College of Medicine and Health Science

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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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    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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    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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    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.
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    Uncontrolled hypertension And Associated Factors Among Adult Hypertensive Patients Attending on Follow up At Public Health Facilities Hawassa City Administration Hawassa, Sidama Region Ethiopia,
    (hawassa universty, 2024-05) TEKETEL NEGASH
    Background: Uncontrolled hypertension refers to systolic blood pressure ≥140 mmHg and diastolic blood pressure ≥90 mmHg, even when patients are on anti-hypertension medication. Repeatedly unrecognized risk factor that contributes to putting many people into various complex health problems. It can lead to kidney, heart disease, brain, and other diseases, and sudden death. Objective: To assess the magnitude of uncontrolled hypertension and associated factors among adult hypertensive patients attending in follow-up at public health facilities in Hawassa city administration Methods: A cross-sectional study was carried out, from March to April 2024 including 411 hypertensive patients older than 18 years. The study was carried out at public health facilities at Adare General Hospital, Motiti Fura Primary Hospital Millennium Health Centre, Alamura Health Centre in the chronic follow up unit in the Hawassa city administration. Data were collected through patient interviews and patients’ medication record reviews. Descriptive statistics, bivariable and multivariable logistic regression were used to assess the association between independent and dependent variables. The output of the analysis is presented using adjusted odds ratio with 95% confidence interval. Result: Out of the 422 hypertension patients who were selected, the study's direct participants, 411 of whom had a 2.6% refusal rate (n = 11), The prevalence of uncontrolled hypertension was 55.7% (n = 229) 95%CI= CI = 50.8–60.6) in the study were in the age group of <60 years57.9% (n=238) After adjusting for other determinants, age, ≥60 years (AOR=3.287 95% CI: 2.043-5.288). diet-nonadherence (AOR=2.95, 95% CI: 1.592 5.475) physical activity (AOR=1.803 95% CI: 1.079-3.014).and co-morbidity (AOR = 2.737, 95% CI: 1.612-4.647) are found to be statistically significant predictors of uncontrolled hypertension Conclusions and recommendation: There were, Age, diet non adherence, nonphysical exercise adherence and co-morbidity, which are independently predicted. Advise patients to follow suggestions for lifestyle adjustments to improve hypertension self-management.
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    THE LEVEL OF ROUTINE HEALTH INFORMATION SYSTEM DATA QUALITY AND ASSOCIATED FACTORS AT PUBLIC HOSPITAL IN SILTE ZONE, CENTRAL REGION, ETHIOPIA, 2023
    (hawassa universty, 2023-11) NIGUSSIE DUKAMO
    Background: Routinely collected data of poor quality can compromise the validity of effect evaluations and lead to poor decision-making, inappropriate resource allocation, and a loss of trust in the health system. Routine health information system data are seen as poor in quality and are not used for decisions in Ethiopia, and continues to be a significant problem. Objectives: To assess the level and associated factors of routine health information system data quality; and explore the factors affecting data quality at public hospitals in Silte Zone, Central Region Ethiopia, 2023 Methods and materials: Facility based mixed method with an embedded study design was conducted. A total of four public hospitals, 32 units or departments, 605 health care workers, and 12 key informant interviews were selected. Simple random sampling and purposive sampling techniques were used for selecting study participants in quantitative and qualitative study. The data was entered into Epi-data version 4.4, open code 4.03 and exported to SPSS version 26, and descriptive statistics were used to assess the level of data quality, and Binary logistic regression and thematic analysis was run to identify factors affecting data quality. Adjusted odds ratios with 95% confidence intervals and themes or subthemes were reported. Result: The overall study conducted facility data quality level was 90.84%; completeness and consistence of data in this study were 85.5% and 85.3% respectively. Easily understandability of registration and report format [AOR 1.92; CI 1.11-3.33], receive training [AOR 1.62; CI 1.07- 2.44], getting supervision [AOR 1.66 CI 1.05-2.61], provide regular feedback [AOR 1.72 CI 1.07- 2.75], team’s work appreciated and valued by supervisors [AOR 1.61; CI 1.04-2.75] and decisions and follow up actions identified in Performance monitoring team meetings [AOR 1.73; CI 1.12- 2.67] were significantly associated with data quality ; and thematic analysis was done and categorized into four themes and twelve sub-themes. Conclusion and recommendation: The level of data quality at the public hospital in Silte Zone is almost equal to the national expected level of data quality, but completeness &consistency of the data were lower than the national expected level. For MOH and other supporting organization to fully transforming the paper based service registration to an electronic-based medical recording system in which it will reduce incompleteness and inconsistency of data and to increase data quality
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    UTILIZATION OF LONG LASTING INSECTICIDAL NETS AND ASSOCIATED FACTORS IN BORICHA AND BILATE ZURIA WOREDA, SIDAMA REGION, SOUTHERN ETHIOPIA: CROSS SECTIONAL STUDY
    (hawassa universty, 2023-11) MESELE ALARO
    Background: Malaria is a major cause of mortality and morbidity in developing countries. Sleeping under long lasting insecticidal nets (LLIN) is the most widely adopted preventive measure against malaria. LLINs represent a cost effective means of malaria prevention for at risk populations. Even though there have been studies indicating the utilization of LLIN use in Southern Ethiopia, there is no study conducted in Sidama region, Boricha and Bilate Zuria Woredas. Objective: The objective of this study was to assess utilization and associated factors of long lasting insecticidal nets in Boricha and Bilate Zuria Woredas, Sidama, Ethiopia in 2023. Methods: A community based cross sectional study was conducted in Boricha and Bilate Zuria woredas from February to March 2023. A total of 726 households were included in the study. A multi stage sampling technique was used to obtain the intended sample size. Quantitative data were collected using a structured questionnaire using face to face interview. The collected data were entered using Epi data version 3.1, and finally analyzed using SPSS version 20. Binary logistic regressions were computed to identify associated variables with the utilization of LLIN. Variables having P value < 0.25 in bi-variable analysis were candidate for multivariable analysis. Variables with P-Value <0.05 were declared as independent predictors of LLIN utilization at alpha 5%. Results: The proportion of people utilizing LLIN was 85.5% with 95% CI of (82.5% - 88.1%). Having one LLIN (AOR= 3.55; 95% CI of (1.92, 6.57) compared to two and more LLIN and family size of less than 5 persons (AOR= 0.60; 95% CI 0.37, 0.96) compared to 5 and more persons were independently associated with LLIN utilization. Conclusions: Percentage of long-lasting insecticide-treated nets (LLINs) that were used by anyone the night before the study was high compared to the national 62.3% according to malaria indicator survey of 2015. It was significantly associated with number of LLIN and family size.
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