Master of Public Health

Permanent URI for this collectionhttps://etd.hu.edu.et/handle/123456789/27

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End date: 2025Subject: search.filters.subject.Ethiopia

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    Willingness to Renew Community Based Health Insurance Membership and Associated Factors in Maraka woreda, Dawuro zone, South-west Regional State, Ethiopia
    (hawassa universty, 2023-11) Mikiyas Zelalem
    Background: Although potential instrument to achieve Universal Health Coverage, Community Based Health Insurance schemes commonly suffer from low membership renewal, which threatens the schemes’ sustainability in many developing countries. Hence, this study investigated the willingness to renew Community Based Health Insurance membership and associated factors among enrolled households in Maraka woreda, Dawuro zone. Objective: To assess willingness to renew Community Based Health Insurance membership and associated factors in Maraka woreda, Dawuro zone. Methodology: Community based cross-sectional mixed methods design with sequential explanatory qualitative methods was employed. Using multi-stage random sampling, 5 kebeles were included in the study, from which 693 enrolled households were selected through systematic random sampling (k=5). Descriptive, bivariate, and multivariate logistic regression analyses of data was done using SPSS version 25 software, with statistical significance considered at P-value <0.05. Qualitative data were collected through focus group discussions and key informant interviews, with samples selected using maximum-variation methods. The obtained data were coded and thematically analyzed using ATLAS.ti 9 software. Results: Willingness to renew Community Based Health Insurance membership was shown to be 79.1%. Presence of chronic illness (AOR = 0.30; CI: 0.18-0.52), proportion of household members with poor self-rated health status (AOR = 2.01; CI: 1.04-3.72), recent hospitalization history (AOR = 0.2; CI: 0.11-0.35), perceived availability of medications (AOR = 2.52; CI: 1.48-4.29), premium affordability (AOR = 2.2, CI: 1.26-4.79), perceived benefit packages adequacy (AOR = 2.90; CI: 1.76-4.79), enrollment duration (AOR = 4.01; CI: 2.12-7.56), and participation in scheme related meetings (AOR = 2.40; CI: 1.27-4.58) were predictors shown to be significantly associated with members’ willingness to renew membership. Conclusion: Magnitude of willingness to renew Community Based Health Insurance membership in the woreda was shown to be relatively lower than the woreda’s renewal target for 2016 E.C. Therefore, increased scheme transparency and community engagement, along with policy interventions involving differential premium pricing based on ability to pay and upgrading of the current scheme design to a larger regional or federal pool are recommended to increase members’ desire to renew membership.
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    MAGNITUDE OF URBAN MALARIA AND ITS ASSOCIATED RISK FACTORS IN DAMBOYA TOWN, KEMBATA ZONE, CENTRAL ETHIOPIA
    (hawassa universty, 2023-11) BIRUK MULACHEW GELESHO
    Background: In Africa, urban malaria is emerging as a potential Health problem. Because of the rapidly growing number of towns in Ethiopia, there is a persistent need to improve the understanding of the epidemiology of urban malaria. Objective: This study aimed to determine the prevalence of urban malaria and its associated risk factors in Damboya town Kambata Zone, Central Ethiopia region. Methods: A Community-based cross-sectional study was carried out in Damboya town from March 7 to May 29, 2023. A total of 422 individuals were randomly selected and a structured questionnaire was employed to collect socio-demographic data and malaria-associated risk factors. Finger/ heel prick blood was used to detect malaria parasites by light microscopy and malaria rapid diagnostic test. Data were entered in Epi data 3.1 and analyzed in SPSS version 25 software. The association between dependent and independent variables was explored by using binary logistic regression analyses. An adjusted odds ratio with a 95% confidence interval was calculated and the association was declared at a P-value of <0.05. Result: The overall prevalence of malaria was 5% (95%CI:3.1-7.5) with the predominant P. vivax infections accounting for 61.9%. The presence of stagnant water (AOR=3.88, 95% CI: 1.14-13.22, P=0.030), unavailability of insecticide-treated bed net (AOR=3.24, 95% CI: 1.01 10.41, P=0.048), living in a house with eaves (AOR=4.22, 95%CI: 1.17-15.00, p=0.027), were more significantly associated with malaria prevalence. Conclusion: Malaria is still a public health problem in Damboya town. Thus, improved access to all malaria interventions is needed to interrupt the transmission in the community of this town.
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    LEVEL OF PATIENT SATISFACTION AND ASSOCIATED FACTORS AMONG PRIVATE WING PATIENTS OF WOLAITA SODO UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, WOLAITA, ETHIOPIA: A HEALTH FACILITY-BASED CONVERGENT PARALLEL MIXED STUDY
    (hawassa universty, 2023-11) BINYAM DANIEL
    Background: To improve the quality of health care given in the private wing, the health care provider needs to know what factors influence patient satisfaction. Although few studies have been conducted on patient satisfaction in private-wing health services it was never been done in this study area. Objective: To assess the level of Patient Satisfaction and associated factors among Private wing patients of Wolaita Sodo University Comprehensive and Specialized Hospital, Wolaita, Ethiopia 2023 G.C Methods: A health facility-based convergent parallel mixed study was conducted. A Systematic random sampling technique was used to select 300 patients. Data was collected by the ODK collect app and was then imported to SPSS version 25 for analysis. The views of 7 qualitative participants selected conveniently until data saturation were explored using in-depth interview. Frequency distribution of variables was tabulated. Bivariate and multivariable logistic regressions were fitted to identify the factors that determine patient satisfaction. Qualitative data analysis used a thematic analysis technique which was supported by ATLAS.ti 7.5.16 data management software. Result: A total of 300 patients were included in the study and 260 (86.7%) (95% CI= 82.3-90.3) of the patients were satisfied with the service they had gotten. Age between 18-34 (AOR= 0.26, 95% CI= 0.17-0.36), doctors explain medical terms (AOR= 3.50, 95%CI= 1.21-10.07), pharmacist explains about the medication (AOR= 3.16, 95%CI= 1.06-9.41) were significantly associated with patient satisfaction. Similarly, the lack of drugs and supplies in the hospital pharmacies and laboratory, and the unavailability of private toilets and showers were also major problems that led to less satisfaction with the overall private wing services. Conclusion and recommendation: In conclusion, the net overall level of satisfaction was high. Regarding this study, significant predictors of patient satisfaction were age, doctors explain medical terms, and pharmacists explains about the medication. Making all the essential laboratory investigations, drugs, and standard medical equipment available in the hospital along with toilets and showers available in every private room is important to improve patient satisfaction in the private wing setting
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    FACTORS ASSOCIATED WITH DIETARY PRACTICE AND NUTRITIONAL STATUS AMONG PREGNANT WOMEN ATTENDING ANC AT MAALIE WOREDA, SOUTH OMO ZONE, ETHIOPIA: FACILITY BASED CROSS SECTIONAL STUDY.
    (Hawassa University, 2024-05) WONDU BERRA
    Background: Maternal dietary practices during pregnancy play an important role. Hence, this study was intended to assess factors associated with the dietary practice and nutritional status of pregnant women in Maalie Woreda, South Omo zone, Ethiopia. Methods: Facility based cross-sectional study design was conducted among 318 pregnant women had participated. Socio demographic and socio economic data were collected using a structured interviewer-administered questionnaire. The dietary practice was measured using 16 dietary practice questions. Dietary diversity was obtained by using a 24-hr dietary recall method and Nutritional status was assessed by using mid-upper arm circumference (MUAC) measurements. Binary and multiple logistic regression analysis were conducted. Variables with P ≤ 0.2 in bivariate analysis were entered for multiple logistic regressions. At a 95% confidence interval, variable with < 0.05 in multiple logistic regression analysis was considered statistically significantly associated with dietary practice and Nutritional status. Result: About 68.6% of the pregnant women had poor dietary practice and 34.3% were undernourished. Educational status (AOR=4.6; 95% CI: 1.50, 11.51), family income (AOR=2.61; 95% CI: 1.35, 6.43), family size (AOR=2.30; 95% CI: 1.10, 2.87), ANC visits (AOR=2.49, 95% CI: 1.09, 4.03), nutrition counseling (AOR=1.81; 95% CI: 1.12, 5.46) and Knowledge (AOR=1.28; 95% CI: 1.13, 4.19) were significantly associated with dietary practice. Husband occupation (AOR=3.29; 95% CI: 1.79, 71.2), cash decision maker (AOR=2.27; 95% CI: 1.14, 3.92), nutrition counseling (AOR=1.73; 95% CI: 1.42, 7.26), Source of nutrition information (AOR=1.51; 95% CI: 1.07 , 8.3), Dietary practice (AOR=1.87; 95% CI: 1.21, 3.51), and knowledge (AOR=1.92; 95% CI: 1.05, 3.06) were significantly associated with nutritional status. Conclusion: The prevalence of good dietary practice during pregnancy was 31.4% and 34.3% were undernourished. Educational status, family income, family size, number of pregnancy, ANC visits, nutrition counseling, Diversity of diet and Knowledge which were significantly associated with dietary practice. Government, health extension workers and responsible stakeholders should focus on pregnant women to have ANC follow-up.
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    PREVALENCE AND FACTORS ASSOCIATED WITH ADVERSE NEONATAL OUTCOMES AMONG CESAREAN DELIVERIES AT PUBLIC HOSPITALS IN HAWASSA CITY, SIDAMA REGION, ETHIOPIA
    (Hawassa University, 2024-06) TAMIRU RIKIBA
    Background: Cesarean deliveries are linked to higher risks of adverse neonatal outcomes compared to spontaneous vaginal births. In Ethiopia, comprehensive data on these outcomes and associated factors is lacking. Understanding these issues in hospitals is crucial for improving maternal and neonatal care. Objective: This study aimed to assess prevalence and factors associated with adverse neonatal outcomes among cesarean deliveries at public hospitals in Hawassa city, Sidama region, Ethiopia. Method and material: a facility based retrospective cross-sectional study was conducted at two public hospitals in Hawassa city from April 1 to 30, 2024, analyzing 522 hospital medical records of mothers who delivered by CS from Jan 2023 to Aug 2024. Data were collected using a structured data extraction checklist via kobocollect 4.0, and Simple random sampling technique was employed to select study participants. Data were analyzed using SPSS version 27, employing Binary and Multiple Logistic regressions to identify factors associated with adverse neonatal outcomes. Statistical significance was stated at p-value<0.05, with adjusted odds ratio (AOR) and 95% confidence interval (CI) reported. Result: nearly one-third of newborns delivered through cesarean section developed adverse outcome. Women who had preeclampsia and abruptio-placenta were 2.9 (AOR: 2.9; 95% CI; 1.104, 3.38 and 3.3 times (AOR: 3.3; 95% CI; 1.36, 8.21) more likely to develop an adverse neonatal outcomes compared with those women who did not have the condition respectively. Similarly women who delivered by midline cesarean section were 2.9 times (AOR: 2.9; 95% CI; 1.125, 7.4) more likely to develop adverse neonatal outcomes compared with those women who delivered by lower transverse cesarean section. Women who referred from other facility were 2.8 times (AOR: 2.8; 95% CI; 1.82, 4.4) more likely to develop adverse neonatal outcomes compared with those women who were not referred. Conclusion: prevalence of adverse neonatal outcomes was high in the study area. Preeclampsia, abruptio-placenta, being referred from other health facility, and delivery via midline cesarean section were factors associated with adverse neonatal outcomes. Timely intervention for high-risk pregnancies could help reduce adverse neonatal outcomes.
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    DETERMINANTS OF DELAY IN TREATMENT SEEKING FOR DIARRHEAL DISEASES AMONG MOTHERS WITH UNDER-FIVE CHILDREN IN PUBLIC HOSPITALS OF SIDAMA REGION ,SOUTHERN ETHIOPIA: UNMATCHED CASE CONTROL STUDY
    (Hawassa University, 2024-05) MENELIK MATHEWOS
    Background-.A significant majority of pediatric diarrheal deaths are caused by delays in receiving timely, appropriate care. Life-threatening consequences are decreased when under five children with diarrhea obtain medical attention promptly and appropriately. Therefore, this study looked into factors that contributed to mothers of children under five delaying of treatment for diarrheal illnesses. Objective – To assess determinant of delay in treatment seeking for diarrheal disease among mothers with under five children in public hospitals in Sidama region, southern, Ethiopia from April 1 to May 30,2024 Methods - A Facility-based unmatched case control study was conducted on 414(207 Cases and 207 Controls). Cases were under-five children paired with their mothers/caregivers who sought treatment after 24 hours of the onset of signs and symptoms of diarrheal diseases, and controls were under-five children paired with their mothers/caregivers who sought treatment within 24 hours of the onset of signs and symptoms of diarrheal diseases. Data were collected using KOBO collect with smart Phone and analyzed by using SPSS 26. Bivariate and multivariable logistic regressions were computed to identify independent determinants of delay in treatment seeking. Association was described using an adjusted odds ratio along with their 95% confidence interval. Significance was declared at p<0.05 in the multivariable logistic regression. Results- from 418 selected participants, 414 mothers (207 cases and 207 controls) were included. Being rural resident (AOR 3.40(95 % CI 2.03-5.72), Child age < 24 months (AOR 4.43(95 % CI=2.35-8.34), Mothers without formal education (AOR 11.679(95 % CI 3.705 36.81), difficult to pay cost of treatment (AOR 4.345(95 % CI 2.019-9.352), Absence of health insurance AOR 3.182(95 % CI 1.945-5.207), were significant determinants of delayed treatment seeking. Conclusion-Young age of child, rural residence, Educational level of mothers, difficulty to pay Cost of treatment and absence of health insurance were important determinants of delay in treatment seeking. Thus comprehensive strategies that might enhance health facility accessibility crucial to reduce diarrhea related complications
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    PREVALENCE AND FACTORS ASSOCIATED WITH SEXUAL VIOLENCE AMONG FEMALE HOUSEMAIDS ATTENDING EVENING PRIMARY PUBLIC SCHOOLS IN HAWASSA CITY, SIDAMA, ETHIOPIA: A MIXED METHOD STUDY.
    (Hawassa University, 2024-06) MAEREGE HABTNEH
    Introduction: Threats of rape, attempted rape, rape, sexual harassment, and coerced sexual contact are examples of sexual violence. One of the groups of workers most at risk from sexual violence worldwide is the housemaid. Sexual violence against housemaids remains usually concealed as victims cannot report such offences. This study aims to assess prevalence and factor associated with sexual violence among female housemaid attending evening public schools in Hawassa city, Sidama region, Ethiopia. Objectives. This study intended to assess the prevalence and factors associated with sexual violence among housemaids attending evening primary public schools at Hawasa 2024. Method. School-based cross-sectional study complemented with qualitative approach was conducted among 405 housemaids and 13 purposely selected participant. Simple random sampling was used for the quantitative part while purposive sampling was done to select key informants. Data were collected using an interviewer-administered questionnaire by Kobo Collect for quantitative study then exported to SPSS, while key-informant interview using semi structured interview guide was used for the qualitative study. Both bivariable and multivariable logistic regression analysis were done to assess the association between independent and dependent variables. The strength of association was determined using the adjusted odds ratio (AOR) with their corresponding 95 % confidence interval. P-values of <0.05 were used to declare statistical significance. Tables and diagrammatical presentation were used, and mean with standard deviation were used to interpret continuous variables. ATLAS.ti was used for qualitative data analysis. Finally, the finding was explained by triangulating with the quantitative findings in the result. Result: The prevalence of sexual violence among was 67.9% (95% CI: 63%-72%). The odd of sexual violence was higher among housemaids whose agreement were daily (AOR=11.173, 95% CI =1.220, 15.298), there employer drunk alcohol (4.174, 95% CI = 1.851, 9.416), housemaids origin from rural area (AOR= 2.95 (1.56, 5.55), whereas housemaid living with another housemaid in the household were less likely to face sexual violence (AOR=0.429, 95% CI = 0.218, 0.844). Conclusion: There was a high prevalence of sexual violence among housemaids. Types of agreement, origin of the housemaid, and presence of other housemaid and employers alcohol consumption were significantly associated with sexual violence.
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    DETERMINANTS OF PODOCONIOSIS IN NORTHERN ZONE OF SIDAMA REGION, ETHIOPIA: AN UNMATCHED CASE- CONTROL STUDY
    (Hawassa University, 2024-08) MELKAMU UGAMO
    Background: Podoconiosis is a type of elephantiasis caused by long-term barefoot exposure to red clay soil. It is a debilitating disease that leads to disability and stigma. Despite the widespread prevalence of podoconiosis, the determinants of it remain largely unexplored, especially within the context of the Sidama region. The findings will contribute to a comprehensive understanding of the determinants, facilitate the development of targeted prevention strategies in the specified region, and bridge the existing knowledge gap pertaining to determinants in southern Ethiopia. Objective: To identify the determinants of podoconiosis in the Northern Zone of Sidama Region, Southern Ethiopia, in 2024. Methods: An unmatched case-control study design was employed in selected districts within the northern zone of the Sidama Region. The cases comprised 191 randomly selected individuals with clinically confirmed podoconiosis and a negative filarial test. The controls consisted of 383 randomly selected individuals who exhibited no signs or symptoms of podoconiosis. Data were collected through structured interviews conducted using the KoBo mobile application. Both bivariable and multivariable logistic regression analyses were performed to evaluate the associations between potential determinants of podoconiosis. Statistical significance was declared at a p-value of less than 0.05. The magnitude of the association was presented using the adjusted odds ratio (AOR) with a 95% confidence interval. Results: A total of 574 (191 cases and 383 controls) participants were included in the study. Age ≥50 years (AOR=2.61; 95% CI: 1.22, 5.58), no formal education (AOR=3.04; 95% CI: 1.06, 7.73) , primary education (AOR=3.67; 95% CI: 1.32, 10.20), not wearing shoes (AOR=4.10; 95% CI: 1.72, 9.79), having unclean feet (AOR=4.80; 95% CI: 2.84, 8.11), purchasing no or a pair of shoes in a year (AOR=2.61, 95% CI: 1.48-4.61), poor knowledge (AOR = 3.52; 95% CI: 2.14, 5.78) and negative attitude (AOR = 1.80; 95% CI: 1.11-2.94) were significantly associated with podoconiosis. Conclusions: The study identified older age, lower educational attainment, not wearing shoes, poor foot hygiene, buying no shoes or a pair of shoes in a year, poor knowledge, and poor attitude as significant factors for podoconiosis. Multifaceted interventions on awareness- creation education, consistent shoe use and foot hygiene, and changing attitudes towards podoconiosis are crucial to mitigating this neglected tropical disease in endemic regions.
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    INTENTION TOWARDS FEMALE GENITAL MUTILATION AMONG WOMEN OF REPRODUCTIVE AGE GROUP, USING BEHAVIORAL INTENTION APPROACH ATOTEHULO DISTRICT, HALABA ZONE, CENTRAL ETHIOPIA, 2024
    (Hawassa University, 2024-09) DAGMAWIT GIRMA
    Introduction: female genital mutilation /cutting are a deeply rooted harmful traditional practice, affecting millions of girls and women globally which have serious physical and psychosocial consequences. Understanding the intentions and attitude towards Female genital mutilation among women of reproductive age is crucial however there is only limited research in Ethiopia to have comprehensive understanding of the problem. Therefore, this study was aimed to asses intention towards Female genital mutilation is highly valuable. Methods and materials: Embedded mixed study design was conducted among reproductive age group between April 1 and April 30, 2024. A total 497 women were selected for the quantitative data using a multi-stage sampling procedure. Data was collected using a structured questionnaire with Kobo collect application. Then, SPSS version 25 was used to clean, to code and analyze of the data. Variables that had a p-value of less than 0.25 in the bivariable logistic regression were selected as candidate variables for the multivariable logistic regression model, and a P value of less than 0.05 at a 95% confidence interval was considered statistically significant. Finlay, the findings were presented using tables, charts and graphs accordingly, for qualitative data, semi structured interview was used among 8 participants and thematic analysis was done by using ATLAS ti.version 24 software Result: - prevalence of intention towards the practice in this study was 54.1%. the odds of intention to continue were 2 times higher on women who had Favorable attitude than their counterparts (AOR= 2.4: 95% CI= 1.37-4.3: P=0.002), odds of Favorable subjective norm (AOR=4.91, 95%CI: 2.76-8.63, P=0.000)were about 5 times higher intend to continue than their counterparts also, Circumcision history of women (AOR=2.76, 95%CI=1.2-6.3, P=0.017) and Child with circumcision (AOR= 5.75, 95% CI= 2.2-14.7, P=0.000) were found to be significantly associated with intention. For qualitative part 3 themes were extracted from total respondents including, attitude, subjective norm and intention to continuation. Conclusion: According to this study 54.1 of the participant had intended to continue the practice. Attitude, subjective norm, child circumcision history, mother circumcision history as a child was associated with intention. For qualitative part. Participant’s attitude, Subjective norm and intention to continue were the themes extracted from analysis, which support our quantitative findings.
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    DETERMINANTS OF DELAY IN TREATMENT SEEKING FOR DIARRHEAL DISEASES AMONG MOTHERS WITH UNDER-FIVE CHILDREN IN PUBLIC HOSPITALS OF SIDAMA REGION ,SOUTHERN ETHIOPIA: UNMATCHED CASE CONTROL STUDY
    (Hawassa University, 2024-05) MENELIK MATHEWOS
    Background-.A significant majority of pediatric diarrheal deaths are caused by delays in receiving timely, appropriate care. Life-threatening consequences are decreased when under five children with diarrhea obtain medical attention promptly and appropriately. Therefore, this study looked into factors that contributed to mothers of children under five delaying of treatment for diarrheal illnesses. Objective – To assess determinant of delay in treatment seeking for diarrheal disease among mothers with under five children in public hospitals in Sidama region, southern, Ethiopia from April 1 to May 30,2024 Methods - A Facility-based unmatched case control study was conducted on 414(207 Cases and 207 Controls). Cases were under-five children paired with their mothers/caregivers who sought treatment after 24 hours of the onset of signs and symptoms of diarrheal diseases, and controls were under-five children paired with their mothers/caregivers who sought treatment within 24 hours of the onset of signs and symptoms of diarrheal diseases. Data were collected using KOBO collect with smart Phone and analyzed by using SPSS 26. Bivariate and multivariable logistic regressions were computed to identify independent determinants of delay in treatment seeking. Association was described using an adjusted odds ratio along with their 95% confidence interval. Significance was declared at p<0.05 in the multivariable logistic regression. Results- from 418 selected participants, 414 mothers (207 cases and 207 controls) were included. Being rural resident (AOR 3.40(95 % CI 2.03-5.72), Child age < 24 months (AOR 4.43(95 % CI=2.35-8.34), Mothers without formal education (AOR 11.679(95 % CI 3.705 36.81), difficult to pay cost of treatment (AOR 4.345(95 % CI 2.019-9.352), Absence of health insurance AOR 3.182(95 % CI 1.945-5.207), were significant determinants of delayed treatment seeking. Conclusion-Young age of child, rural residence, Educational level of mothers, difficulty to pay Cost of treatment and absence of health insurance were important determinants of delay in treatment seeking. Thus comprehensive strategies that might enhance health facility accessibility crucial to reduce diarrhea related complications.