grades 1–3) and is
characterized by rapid weight loss or an inability to gain body mass. Both conditions are linked to
poor school attendance and academic performance in mathematics, reading, and writing skills.
Additionally, sick or undernourished children often face difficulties with motor function, concentration,
problem-solving, and memory recall, all of which contribute to poor academic performance.
Undernutrition among schoolchildren in developing countries is a critical global health challenge with
far-reaching consequences for their well-being and future opportunities. Nutritional deficiencies
during early childhood can lead to poor brain development. Long-term undernutrition can negatively
impact academic performance, leading to chronic disorders, hindering cognitive development, and
even causing premature death.
Addressing both undernutrition and overnutrition among children aged 5–7 presents a significant
challenge for the food and nutrition policies in developing countries like Ethiopia. This age group
represents a critical developmental stage marked by key growth and developmental milestones and
the development of motor skills. Catch-up growth is particularly important for children with moderate
thinness (MT), as they may face developmental delays that could impact their long-term health and
well-being. This age is also critical for motor skill interventions as it coincides with significant brain
development that is closely linked to cognitive and behavioral growth during preschool years. In
Ethiopia, however, MT children aged 5-7 are often overlooked due to the absence of specific
treatment guidelines for MT. To address this, the management of acute malnutrition should focus on
preventing the progression of MT to severe thinness (ST). To effectively manage MT and prevent its
progression to ST, appropriate dietary interventions are essential. This includes providing nutrient
rich supplementary food or lipid-based Ready-to-Use Supplementary Food (RUSF) tailored to meet
the needs of children with MT. In addition to proper nutrition, motor skill training (high-intensity
motor learning (HiML)) interventions significantly enhance motor skill development in typically
developing children. HiML is very intensive as it is performed daily over an extended period, requiring
a minimum of 30–40 hours of training. The focus is on maximizing time spent on the task during
training, with a training/rest ratio of at least 70–30%. Active play, which involves repetitive muscle
movements that help build strength, speed, and agility, contributes to the development of both gross
and fine motor skills. Furthermore, existing literature on active play or goal-oriented play among
preschoolers and early school-aged children demonstrates its positive impact on motor skills.
Activities such as ball play, balancing exercises, walking, running, and jumping, or hopping have
been shown to improve coordination and physical abilities, reinforcing the importance of integrating
both nutrition and physical activity in early childhood development programs.
Therefore, the main aim of this study was to evaluate the effect of RUSF with(out) HiML compared
to no intervention on various outcomes, including weight, height, body composition, muscle strength,
and motor skill-related physical fitness of children with MT age 5-7 living in Jimma, South-West
Ethiopia. A summary of each chapter of this dissertation is provided below.
Chapter 1 is an introduction providing an overview of malnutrition. It begins by defining
undernutrition and moderate thinness, discussing their common drivers and consequences. The
chapter also presents malnutrition's global, regional, and national status, highlighting its prevalence
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and public health significance. Additionally, the chapter identifies gaps or areas that previous studies
had not adequately addressed concerning moderate thinness. By providing this comprehensive
introduction, the first chapter gives a context for the subsequent chapters of the dissertation, which
will dive deeper into specific aspects of moderate thinness and its implications.
Chapter 2 outlines the general methods used in the study, including the study design, period,
setting, and population, inclusion and exclusion criteria for participant selection, the sampling
strategy, and the sample size calculations. Furthermore, it elaborates on the data collection methods
and procedures, the specific tools or instruments used, data management procedures including data
entry, storage, and quality control measures, and information on statistical tests or analytical
techniques used to examine the study variables and assess the outcomes of interest. It also
elaborates on the intervention packages implemented in the study, providing an overview of the
specific interventions or treatments administered to the participants and key measures or indicators
used to assess the outcomes under investigation. Ethical considerations are emphasized in this
chapter, highlighting the steps taken to ensure the protection of participants' rights and well-being.
Chapter 3 presents the findings of a school-based comparative cross-sectional study carried out in
Jimma Town. The study compared the body composition of 5-7-year-old children with MT to that of
their well-nourished (WN) peers and identified associated factors. Data were collected from 388
children (194 with MT and 194 with WN). The finding showed that, on average, moderately thin
children had significantly lower fat mass and fat-free mass compared to well-nourished children,
indicating malnutrition-related loss in both compartments. Body mass index (BMI) for age, age, and
sex were significantly associated with both fat-free mass and fat mass.
Chapter 4 presents the findings of a study that investigated the relationship between MT and muscle
strength in children aged 5-7 years in Jimma Town, Southwest Ethiopia. Conducted as a school
based comparative cross-sectional study between June and July 2022, the study assessed children's
nutritional status (MT vs. WN) using BMI for age and sex. Muscle strength was evaluated by
measuring grip strength with a JAMAR device, and biceps, quadriceps, and gastrocnemius strength
were measured using Digital Handheld Dynamometry model (Hoggan MicroFET2™). The result
revealed that children with MT had significantly lower muscle strength compared to their WN peers,
highlighting the negative functional effect of wasting. These findings underscore the importance of
integrating strategies to improve muscle strength into routine health care for children with MT.
Chapter 5 presents the result of a systematic review and meta-analysis on the effectiveness of RUSF
compared to other dietary interventions or no intervention on functioning at different levels of the
International Classification of Functioning, Disability, and Health (ICF) among children with MT
between 2 -12 years old. Eight studies were included in the analysis. The use of RUSF intervention
shows promise in improving nutritional outcomes and recovery rates in children with MT compared
to other dietary interventions. However, the low level of evidence highlights the need for robust
randomized controlled trials in MT children to determine the true effect of RUSF.
Chapter 6 presents the findings of a cluster-randomized controlled trial that examined the effect of
Ready-to-Use Supplementary Food (RUSF), with or without high-intensity motor learning (HiML), on
weight, height, body composition, and muscle strength in 5–7-year-old children with MT in Jimma
Town, Ethiopia. The study found that RUSF was effective on its own, but when combined with HiML,
it had an even greater impact. Both the RUSF and RUSF+HiML interventions led to improvements in
body composition, height, weight, and muscle strength of malnourished children. These findings
suggest that using RUSF and combining it with HiML could help mitigate the negative effects of
malnutrition in Ethiopia. The researchers recommend further exploration of these interventions in a
larger community-based study.
Chapter 7 presents the results of a cluster-randomized controlled trial that assessed the effect of
RUSF with or without HiML on motor skill-related physical fitness in children with MT. A 12-week
combination of RUSF + HiML was proven to be safe in children with MT and caused clear
improvements in skill-related physical fitness. When the children received RUSF with HiML training,
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similar gains were observed in stepping, side jumping, standing long jump, and jumping and hopping,
except for the ball skills, where the HiML training group performed better.
Chapter 8 discusses the main findings, strengths, and limitations of the studies and provides
conclusions, future research directions, and policy, methodological, and practical implications. It
highlights the significance of the findings in relation to the research objectives, addresses the
strengths of the methodology, and acknowledges the study's limitations. The chapter also explores
potential improvements in research design, sample size, and data collection techniques. Finally, it
offers practical recommendations for translating the findings into effective strategies to mitigate
moderate thinness and its drivers among children aged 5 to 7 years
Isolation, antibiogram profile and associated risk factors of Salmonella from poultry in selected districts of Jimma zone, south western Ethiopia
No full textSalmonella is a significant pathogen affecting the poultry industry, leading to substantial
economic losses through decreased production and morbidity of flocks. It’s the primary
cause of food borne infections, particularly from animal-derived foods, with poultry being
a major source. While various studies have examined the prevalence of Salmonella in
poultry across different regions of Ethiopia, research specific to this study area has been
limited. To address this gap, a cross-sectional study was conducted between January and
September 2024 in three purposively selected districts of Jimma Zone: Dedo, Saka
Chekorsa and Kersa chosen for their road accessibility and proximity to Jimma University.
A total of 400 cloacal swab samples were collected and analyzed to isolate Salmonella
from poultry and its antimicrobial susceptibility. Descriptive analysis and logistic
regression were employed for data analysi
Determinants of Malt Barley Commercialization and Its Impact on Income of Smallholder Farmers in Lemu-Bilbilo District, Arsi Zone, Ethiopia
No full textThe transition of smallholder farmers from subsistence to market-oriented agriculture is
meant to increase smallholder farmers’ income and overall rural economic progress. Malt
barley is both a food and cash crop that is considered to enhance smallholder farmer income
in Ethiopia. This study was designed to analyze malt barley commercialization and its impact
on smallholder farmers’ income in the Lemu Bilbilo district of the Arsi zone. Both primary
and secondary data were used for the study. The primary data were collected by interview
schedule, focus group discussion, and key informant interview. Combinations of purposive
and simple random sampling procedures were employed to draw 340 sample households for
the stud
Species composition, relative abundance and threat of medium and large sized mammals in Chebera Churchura National Park, South Western Ethiopia: Implication for ecotourism development
No full textLarge and medium sized mammals can be found all over Ethiopia, ranging from desert to afro
alpine environments and their distribution have been linked to habitat pattern, composition, and
landscape configuration, and habitat structure. The objective of this study was to investigate the
Species composition, diversity, relative abundance and threat of medium and large sized
mammals and its implication for ecotourism development in Chebera Churchura National Park,
South Western Ethiopia. The data were collected during both dry and wet seasons between
February and July,2024 Based on the vegetation cover and topographic variation, the study area
was stratified into four habitat types. We collected data by conducting line transect and
interviewing key informants. The data was analyzed by using SPSS version 20 software and Micr
o soft Excel 2010. A total of 33 specie of mammals grouped in 8 orders and 15 families were reco
rded from the study are
Assessment of Knowledge, Attitude, and Practices of the Community on Bovine Tuberculosis in Yemalogi Welel District of Kellem Wallaga Zone, Western Ethiopia
No full textBovine tuberculosis (BTB) continues to pose a major threat to both public health and economic
stability globally. In developing nations like Ethiopia, the challenge is exacerbated by relatively
low levels of community awareness and appropriate practices regarding the disease. A study of
the community’s knowledge, attitudes, and practices (KAP) regarding bovine TB was conducted
in the Yemalogi Welel district of Kellem Wallaga zone, Ethiopia, during March-October 2024. A
community-based cross-sectional survey was conducted among 422 randomly selected
community members. Socio-demographic data was gathered through face-to-face interviews.
Data were analyzed using SPSS version 27. The logistic regression technique determined the
association between socio-demographic characteristics and communities’ KAP of bovine
tuberculosis in the are
Prevalence of Cryptosporidiosis in Calves in and Around Hosanna Town, Southern Ethiopia
No full textCryptosporidiosis, a protozoan parasitic infection caused by the genus Cryptosporidium, is a
zoonotic disease that affects young animals and humans. A cross-sectional study was
conducted from May 2023 to October 2024 to estimate the prevalence of Cryptosporidium
infection in calves and to assess associated risk factors in Hosanna town, Southern Ethiopia.
During the study period dairy farms were selected using simple random sampling approach
and a total of 384 calves less than 12 months of age were selected in purposive sampling
techniques
Prevalence Of Second Dose Measles Vaccination Utilization And Associated Factors Among Children Aged 15-36 Months In Tocha Woreda, Dawuro Zone, Southwest Ethiopia, 2025
No full textBackground: Measles is a highly contagious viral disease and a major cause of disease and death
globally. Even though Measles is preventable with two doses vaccination and 95% vaccine coverage, only
74% received the recommended second dose globally in 2023. In Ethiopia, the second dose of the measles
vaccine is a vaccine scheduled in national routine immunization program to be given at the age of 15
month for those who took the first dose measles vaccine and only 9 percent of children aged 24-35 months
received the second dose of the measles vaccine. However, little is known regarding the utilization of
second dose measles vaccination and its associated factors in Ethiopia especially in the study area.
Objectives: To assess prevalence of second dose measles vaccination utilization and associated factors
among children aged 15-36 months in Tocha woreda, Dawuro zone, Southwest Ethiopia, 2025
Methods: A community-based cross-sectional study design was conducted among 585 children aged 15
36 months selected by multi-stage systematic sampling technique in Tocha woreda. Data was collected by
face to face interview of respondents by using kobo collect mobile application. The data collected through
kobo collect tool was exported to SPSS version 27.0 for analysis. Descriptive statistics were computed
and Candidate variables with P-value < 0.25 in bi-variable logistic regression analysis were fitted in multi
variable logistic regression model to identify factors associated with utilization of second dose measles
vaccination and in multi-variable logistic regression model P-value<0.05 was used to declare statistically
significant association. Multi-collinearity among independent variables was checked using variance
inflation factor and model goodness of fit was checked using Hosmer-Lemeshow test.
Results: A total of 585 children with a response rate of 94.4% were included. Among the study
participants, 67.2% with 95%CI (63%−71%) of them utilized measles second dose vaccine. Urban
residence (AOR=3.43, 95%CI: 1.74-6.44), Mothers/caregivers college and above educational status
(AOR=12.76, 95%CI: 4.39-20.64), Pregnant women’s conference participation (AOR=2.25, 95%CI: 1.11
4.56), waiting time of ≤ 15 minutes (AOR=4.28, 95%CI: 1.83-10.01), waiting time of 15-30 minutes
(AOR=3.33, 95%CI: 1.35-8.16) and mothers/caregivers favorable attitude (AOR=6.05, 95%CI: 2.96
12.35) were significantly positively associated with the utilization of measles second dose vaccination.
Conclusion and Recommendation: The utilization of second dose measles vaccine in Tocha Woreda was
below the WHO measles elimination target of > 95%. Variables such as urban residence, educational
status of the mother/caregiver, pregnant women’s conference participation, waiting time for vaccination
and mother’s/caregiver’s attitude towards MCV2 were found to be independent predictors of second dose
measles vaccination Utilization. Therefore, Woreda Health Office managers should collaborate multi
sectoraly to foster mother’s/caregiver’s educational status, advocate pregnant women’s conference,
expand immunization service delivery to rural residents and work to shorten waiting time for
immunization and improve mother's attitud