Master of Public Health in Reproductive Health

Permanent URI for this collectionhttps://etd.hu.edu.et/handle/123456789/30

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Start date: 2023

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    PREVALENCE AND ASSOCIATED FACTORS OF MALARIA AMONG THE COMMUNITY OF LOKA ABAYA DISTRICT, SIDAMA REGIONAL STATE, SOUTHERN ETHIOPIA
    (hawassa universty, 2023-11) SIRATU SEYOUM
    Background: Malaria remains a major public health concern in Ethiopia, despite the widespread use of insecticide-treated mosquito nets. In most rural Ethiopian settings, insecticide-treated net coverage and proper use are major challenges. The goal of this study was to determine the prevalence of malaria, the proportion of Plasmodium species, and the risk factors for disease transmission in the study area. Methodology: From April to May of 2023, a community-based cross-sectional study was conducted among 419 participants in Loka Abaya District, Sidama. A face-to-face interview and visual observation were used to collect socio-demographic data and other associated factors. A capillary blood sample from each study participant was collected and tested with smear microscopy and rapid diagnostic tests for the presence of malaria parasites. Epi-data manager version 4.6 was used to enter and clean the data, and SPSS version 26 was used to analyze it. Bivariate and multivariate logistic regression results were used to assess the association between the dependent and independent variables. Statistical significance was defined at p-value < 0.05. Result: The overall prevalence of malaria infection was 61 (14.6%) with 95% CI: 11.0 - 18.0. The relative proportions of P. falciparum and P. vivax infection were 59.0% and 36.1% respectively, while the proportion of mixed (P. falciparum and P. vivax) infection was 4.9%. No formal education (AOR: 2.56; 95% CI: 1.10 - 5.94) compared to secondary and above education, low monthly income (AOR: 2.97; 95% CI: 1.07 - 8.25) compared to high monthly income, those who did not have ITN (AOR: 2.56; 95% CI: 1.14 - 5.75), never used ITN during sleep (AOR: 2.875; 95% CI: 1.130 - 7.317), living in areas with stagnant water (AOR=2.12, 95% CI: 1.14 - 3.99) were independent predictors of malaria infection. Conclusion: The prevalence of malaria in the study population was high, with P. falciparum being the most common causative agent. Regarding associated factors, educational status, monthly income, ITN availability and utilization, and the presence of stagnant water around the house were all potential determinants of malaria. Continued community health interventions focusing on the proper use of ITN, drainage of stagnant water, and increased public awareness about reducing the risk of insect bites have the potential to reduce infection.
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    A research paper to be submitted to Hawassa University College of Medicine and Health Science School of Public Health in Partial Fulfillment of the Requirement for Degree of Masters in Public Health in Reproductive Health
    (hawassa universty, 2023-11) Simegn Anbese
    Background: Vaginal birth after cesarean (VBAC) is giving birth through vagina after giving birth previously by cesarean section. Repeated caesarean deliveries associated with maternal and child complication. It had expanded hospital duration, and high risk of postpartum hemorrhage. However vaginal birth after cesarean is the best choice to reduce repeated CS. But there was insufficiency of evidence to predict determinants of successful vaginal birth after cesarean. So the aim of this study to identify determinants of successful vaginal birth after cesarean section to decreases the overall CS rate and related complication. Objective: To identify determinants of successful vaginal delivery after Caesarean Section at Public hospital in Hawassa city, Sidama Region, Ethiopia, 2023. Methodology: A facility based un-matched case control study was conducted at public hospitals in Hawassa city, Sidama region. A total of 107 consecutive cases and 214 controls were included. Data were collected using pre-tested interviewer administered questionnaire and chart reviewing. Then the data were exported to SPSS for analysis. Descriptive statistics analysis was done. A bi variable regression analysis was done for all independent variables .Variables with p values < 0.25 in bi variable analysis were taken and analyses in multivariable logistic regression .Finally the multivariable logistic regression model were considered statistically significant p values of <0.05 with corresponding 95% CI. Result: In this study 321 mothers were participated from those 107 give birth through birth canal after trial of lobour and 214 mothers end the labour with repeated CS. Mothers who have counseling about trial of labour during Anti natal follow up (AOR2.808; 95%CI1.543-5.112) ,mother who have history of successful vaginal birth after cesarean section(AOR4.170; 95%CI 2.317-7.504), membrane ruptured on admission (AOR 4.891; 95%CI 2.728-8.771) and BISHOPE score >6(AOR 2.661; 95%CI 1.415-4.881) significantly associated with successful VBAC. Conclusion Successful VBAC is reduced repeated cesarean delivery and related complication. So in our study counseling about TOLAC during ANC follow up, History of successful VBAC, Membrane ruptured on admission and BISHOPE score >6 were determinants of successful VBAC
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    KNOWLEDGE OF NEONATAL DANGER SIGNS AND ASSOCIATED FACTORS AMONG FATHERS AND MOTHERS WHO GAVE BIRTH IN THE LAST SIX MONTHS IN HAWASSA CITY ETHIOPIA 2023
    (hawassa universty, 2023-11) SELAMAWIT ABERA
    Introduction Preventable neonatal mortality and morbidity remain challenging in many sub Saharan African countries including Ethiopia. The majorities of neonatal death were due to avoidable causes and occurred at home. In a developing country like Ethiopia, since husbands are considered decision-makers when it comes to healthcare-seeking in the family, care-seeking behavior toward their neonates highly relies on their knowledge about neonatal danger signs. Lack of knowledge about neonatal danger signs contributes to delays in seeking help which in turn increases neonatal morbidity and mortality. Objective: The aim of this study is to assess the knowledge of neonatal danger signs and associated factors among fathers and mothers who gave birth in the last six months in Hawassa city. Method: A community based comparative cross-sectional study was conducted with a sample size of 633 couples in selected kebeles of Hawassa city from February 6 to 20. Data was collected by face-to-face interview using semi structured questionnaire. The data was entered into EPI data version 4.2 and exported to SPSS for further analysis. Bivariate and multivariate logistic regression analysis was performed using SPSS version 25 to determine significant factors associated with knowledge of neonatal danger signs. Result: The result of this study showed that mothers and fathers who have good knowledge of neonatal danger sign were found to be 56 %( 95%CI 52-60) and 40.1% (95% CI 36-44) respectively. The odds of having good knowledge among fathers were positively associated with accompanying spouse during ANC follow-up (AOR=2.674, 95% CI 1.532to 4.66). Having three or more children (AOR=2.155, 95% CI 1.287to 3.61) history of neonatal illness (AOR=3.431, 95% CI 1.715 to 6.862). And the odds of having good knowledge among mothers were having a history of neonatal death, (AOR=2.371, 95%CI 1.145-4.911), having three or more children. (AOR=1.49, 95%CI 1.061-2.120) and being counseled by health care professionals at postnatal (AOR=1.482, 95%CI 1.016-2.161) Conclusion and recommendations in this study, Mothers’ and fathers’ knowledge about neonatal danger signs was found to be low. Therefore, an intervention modality that focuses on reducing the knowledge gap through health education was pinpointed
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    TREATMENT OUTCOMES AND ASSOCIATED FACTORS AMONG CHILDREN ADMITTED TO PEDIATRIC EMERGENCY UNIT OF DILLA UNIVERSITY REFERRAL HOSPITAL, ETHIOPIA, 2023.
    (hawassa universty, 2023-11) SAMUEL JIGSO DUBE
    Background: Children in pediatric emergency units are those who need special attention, and unless treated early, they are a vulnerable population to unwanted outcomes. However, the majority of the children admitted to pediatric emergency units was improving and discharged; a significant number of children are still experiencing death, discharge against medical advice or referral from emergency units within 24 hours. However, there is limited information regarding their outcomes and determinants of outcomes. Objectives: To assess treatment outcome and associated factors among children admitted to pediatric emergency unit of Dilla university referral hospital, Ethiopia 2023. Methods: An institution-based cross-sectional study design was employed among children admitted to the pediatric emergency unit at Dilla University Referral Hospital from May 8, 2023 –June 8, 2023. A one year all charts of the children aged 29 days -14 years were reviewed for the study with final (complete) charts of 885. Data was collected based on a structured checklist developed on the Kobo Toolbox mobile application. Collected data was exported into and analyzed using STATA version 14. Frequency and percentage was used to describe variables. A multinomial logistic regression model was used to determine factors associated with treatment outcome. Model goodness of fit was checked using likelihood ratio test and it showed goodness of model fit. Bivariable and multivariable multinomial logistic regression analysis were employed. After multivariable analysis, variables with an adjusted odds ratio and a p-value of <0.05 at 95% confidence interval (CI) were declared as factors significantly associated with treatment outcome. Result: Out of the complete 885 patient charts reviewed, the magnitude of patients improved, transferred, died, referred and discharged against medical advice was 51%, 40.9%, 7.6%, 0.1%, and 0.4%, respectively. Children presented with diarrhea [AOR=2.92, 95%CI (1.46-5.84)], severe respiratory distress [AOR=5.08, 95%CI (2.49-10.35)], coma [AOR=3.71, 95%CI (1.24 11.13)], comorbidity [AOR=3.33, 95%CI (1.49-7.41)] and staying home without seeking health care for > two days since the onset of signs and symptoms [AOR=1.99, 95CI (1.03-3.83)] were significantly associated factors with emergency unit mortality, whereas pneumonia [AOR=1.76, 95%CI (1.16-2.65)] and severe acute malnutrition [AOR=3.46, 95%CI (2.06-5.81)] were significantly associated factors with intra-hospital unit/ward transfer. Conclusion: The findings of this study showed that the magnitude of mortality, transfer to the ward and discharge against medical advice was relatively higher. Presenting with diarrhea, respiratory distress, comorbid illnesses, coma, delay to present, pneumonia and severe acute malnutrition are factors associated with pediatric emergency treatment outcomes. Interventions focused on early diagnoses and the initiation of appropriate treatments was of the utmost relevance to improve patient‟s outcomes.
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    UTILIZATION LEVEL OF ELECTRONIC COMMUNITY HEALTH INFORMATION SYSTEM AND ASSOCIATED FACTORS AMONG HEALTH EXTENSION WORKERS IN SIDAMA REGION, ETHIOPIA
    (hawassa universty, 2024-11) KIDEST FEKADU
    Background: Effective community health management information systems are important in low-resource countries that rely heavily on community-based health care providers. However, there is no evidence of the level of utilization of electronic community health information systems. The aim of this study is to assess the utilization of electronic community health information systems and associated factors among health extension workers in the Sidama region of Ethiopia in 2023. Methods: Concurrent mixed methods design was used: Quantitative cross-sectional studies and qualitative phenomenology designs among 402 health extension workers and 8 participants for qualitative study from April to June 2023. Multi-stage sampling techniques have been used. Data were extracted by interview methods using the Kobo toolbox and then exported to SPSS version 25 for analysis. Variables having P<0.25 in bivariate analysis were fitted for multivariable regression. Whereas, an explorative qualitative study was employed, involving key informant interviews and in-depth interviews with a purposefully chosen interviewee, and the data was analyzed using Atlas software. Result: The study revealed the overall utilization level of the community health information system in Sidama was 40.3% (95% CI: 35.5%, 45.3%). Supportive supervision from primary health care units (AOR = 0.46, 95% CI = 0.28, 0.55), supportive supervision from Woreda Health Office (AOR = 0.51, 95% CI = 0.29, 0.91), connectivity (AOR = 0.55, 95% CI = 0.32, 0.94), receiving electronic community health information system guidelines (AOR = 0.45, 95% CI = 0.27, 0.75), and perceived competency (AOR = 0.54, 95% CI = 0.34, 0.86) were significant factors. The budget constraint, infrastructure, follow-up problem, technological problems, lack of commitment, and role confusion were challenges for the utilization of the system. Conclusion and Recommendation: More than half of the health extension workers had no electronic health information system utilization . Supervision from primary health care units , Supervision fromworeda health offices, connectivity, guidelines and perceived competency were responsible for the result. Therefore, Improving, boosting internet connectivity, supportive follow-up, training access for their competency and fulfilling the guidelines are important to scale up the utilization. This finding is supported by qualitative study.
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    Implementation of Integrated Management of Neonatal and Childhood Illness Guidelines and Associated Factors among Health Professionals at Public Health Facilities in Guji Zone, Oromia Region Southern Ethiopia, 2023
    (hawassa universty, 2023-11) JemalAyub
    Introduction: Integrated Management of Neonatal and Childhood Illness strategy is a management of the most common childhood conditions, with a focus on the most important causes of death. Nevertheless, there is limited information and evidence on its implementation status and operational constraints which has limited the development of intervention strategies in line with child mortality rate reduction. Objective: To assess health professionals’ Utilization of the integrated management of neonatal and childhood illness guidelines and associated factors at public health facilities in Guji Zone, Oromia Region Southern Ethiopia, 2023. Methods: Across sectional study was conducted among 284 randomly selected health professionals at Guji Zone. Data were collected using Self-administered questionnaire. The collected data were cleaned, coded and entered into epi-data and exported to SPSS version 21 for data analysis. Descriptive statistics was used to describe the study population in relation to socio-demographic and other relevant variables. Binary logistic regression was used to identify factors associated with implementation of IMNCI. In the variable model, covariates with p values ≤ 0.25 were selected to be included in the multivariable model. The Adjusted Odds Ratio (AOR) with a 95 % Confidence Interval (CI) and p-value of ≤ 0.05was computed to show the strength of the association. The model fitness was checked using Hosmer Reshow model with the P-value of >0.05. Results: Data were obtained from 286 health care professionals working in four districts, with a response rate of 100%. The high-level implementation of IMNCI among health professionals in selected districts of Guji Zone was 75.2%. Receiving IMNCI training (AOR: 1.8(1.06-15.16) and Received IMNCI follow up training (AOR: 8(3.0-11.9) were independent determinants of implementation of IMNCI. Conclusion: A variety of factors can determine utilization of IMNCI. Of these, level of qualification and IMNCI training. Improving health professionals’ level of qualification and providing adequate IMNCI training would improve IMNCI utilization.
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    DETEMINANTS OF SURGICAL SITE INFECTION FOLLOWING CESAREAN DELIVERIES IN HAWASSA UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, HAWASSA, ETHIOPIA : UNMATCHED CASE –CONTROL STUDY
    (hawassa universty, 2023-05) SISAY DEJENE
    Background - Globally the incidence of infection following Cesearn delivery was significantly higher in lower-income countries including Ethiopia. Even though surgical site infection is among the leading causes of maternal mortality and morbidity, only a few studies have been conducted on the determinants of surgical site infection following cesarean deliveries. Objective – This study aimed to identify the determinants of surgical site infection following cesarean deliveries in Hawassa University Comprehensive Specialized Hospital Hawassa, Ethiopia. Methods – A hospital-based unmatched case-control study was conducted from September 2019- to September 2022 at Hawassa University Comprehensive Specialized Hospital. Data was extracted from April 15 to May 15, 2023. Cases were selected through consecutive sampling, while controls were selected using a systematic random sampling method. A total of 320 participants were included (107 cases and 213 controls). Data were collected by using the Open Data kit (ODK) downloaded and exported to XLS then imported to SPSS version 26. A binary logistic regression model was conducted and a variable with a p-value of < 0.25 was selected as a candidate variable for the final multivariable logistic regression model and a P-value of less than 0.05 was statistically considered as significant predictors. Results: A total of 320 mothers (107 cases and 213 controls) were included in this study. Women with diabetes mellitus were 3.7 times [AOR: 3.71, 95%CI: 1.18–11.66] at higher odds for surgical site infection compared to women who did not have diabetes mellitus. Vaginal examination [AOR= 2.28 (95%CI, 1.15-4.54)], post-operative hematocrit less than 30% [AOR= 4.12(95% CI 1.97-8.61).women in labour during C/S [AOR= 5.16( (95%CI,1.33-20.1)]. more than 5 days duration of hospital stay[AOR=3.42 (95%CI, 1.32-8.89)] were identified factors. Conclusion and Recommendation ; In this study Diabetes mellitus, Number of vaginal examinations, post-operative hematocrit, labor status during C/S and length of hospital stay were the identified as determinants of surgical site infection following cesarean deliveries. Therefore early detection and risk assessment during certain times in order to reduce these determining factors of surgical site infection is important
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    UTILIZATION OF ELECTRONIC COMMUNITY HEALTH INFORMATION SYSTEM (eCHIS) AND ASSOCIATED FACTORS AMONG HEALTH EXTENSION WORKERS IN SIDAMA REGION, ETHIOPIA
    (hawassa universty, 2023-05) KIDEST FEKADU
    Background: Effective community health management information systems (C-HMIS) are important in low-resource countries that rely heavily on community-based health care providers [3]. Electronic community health information systems (eCHIS) have been increasingly developed and deployed to quantify and support services delivered by community health workers. However, there is no evidence of the level of utilization of electronic community health information systems. Objective: The main aim of this study is to assess the level of electronic community health information system (eCHIS) and associated factors among health extension workers in the Sidama region, Ethiopia, in 2023. Methods: This study employed quantitative (cross-sectional) studies complemented by qualitative (Phenomenology) study designs. All health posts found in the Sidama region and health extension workers have been included in the study. Quantitative data has been collected using a pre-tested, structured, self-administered questionnaire whereas qualitative data has been collected from in-depth interviews with key informants (KIs). The collected quantitative data has been entered into Epi-Data Version 3.1 and is being analyzed using SPSS version 25 software. A descriptive summary has been computed using proportions and frequencies. Multi Variable Logistic Regression analysis has been computed to identify the factors associated with eCHIS use and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) has been reported. On the other hand, the qualitative data has been analyzed thematically and the results had being presented in narration. Work plan and Budget: The study has been conducted from January October 2022 to May 2023 and a total of 131,540.2 Birr has been required to carry out this study.