Public Health

“I want to perform and succeed more than those who are HIV-seronegative” Lived experiences of youth who acquired HIV perinetally and attend Zewditu Memorial Hospital ART clinic, Addis Ababa, Ethiopia

Thu, 27 May 2021 00:00:00 GMT

“I want to perform and succeed more than those who are HIV-seronegative” Lived experiences of youth who acquired HIV perinetally and attend Zewditu Memorial Hospital ART clinic, Addis Ababa, Ethiopia Habtamu, Nahom S; Molla, Mitike; Ketema, Bezawit Abstract Background In Ethiopian Human Immunodeficiency Virus (HIV) prevention program one of the focusing areas is prevention of mother-to-child transmission and decreasing morbidity and mortality among those who already acquired it. However, the needs and the sexual behavior of chil dren who acquired HIV perinatally was not given due attention. Therefore, we conducted this study with the aim of exploring the lived experiences of youth who acquired HIV perina tally to contribute to HIV prevention and control program. Methods We conducted a qualitative study using a phenomenological approach from March to May 2018 among 16 purposively selected youth who were infected with HIV vertically and receive ART services at Zewditu Memorial Hospital, Addis Ababa, Ethiopia. They were recruited based on their willingness after obtaining written informed consent and assent. Data were audio taped, transcribed verbatim in Amharic and later translated to English, and coded using Open Code version 4.02 software. Findings were summarized under four themes by applying interpretative phenomenological analysis. Findings Seven males and nine females, aged 16 to 22 years have participated in the study. These youth reported as they had support from families and ART clinics, while pill-load, and fear of stigma are some of challenges they have faced, especially majorities don’t want to disclose their status because of fear of stigma and discrimination. Half of them have ever had sexual relations usually with a seronegative partner and most of these had their first sex in their17-18 years of age. Unsafe sex was common among them where four girls reported to have had unprotected sex with their seropositive or seronegative sexual partners. Most wish to have purposeful life and love mate of the same serostatus but also fear they may remain alone. Conclusion Youth who had acquired HIV from parents are challenged due to their serostatus and were not sure what type of life they may have in the future. They were also not comfortable in dis closing their serostatus and also engaged in unsafe sexual relation. This calls for an urgent intervention among HIV infected youth and their families; health care providers, and young people in general to halt HIV transmission. Special attention should be given on sexual behavior of all young people (10–24) and in disclosure of HIV status to children and life skills education to cop-up with stigma and discrimination.

The impact of intimate partner violence on adverse birth outcomes in public health facilities. A prospective cohort study

Sat, 09 Sep 2023 00:00:00 GMT

The impact of intimate partner violence on adverse birth outcomes in public health facilities. A prospective cohort study Wassie, Semahegn Tilahun; Tilahun, Abel Girma; Ejigu, Amare Genetu; Lambyo, Shewangizaw H Maryam Background: During pregnancy, intimate partner violence (IPV) is a health problem associated with severe adverse birth outcomes. The Ethiopian Demographic Health Survey showed that more than one-third of married women faced IPV. Therefore, this study aimed to investigate the effects of IPV during pregnancy on adverse birth outcomes. Methods: A prospective cohort study was conducted from September 1st, 2021 to April 30th, 2022. Using a systematic random sampling technique, participants were enrolled from 20 to 24 weeks of gestation at antenatal visits at the selected public health institutions. The validated and modified standards of the World Health Organization Domestic Violence Questionnaire were used to screen for IPV. Bivariate and multivariate logistic regression models were used in this study. The relative risk was also calculated to predict the occurrence of adverse birth outcomes. Results: Overall, 701 pregnant women were followed from 20 to 24 weeks of gestation until delivery in a 1:2 ratio (244 exposed to 457 non-exposed). Preterm birth increased by 1.02 times (RR=1.02, 95 CI; 0.979-1.047), low birth weight with RR= 2.023, 95% CI; 1.201-3.407 and stillbirth (RR= 1.124, 95%CI; 0.43-3.055). Among the exposed groups, 167(23.8%), 83 (11.8%), and 51 (7.3%) had emotional, physical, and sexual violence, respectively. The odds of developing adverse birth outcomes from IPV exposure were [AOR=1.63,95% CI: [1.23, 3.75], emotional violence [AOR= 1.70:95% CI: [1.24, 4.24], and physical violence [AOR= 3.99:95% CI: [1.51, 10.52] times higher than those of their counterparts. No significant association was observed between sexual violence and adverse birth outcomes. Being unsupported by the husband and having previous adverse birth outcomes increased IPV by nearly four-fold [AOR=3.80:95% CI; 1.19, 12.09] and [AOR= 3.70:95% CI:1.49, 9.17], respectively. The odds of mothers with a 2nd visit MUAC measurement of < 23 cm were [AOR=2.81:95% CI; 1.20, 6.61]. Conclusion: The incidence of adverse birth outcomes was significantly higher in the physically IPV-exposed group than in the non-exposed group. Therefore, pregnant women should be screened for IPV during their antenatal period. Thus, IPV-exposed pregnant women should be counseled and closely followed up. Keywords: Adverse birth outcomes; Bench-Sheko Zone; Low birth weight; Physical violence; Preterm birth; Stillbirth.

Magnitude and determinants of unmet need for family planning among reproductive age women in East Africa: multilevel analysis of recent demographic and health survey data

Tue, 25 Jan 2022 00:00:00 GMT

Magnitude and determinants of unmet need for family planning among reproductive age women in East Africa: multilevel analysis of recent demographic and health survey data Alie, Melsew Introduction: Unmet need for family planning is the main obstacle to achieve healthy timing and desired numberof children. Decreasing the unmet need for FP respects and protects human right and help to decrease theinfluence on biodiversity. Unmet need for family planning is the contributor and devastating issue of maternalhealth. Therefore, meeting the unmet need of contraceptive averts the maternal death and poverty. Therefore,determining the magnitude and its determinants is very important to intervene and design appropriate programumbrella.Objective: To determine the magnitude and its determinants of unmet need for family planning amongreproductive age women in East Africa.Method: This study was analyzed secondary data from Demographic and Health Surveys (DHS) of which containeddetailed family planning for all interviewed women aged 15 to 49 years. The data were weighted using samplingweight before any statistical analysis to account the sampling design. STATA version 15 was used for extracting,editing, recoding, and multilevel analysis. Median odds ratio (MOR), proportional change in Variance (PCV), Intraclasscorrelation coefficient (ICC), and Akaike Information Criteria (AIC) was analyzed. Four model was build and the bestmodel was selected based on the smallest Akaike Information Criteria (AIC). Both bivariable and multivariablemultilevel analysis was done. Variable with p-value< 0.25 were selected for multivariable multilevel logisticregression analysis. Variables with p-value ≤5% declared as statistical significant with outcome variable. Results: The magnitude of unmet need for family planning was 24.66% (95%CI: 24.1–25.2). The identifieddeterminants of unmet need for family planning was 30–39 years (AOR = 0.7; 95% CI 0.54–0.91), age of 40–49(AOR = 0.76; 95% CI 0.58–0.99), rural residence (AOR = 1.17; 95% CI 1.02–1.34), female household head (AOR = 0.66;95% CI 0.61–0.73), women having 4–6 child (AOR = 1.76; 95% CI 1.55–1.99), women having 7–9 child (AOR = 2.77;95% CI 2.34–3.28) women having ≥10 child (AOR = 3.51; 95% CI 2.58–4.78), women who give their first birth 19-25years (AOR = 1.1; 95% CI 1.0–1.26), 26–34 years (AOR = 1.4; 95% CI 1.19–1.83) ≥35 years (AOR = 2.1; 95% CI 1.1–4.27)and no fertility desire (AOR = 1.52; 95% CI 1.36–1.67) were the determinants of unmet need for family planning ineast Africa.Conclusion: Unmet need in east Africa is high as compare to other previous study. Maternal age, residence, sex ofhousehold head, number of children, age at first birth and fertility desire were the determinants identified in thisstudy. Therefore, health interventions that reduce unmet need which enhance family planning service deliveryamong rural, male-headed household, women having more than three children and women who had no fertilitydesire needed in advance. Policies and programs of unmet need should be tailored the rural, young and no fertilitydesire women as well as male headed households.

Intention to Use and Its Predictors Towards Preconception Care Use Among Reproductive Age Women in Southwest Ethiopia, 2020: Application of Theory of Planned Behavior (TPB)

Mon, 16 Aug 2021 00:00:00 GMT

Intention to Use and Its Predictors Towards Preconception Care Use Among Reproductive Age Women in Southwest Ethiopia, 2020: Application of Theory of Planned Behavior (TPB) Alie, Melsew Background Preconception care should be given in universal manner worldwide by manifesto of WHO. The government of Ethiopia gives the emphasis to maternal and child health but the progress of its improvement is too slow. Maternal health services especially before pregnancy is the unreached agenda in Ethiopia. Therefore, there is limited evidence on the intention to preconception care and its determinants in southwest Ethiopia. So, the aim of this study to determine the intention to use and its predictors of preconception care use among reproductive age women. Methods A community-based cross-sectional study was conducted in southwest Ethiopia. Systematically selected 427 reproductive age women were involved in this study. Face-to-face interview was used to collect the data by trained data collectors. The collected data was entered into EpiData version 3.1 and then exported to SPSS version 25 for further analysis. Multiple linear regression analysis was conducted to identify predictors to intention to use preconception care. P-value less than 5% was considered to indicate significant association. The standardized β-coefficient was presented as measure of association following a multivariable linear regression analysis. Results The response rate of the study was 98.13%. The mean age of respondents in the study was 34.21[±6.21] years. Nearly twenty (19.8%) respondents had used preconception care previously. The attitude (β =0.320, p=0.0418), subjective norm (β =0.344, p<0.001), perceived behavioral control (β=0.512, p<0.001), indirect subjective norm (β =−0.108, p=0.002) and age of respondents (β =0.046, p=0.020) were predictors of intention to use preconception care. Conclusion Intention to use preconception care is a multiplicative effect of attitude, subjective norm, perceived behavioral control and indirect subjective norm. Age is the only socio-demographic variables associated to intention.