33 research outputs found
The Cost of Maternal Complications and Its Associated Factors Among Mothers Attending Public Hospitals in Harari Region and Dire Dawa City Administration, Eastern Ethiopia: An Institution-Based Cross-Sectional Study
No full textSamrawit Shawel,1 Behailu Hawulte Ayele,1 Yadeta Dessie,1 Abera Kenay Tura,2 Gimaye Dinsa,1,3 Abainash Tekola,1 Miheret Mandefro,1 Awoke Masrie,1 Aklilu Tamire,1 Obsan Kassa Tefasa1 1School of Public Health, Haramaya University, Harar, Ethiopia; 2School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia; 3School of Population and Public Health, University of British Columbia, Vancouver, CanadaCorrespondence: Samrawit Shawel, Tel +251 913 705 953, Email [email protected]: Pregnant women face high costs for health-care services despite being advertised as free. These costs include non-medical expenses, lost productivity, difficulties caring for family members, and long-term financial impact from complications. Limited research has been done on the cost burden of maternal services and complications, despite numerous studies on maternal health service provision. This is notable considering the government’s claim of providing free maternal health-care services.Methods: A cross-sectional study was conducted in July (1– 30) 2022 among 425 randomly selected mothers in Harari and Dire Dawa City, Eastern Ethiopia. Data were collected through structured questionnaires and medical record reviews. The collected data was entered into Epi-Data version 3.02 and analyzed using STATA version 14.0 after data cleaning. Descriptive statistics and linear regression analysis were used to examine the data, ensuring assumptions of linearity, independence, homoscedasticity, and normality were met. The correlation coefficient was used to assess the strength of the association.Results: The median cost of maternal complications was around 4250 ETB (81.3 USD; IQR = 2900– 5833.3), factors that predicted cost were monthly family income of ≥ 3001 birr (β=1.13; 95% CI: 1.00, 1.26), distance from hospital (β=0.73; 95% CI = 0.64– 0.83), being admitted for less than 4 days (β=0.60; 95% CI = 0.53– 0.69), accompanied by relatives besides their husbands (β=1.93; 95% CI = 1.52– 2.46), caesarian sections delivery (β=1.17; 95% CI = 1.04– 1.31), and giving birth to a normal baby (β=0.86; 95% CI = 0.77– 0.97).Conclusion: Maternal complications incur significant costs, with factors such as family income, travel time, hospital stay, caregiver presence, mode of delivery, and neonatal outcome predicting these costs. The Ethiopian health system should address the additional expenses faced by mothers with complications and their caregivers.Keywords: direct cost, indirect cost, medical-cost, maternal complication, Eastern Ethiopi
Implementation Evaluation of HIV/AIDS Voluntary Counseling and Testing (VCT) Service at Public Health Facilities of Akaki Kality Sub-City, Addis Ababa, Ethiopia
No full textAwoke Masrie,1 Samrawit Shawel,1 Aklilu Tamire,1 Miheret Mandefro,1 Tilaye Gebru,2 Meskerem Seboka Ergiba,3 Muluneh Getachew3 1School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3Department of Health Policy and Management, Public Health Faculty, Institute of Health Jimma University, Jimma, Oromia, EthiopiaCorrespondence: Awoke Masrie, Email [email protected]: Voluntary Counseling and Testing (VCT) is widely acknowledged globally as an effective method for preventing and treating HIV/AIDS. It allows people to understand their HIV status, make informed choices about getting tested for it, evaluate their personal risk of contracting HIV, and create plans to reduce that risk. The study aimed to evaluate the process of VCT services in public health facilities of Akaki Kality sub-city, Addis Ababa, Ethiopia.Methods and Materials: A case study evaluation design with a mixed method was employed from May 12 to June 12, 2021. A total of 244 clients were interviewed during the study period. Furthermore, 12 direct observations, a review of documents from the past six months to the study period, and 12 key informant interviews were conducted. Quantitative data were entered into Epi data 4.6 and exported to SPSS version 25 for analysis. Univariate analysis was done and presented in tables and texts. Qualitative data were transcribed, translated, coded, and analyzed using thematic analysis. The overall service implementation process was measured on the basis of pre-determined judgmental criteria.Results: The overall level of VCT service implementation was 83.84%, to which the availability of resources (84.8%), compliance of service providers with the national guidelines (85.38%), and client satisfaction (76.93%) contributed. One facility had stock-outs of test kits in the last three months, and all VCT counseling and testing rooms lacked audio-visual privacy. Supportive supervision, the use of IEC materials during counseling, linking all HIV-positive clients to treatment and care services, and sending complete reports were practiced in a way that needs some improvement.Conclusion: Overall, the service implementation was deemed satisfactory, but further action is required to improve resource availability, ensure provider compliance with national guidelines, and enhance the status of the service. In addition, the Woreda Health Office and Addis Abeba Health Bureau should regularly supervise and provide feedback.Keywords: client satisfaction, availability, complianc
Undernutrition and associated factors among adults with mental and neurological disorders in public health hospitals, Eastern Ethiopia, 2019: a cross-sectional study
No full textAbstract Background Poor nutritional status can be consequence of impaired mental health that may lead to involuntary weight gain, weight loss, or deficiency of essential nutrients. However, little has been documented about the nutritional status of adults with mental disorders and the contributing factors in low-income countries like Ethiopia. The aim of this study was to assess the magnitude of undernutrition and associated factors among adults with mental disorders in public hospitals of Eastern Ethiopia. Methods Institution-based, cross-sectional study was conducted among 507 adults with mental disorders from March 1, 2019 to April 1, 2019. Interviewer administered pretested structured questionnaire was used to collect data. Anthropometric data were collected using calibrated weighing scale and height measuring board. Descriptive statistics was computed to describe the data. Bivariable and multivariable logistic regression analyses were applied to identify factors associated with the undernutrition. Odds ratio alongside 95% confidence interval (CI) were estimated to measure the strength of the association. Level of statistical significance was declared at p-value less than 0.05. Results Undernutrition affected 62.7%; 95% CI: (58.3%, 67.7%) of the patients. Undernutrition was associated with meal frequency < 3 per day (adjusted odds ratio [(AOR = 2.07, 95% CI: (1.18, 3.63)], use of multiple medication (adjusted odds ratio [(AOR = 3.02, 95% CI: (1.88, 4.84)], being non-smoker [(AOR = 0.50, 95%CI: (0.25, 0.91)], and use of prescribed diet [(AOR = 0.45, 95%CI: (0.26, 0.78)]. Conclusions The magnitude of undernutrition was high among the study participants. Multiple medication, cigarette smoking, frequency of meal and taking prescribed diet were significantly associated with undernutrition. Nutrition education for patients with mental disorders and their caregivers about the impact of taking multiple medication and substance use needs to be emphasized alongside nutritional screening and support to improve their nutritional status
Process Evaluation of Health System Responsiveness Level and Associated Factors Among Mothers Gave Birth at Obstetric Ward in a Tertiary Hospital, Southwest of Ethiopia: Mixed Study Methods
No full textGezu Girma,1 Aklilu Tamire,2 Gebeyehu Jeldu Edessa,3 Mesay Dechasa,4 Obsan Kassa Tefasa,2 Abraham Negash,5 Jerman Dereje,6 Awoke Masrie,2 Samrawit Shawel,2 Miheret Mandefro,2 Gelila Abraham3 1Department of Health Research, International Center for AIDS Care and Treatment Program (ICAP), Finfine, Ethiopia; 2School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Harari, Ethiopia; 3Department of Health Policy and Management, Public Health Faculty, Institute of Health Jimma University, Jimma, Oromia, Ethiopia; 4Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Science, Haramaya University, Harar, Ethiopia; 5School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 6Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Aklilu Tamire, School of Public Health, College of Health and Medical Science, Haramaya University, P.O. Box 235, Harar, Harari, 3200, Ethiopia, Tel +251921211752, Email [email protected]: The term responsiveness emerged during the World Health Organization (WHO) report in 2000 as new and essential goals of the health systems to meet the needs of people to their expectations from different services being given in healthcare systems. Obstetric violence and childbirth mistreatment are global problems, but the worst obstetric violence usually occurs in underdeveloped countries. Thus, the main objective of this study was to evaluate the responsiveness of obstetric service at Jimma University Medical Center.Methods: A single-case study design with quantitative and qualitative data collection was employed. Availability with 17 indicators and health system responsiveness with 24 indicators were used. Consecutive sampling technique was used to select the clients and qualitative data were collected from key informants. SPSS version 25 was used for the analysis of quantitative data, whereas thematic analysis was conducted for qualitative data. A multiple linear regression model was fitted after all assumptions were checked and fit to ensure the relation of the dependent variable with independent variables.Results: The overall evaluation was 75.6% and judged good. The resource availability and health system responsiveness were 85.5% and 69.7%, which were judged very good and fair, respectively. A stethoscope and thermometer were not available, while 40% glucose, dexamethasone, and intravenous fluid were the most frequently stocked-out supplies. Dignity (72.1%), confidentiality (71.4%), and prompt attention (70%) were the top three good scores for the health system’s responsiveness. Health system responsiveness significantly associated with the following: Not attending formal education, attending college and above, place of delivery (health center), mode of delivery (cesarean section), and being merchant.Conclusion & Recommendation: The health system responsiveness of delivery service in study setting was good. All stakeholders should work for improving the health system’s responsiveness in delivery service.Keywords: obstetric, health system responsiveness, Jimma University Medical Center, Ethiopi
Disordered eating behaviors and associated factors among secondary school adolescents in Harar town, eastern Ethiopia: cross-sectional study
No full textBackgroundAdolescent eating disorders impair physical and mental development and are associated with poor health outcomes in adulthood. However, there is little research on disordered eating in Ethiopia, particularly in the study area. As a result, the purpose of this study is to examine disordered eating behaviors and associated factors in secondary school adolescents in the study area.MethodsA school-based cross-sectional study was conducted among 1104 secondary school adolescents in Harar town from June 30 to July 15, 2022. Multistage cluster sampling was used, and data was collected using self-administered questionnaires. The eating attitude test-26 was used to assess disordered eating behaviors, and scores of 20 and above were considered to have disordered eating behaviors. A binary logistic regression analysis was done to identify factors associated with disordered eating behaviors and the statistical significance level was set at a p-value of 0.05.ResultIn this study, 28.37% [95% CI (25.73%, 31.16%)] of the adolescents had disordered eating behaviors. Being female [AOR = 1.81, 95% CI (1.29, 2.53)], being from a mother, attending technical school [AOR = 3.61, 95% CI: (1.85, 7.04)], and having a higher-educated father [AOR = 1.55, 95% CI: (1.02, 2.36)] were significantly associated with disordered eating behaviors. Furthermore, desire to lose weight [AOR = 2.09, 95% CI (1.49, 2.93)], smoking [AOR = 3.64, 95% CI (2.24, 5.91)], emotional problems [AOR = 1.7, 95% CI (1.14, 2.55)], and body image dissatisfaction [AOR = 0.96, 95% CI (0.94, 0.97)] were associated with disordered eating.ConclusionIn Harar, almost three out of ten secondary school adolescents had disordered eating behaviors. Personal, behavioral, and socio-demographic factors were associated with disordered eating. Since the prevalence of disordered eating is significant at the study site, all relevant stakeholders should have to develop appropriate interventions that target modifiable factors to reduce the burden
Evaluation of carbon accrual in afforested agricultural soils
No full textAfforestation of agricultural lands can provide economically and environmentally realistic C storage to mitigate for elevated CO2 until other actions such as reduced fossil fuel use can be taken. Soil carbon sequestration following afforestation of agricultural land ranges from losses to substantial annual gains. The present understanding of the controlling factors is inadequate for understanding ecosystem dynamics, modeling global change and for policy decision-makers. Our study found that planting agricultural soils to deciduous forests resulted in ecosystem C accumulations of 2.4 Mg C ha-1 yr-1 and soil accumulations of 0.35 Mg C ha-1 yr-1. Planting to conifers showed an average ecosystem sequestration of 2.5 and 0.26 Mg C ha-1 yr-1 in the soils but showed greater field to field variability than when planted to deciduous forest. Path analysis showed that Ca was positively related to soil C accumulations for both conifers and deciduous afforested sites and played a significant role in soil C accumulations in these sites. Soil N increases were closely related to C accumulation and were two times greater than could be explained by system N inputs from atmospheric deposition and natural sources. Our results suggest that the addition of Ca to afforested sites, especially conifers, may be an economical means to enhance soil C sequestration even if it does not result in increasing C in aboveground pools. The mechanism of N accumulation in these aggrading stands needs further investigation
Détermination analytique de la dynamique du carbone du sol
No full textInvitational oral presentation given at the 16th World Congress of Soil Science, Montpellier, France 20-26 August, 1998.Scientific registration n°: 301, Symposium n°: 7, Presentation: oral - invit.The significance and possible management of soil organic C (SOC) in ecosystem functioning, global change and sustainable agriculture is best determined through a knowledge of its dynamics. This requires analytically determined measurements of SOC pool sizes and flux rates. The amount and quality of plant residues inputs, biotic activity, site characteristics and management are reflected in the size of the pools and their turnover rates. Some constituents are decomposed during periods of weeks; some persist for centuries and millenia. Fractionation of the soil and the use of tracers such as 14C and 13C makes possible the determination of the dynamics of the pools involved such that more meaningful estimates of the role of SOC in the many functions in which it plays a role can be calculated
Awareness of prostate cancer and its associated factors among male patients attending care in the urology unit at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
No full textBackground Globally, prostate cancer is the most common cancer among men. It is the second most common cause of cancer-related deaths in men. Symptoms may be non-specific and may not present until the cancer has progressed. Raising awareness, knowing risk factors and symptoms and seeking early medical attention is critical for prevention and detection. The objective of this study is to assess the level of awareness of prostate cancer among male patients attending care in a urology unit in Ethiopia.Methods We conducted a cross-sectional study among 241 male patients at Tikur Anbessa Specialized Hospital from February to April 2021. Data were collected using an interviewer-administered questionnaire adapted from published studies and cancer awareness measurement tools. We used EpiData V.4.6.0 and SPSS V.26 for data entry and analysis. Descriptive statistics and linear regressions were used for analyses. Bivariate and multivariate linear regression analysis identified factors associated with prostate cancer awareness. Adjusted odd ratio (AOR) at 95% CI and p value<0.05 were considered statistically significant.Results A total of 250 patients were approached, and 241 (96.4%) responded. The mean scores for awareness of prostate cancer risk factors, symptoms, screening and prevention were 41.2%, 43.8%, 44.7% and 49.5%, respectively. Families with an average monthly income of more than 8900 ETB (Ethiopian birr), having heard about prostate cancer, having a regular source of care every six months or more, having a history of hospitalisation and having healthcare providers as the main source of information were all significantly associated with awareness of prostate cancer.Conclusion The findings of this study indicate that male patients have a relatively low level of awareness of prostate cancer risk factors, symptoms, screening and prevention. There should be more public awareness initiatives to educate men in Ethiopia on the risk factors, symptoms, screening and prevention of prostate cancer
Explaining consequences of employment insecurity: The dynamics of scarring in the United Kingdom, Poland and Norway
No full textThis deliverable presents three country studies on scarring effects of early employment insecurity in the United Kingdom, Poland and Norway. Traditional analysis of scarring effects has favoured the analysis of the impact of the experience of unemployment on the experience of subsequent unemployment (state dependence) and the monetary costs of previous unemployment in terms of lower subsequent wages (see e.g. Arulampalam, Booth and Taylor 2000; Arulampalam, Gregg and Gregory 2001). The three present country studies go beyond the traditional analysis of scarring effects in order to better understand the trade-offs experienced by young female and male workers when faced with an insecure labour market integration. With national longitudinal data, original methodological designs and research focus, each study contributes in an original way to the research literature. All three studies pay special attention to gender and education as potential moderating variables of scarring effects
Use of carbon-13 and carbon-14 to measure the effects of carbon dioxide and nitrogen fertilization on carbon dynamics in ponderosa pine
No full textSoil C sequestration in predicted, future elevated CO2 environments will be important to atmospheric CO2 levels, soil tilth, and fertility. An elevated CO2 study with ponderosa pines (Pinus ponderosa Laws) grown in chambers produced above ground vegetation with a δ13C of −44‰ and roots with −42‰. This together with carbon dating made it possible to follow soil C dynamics. Fifty percent of the California upland soil C, resistant to acid hydrolysis, was designated as the resistant fraction. Carbon dating showed the mean residence times of this fraction to be 400 to 1500 yr greater than the total soil C for the horizons sampled. Young ponderosa pines grown in CO2 chambers produced negligible leaf litter. There were 32% more roots in the presence of either added N or double CO2 but 77% more in the presence of both. Root-derived soil C was equivalent to 10% of the root C after the 6-yr growth period. Analysis of laboratory CO2 evolution during extended incubation showed the active soil C pool represented 1 to 2% of the soil C with a field-equivalent mean residence time (MRT) of 24 to 53 d. The slow pool represented 46 to 52% of the C with MRT of 24 to 67 yr depending on treatment and soil depth. Analysis of the 13CO2 label during incubation from the elevated CO2 treatments, showed the root-derived 13C of the active fraction to have residence times similar to those of the total soil non labeled C at ≈35 d. Root-derived C of the slow pool at 10 yr MRT turned over three to four time as fast as the general soil C. The 13C of the light fraction (LF), showed it to be most closely associated with the active pool. The particulate organic matter (POM) was part of the slow pool as determined with incubation
